Emergency Medicine (RMH)

Unit Code

01266

Department/Institution Offering Unit

Department of Emergency Medicine
Royal Melbourne Hospital
Grattan St
Parkville
Victoria 3050 Australia

Unit Points

Research Points: 100

Coursework Points: 0

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Contacts

Unit Coordinator/s:

Dr Jonathan Knott
Department of Emergency Medicine
Royal Melbourne Hospital
Grattan St
Parkville
Victoria 3050 Australia

tel: + 61 3 9342 7009
fax: + 61 3 9342 8777
email: Jonathan.Knott@mh.org.au

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Overall Objectives

• To understand the basic principles of clinical research, in particular in relation to prehospital and emergency medicine research
• To be able to design, carry out and communicate the results of original research in prehospital and emergency medicine
• To understand the barriers to high quality clinical research in prehospital and emergency medicine
• To understand the special ethical issues relating to research in prehospital and emergency medicine
• To be able to critically evaluate biomedical literature

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Content

Coursework: N/A

Research: This is the major component. Projects will be offered across a broad range of areas including prehospital and retrieval medicine, trauma and social issues. It is likely that research projects will take students into clinical areas relevant to their project.

Sample Research Topics:

1. Prevalence and Importance of Potential Drug Interactions Among Emergency Department Patients
   
   The use of multiple prescribed medications is common and patients taking two or more medications may be at risk of potential drug interactions. These have been defined as the combining of two or more drugs such that the potency or efficiency of one drug is modified significantly by the presence of another. Drug interactions can alter the absorption, distribution, metabolism, or excretion of a drug or interact in a synergistic or antagonistic fashion, altering their pharmacodynamics. This study will determine the prevalance and nature of potential drug interactions among ED patients, the drugs most commonly involved and the particaulr patient groups at risk of clinically relevent interactions.
2. The Ability of Staff to Undertake Predictable Resuscitation Tasks Whilst Wearing Personal Protection Equipment
   
   Recent world events have increased the probability of a chemical, biological or radiation (CBR) attack on urban centres and civilian hospitals must be prepared for this. In addition, patients may be exposed to noxious agents that pose an on-going risk of contamination. Studies have shown that, in the events of a disaster, most patients will present to the local hospital by private transport and therefore arrive at the Emergency department (ED) potentially contaminated1,2. Decontaminating patients prior to entry into the ED is essential to the safety of patients and staff within the department. However, some casualties may be in urgent need of lifesaving treatment before they can be safely decontaminated. This can pose a challenge for ED staff who must endeavour to perform immediate life-saving procedures without endangering themselves. In such situations ED staff wear Level C personal protective equipment (PPE) 3. This consists of a sealed PVC suit and hood, full-face mask with a charcoal filter, butyl rubber boots and thick butyl rubber gloves. In this research project we will investigate the ability of ED staff to perform a full resuscitation scenario including decontamination in a clinically relevant time. In line with other studies, we will also aim to assess the physiological burden on ED staff working in PPE for a prolonged duration in a temperate climate. In addition, we will assess the subjective impact of staff of resuscitation whilst wearing Level C PPE.
3. Reported Antibiotic Allergy Among ED Patients: Prevalence, Validity and Effect on Practice
   
   Antibiotic allergy can lead to the exclusion of first line drugs in the treatment of certain conditions. Sucg exclsuion may be unecessary if the patinets is not really allergic to these first line drugs. However, this may influence the choice and range of drugs available for treatment with inplications for treatment costs, effectiveness, side effects and drug resistance. This study will examine, in detail, the true nature of antibiotic allergy among patients who report such allergies upon presentation to the ED. It will determine the the proportion of patients whose reported allergies are likely to be unsubstantiated and the effects that this has on treatment management.
4. Longitudinal study of Plaster of Paris (POP) cylinders to identify the nature and frequency of complications
   
   POP cylinders are frequently applied in the emergency department and other areas of the hospital. While the complications of POPs are well described, the frequency and nature of complications for individual POPs, over the duration of their use, has been poorly described. This study aims to document the nature and rate of POP complications over the entire "life" of individual POPs. It aims to determine the various factors that impact upon these complications eg. amount of plaster and padding applied, experience of the operator, nature of the fracture, requirement for manipulation, discharge information and patient compliance factors. Patients with newly applied POPs would be enrolled in the ED or orthopaedic wards and followed until final removal of the POP. The study would provide the student with a wide range of ED, trauma and surgical experience. The study would also provide data upon which guidelines for optimal POP management could be derived.

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Assessment Breakdown

Research Component: 100 points
Research Report (up to 8,000 words): 80%
Oral presentation of the research (20 minutes): 20%

Coursework Component: N/A

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Student Numbers

Number of places available:
3