Evaluating the structures and processes of a Watch House Emergency Nurse (WHEN) model of care
Quick facts
Grants Awarded
A randomised controlled trial of interventional versus conservative treatment of primary spontaneous pneumothorax: How does conservative and interventional management of collapsed lung compare?
Quick facts
Primary spontaneous pneumothorax (PSP) is a collapsed lung with air in the pleural cavity that occurs without a clinically apparent underlying lung disease. Over time this condition has been treated more often with interventional approaches such as a chest drain. The reasons for this are unclear and this approach has recently been questioned in scientific literature.
The research was a multi-site randomised trial of more than 300 patients in over 25 hospitals in Australia and New Zealand, which compared intervention with observation alone.
The study results will largely impact on current medical practice and international consensus guidelines. It will also be of large economic interest for admissions and associated procedures.
Read more about the .
“To challenge this dogma of putting a drain in anybody with a certain size pneumothorax will make clinicians think critically and consider doing nothing when safe. Such an approach may reduce harm, save resources and be more acceptable to both staff and patients.”
—Prof Gerben Keijzers
Grants Awarded
Headache snapshot: Examining the diagnostic approaches for patients presenting to the Emergency Department with a headache
Quick facts
A small proportion of patients with a headache are diagnosed with serious conditions such as subarachnoid haemorrhage (SAH).
About one in three of these patients die and another one in three survive with a disability. Early diagnosis and treatment is essential.
Diagnosis involves a Computed Tomography (CT) scan and a spinal puncture. However, these tests are not 100% accurate, and doctors and patients are concerned about complications from these tests. As a result, variability exists in tests ordered and why they are ordered.
This study looked at how Queensland emergency departments investigated headaches, with a focus on diagnosing SAH. An understanding of this variability can assist doctors to develop guidelines and streamline diagnosis of patients with suspected SAH.
“This study provided a great platform to collaborate with many hospitals in Queensland. It was one of the first state-wide ‘snapshot’ projects supported by QERC, which methodology was later used in AANADEM (link) and ARISE FLUIDS. It also paved the way for the follow up study – HEAD.”
—Prof Gerben Keijzers
Grants Awarded
Distal Ureteric Stones and Tamsulosin
Quick facts
Several medical treatment methods to improve care of patients with ureteric colic have been studied overseas, some of which appear promising.
However, the “medical expulsive therapy” practice for ureteric colic is not widely practiced in Australia. One such medication that is not widely practiced is tamsulosin, which seems to affect the ureter (tube from kidney to bladder) and helps stones pass. This is already in use for other urological conditions in Australia, and studies overseas seem to benefit patients with ureteric colic.
The study found tamsulosin increased the passage of large stones (5-10mm), but no benefit overall of 0.4 mg of tamsulosin daily for patients with smaller stones (less than 5mm) appeared.
“The trial recruited 400 patients and was a successful collaboration of 4 tertiary emergency departments in Queensland and was one of the first Queensland-led, multi-centre clinical trials in the ED setting.”
—Prof Gerben Keijzers