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Chronic obstructive pulmonary disease (COPD) is the second leading cause of avoidable hospital admissions. Anecdotal evidence indicates over-use of frontline resources (e.g. the Emergency Department), and potential gaps in outreach services (e.g. underutilised services).

This project is a unique collaboration between three non-metropolitan health services in South East Queensland (West Moreton, Darling Downs and Gold Coast).

It will inform referral treatment initiatives¡¯ implementation and evaluation (e.g., anxiety management, smoking cessation referral, and quality intra-professional care programs), based on identified causal factors.

Domestic and family violence (DFV), and intimate partner violence against women, is the number one cause of death and disability in women aged 15¨C44.
This project aims to describe current DV screening practices in 10 emergency departments (EDs)s servicing unique populations.The study describes social worker referrals from the ED, surveys ED staff on their attitudes and practices about DFV and DFV screening, and interviews ED nursing and medical staff. It also outlines social workers¡¯ time spent doing DFV referrals from ED, and current ED screening practices.

The results will give an insight into the barriers that may exist to screening and offers potential solutions to these barriers.

Deliberate Clinical Inertia is the art of doing nothing as a positive response, focusing on avoiding harm. The concept aligns with and promotes care in resource use and encourages patients and doctors to ask the question: ¡®Do I really need this test or treatment?¡¯.

Many research projects at Gold Coast University Hospital, such as Deliberate Clinical Inertia, focus on finding treatments that are less invasive for patients, cheaper for the system, easier to administer for the staff, and lead to the same or better health outcomes for the patients.

In the emergency department (ED), deciding who does and who does not need antibiotics can be difficult. An emergency doctor cannot perform a test that tells them who needs antibiotics or what type of antibiotic type to prescribe.

This study describes how many patients receive antibiotics in the ED and what proportion of these antibiotics are not required or have been given incorrectly (incorrect type or dose).

The study results will allow us to:

1. estimate the proportion of ED patients who receive antibiotics
2. determine if a problem exists with when and how Australian EDs give antibiotics in a busy environment.

Most children with asthma presenting to an emergency department (ED) are managed with inhaled medications and oral steroids. Infrequently, some children are very unwell, and require assistance with their breathing, or intravenous medication.

Currently, there is minimal information to guide clinicians on which treatment to choose for severe acute asthma. All have side-effects, and we do not know which is most effective. Studies from the UK and Australasia demonstrate significant variation in practice, although Australasian data is nearly 10 years out of date.

When comparing treatments, it is important to determine whether or not they can reduce the risk of severe complications, or whether they make a difference in important treatment outcomes.

This project will allow us to:

• Determine current management practices for children with severe acute asthma and/or wheeze across Australia and New Zealand.
• Determine how common severe acute asthma is and also how frequently complications of severe asthma occur across Australia and New Zealand.
• Determine where differences in therapy exist between states / regions across Australia and New Zealand.

Once complete, this project will provide important data to allow us to design future research to establish the best treatments for severe asthma.

Children may present to an emergency department with life threatening conditions that require immediate treatment to support their breathing to allow enough oxygen to be supplied to the body.

In these circumstances a child is given medication to put them to sleep and the airway is secured with the insertion of a tube into the windpipe. This transition from spontaneous breathing awake to controlled respiration under anaesthetic via a breathing tube is called intubation and is associated with a high risk for low oxygen levels in the body and has a high rate of failure on the first attempt.

Newer methods to avoid these risks are currently the subject of many trials. In our study we investigate a new approach to prevent a drop in oxygen levels during intubation using high flow oxygen delivery. We have tested this method in children with healthy lungs undergoing anaesthesia for elective surgery and we found that we can maintain oxygen levels more than twice as long as using standard intubation methods. These findings would allow the operator in emergency settings more time and a safer condition to secure the airway in a sick child.

Therefore we aim to compare this new oxygenation method with the current standard practice to intubate a child in an emergency situation. We aim to demonstrate that the new method will reduce the risk for low oxygen levels in the blood and increase the likelihood of success of the procedure on the first attempt.

After whiplash injury, half of patients never fully recover. The human and economic cost is enormous, and current mainstay treatments are ineffective. Most recovery, if it occurs, takes place in the first two to three months. This early time period offers a ¡®window of opportunity¡¯ to pro-actively intervene and prevent the chronic pain. The Emergency Department (ED) is ideally placed to provide very early intervention. We have shown that upregulation of pain in the central nervous system occurs soon after whiplash injury and predicts poor recovery. We aim to target these central nervous system processes with pregabalin in conjunction with evidence based physiotherapy advice/exercise in the ED. The results have potential to fundamentally change the treatment of acute whiplash injury.

The number of presentations to public emergency departments diagnosed with a mental illness in Australia is increasing. Current data collection systems cause some individuals with mental health problems presenting to an emergency department invisible, potentially compromising health service planning and delivery.

This research aims to understand and inform the emergency care for people with acute mental health problems accessing emergency departments in Queensland.

Read more about the .

Most patients need intravenous cannula (a small plastic tube, inserted into the vein) in the emergency department, but many suffer multiple attempts before the health provider is successful. This can cause patient distress and delays the time to diagnose and to carry out potentially life-saving treatments. The study examines current practices of inserting intravenous (IV) cannulas in the Emergency Department at the Gold Coast University Hospital.

From this research, an ultrasound-guided cannulation training program, and other visual and written materials have been suggested. This will enable better recognition of patients with difficult intravenous access and increase ultrasound use during cannulation.

Fractures through the neck of the 5th metacarpal (little finger hand bone) are known as Boxer¡¯s Fractures, as they often occur during a punch. Boxer¡¯s fractures are traditionally managed in plaster. But, recently, some have suggested that to ¡®buddy tape¡¯ the little and ring fingers together allows similar recovery with full mobilisation advantage. Evidence to recommend one treatment over another is insufficient.

This was a randomised controlled study where patients with Boxer¡¯s fractures were randomised to either plaster or buddy tape. The study found similar functional outcomes at twelve weeks from the two groups, but earlier return to work in the buddy group.

This study also found that buddy taping benefits include:

• less time spent in emergency
• simple community follow-up at the patient¡¯s discretion.