Research
Research overview
The Emergency Research Group is located in the Emergency Department which provides urgent medical care to children and adolescents who present to the Royal Children's Hospital Melbourne. Approximately 67,000 children are seen annually, ranging from newborns to teenagers. The hospital is a paediatric tertiary referral centre and also the only paediatric trauma service for
The department has a very strong commitment to clinical research, conducted through the Murdoch Children’s Research Institute. Areas of interest include analgesia and sedation, trauma, mental health and neurological disorders. We have medical students and post-graduate nursing students completing projects through the department on a yearly basis. Senior paediatric trainees from the
The department is a founding member of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) which aims to undertake high level multi-centre research in
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A/Professor Franz Babl |
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Selected projects
Trauma
As the only paediatric trauma centre in
CT scans of the head (brain scans) are vital tools for children after head injuries to detect if there are skull fractures or any bleeding inside the head which might require an urgent operation. At the same time CT scans should only be used when necessary to avoid unnecessary radiation. We are investigating who should receive a CT scan and who can safely be observed in hospital or at home.
Growing out a project with neuropsychologists from the Department of Psychology we are investigating if blood tests can help determine the severity of head injuries.
Sedation and Analgesia
The aim of the sedation program is to provide safe, effective sedation for procedures that are painful or distressing for children. We developed and evaluated a program to educate and accredit emergency department staff in paediatric procedural sedation which has been adopted by many other emergency departments. Ongoing quality improvement data from the program have created a large prospective data set for the analysis of different sedative agents. We are also investigating how to measure pain and distress in pre-verbal and early verbal children, to be able to reduce the experience of pain in a number of paediatric procedures.
Mental health
We are targeting two vulnerable groups in our emergency department, adolescents in mental health crisis and mothers with post-natal depression. In a multi-faceted program we set out to improve care for the many adolescents presenting to the emergency department with acute mental health problems. We are improving process and policy, staff education, links with mental health professionals and the protection of patients and staff through improved practice. We have established and evaluated changes in practice such as a hospital wide “Code Grey” response team and a ‘Safe room’ in the emergency department.
Many young babies present with irritability and feeding problems. Sometimes the issue is more maternal exhaustion and depression rather than a physical problem with the babies. We are currently investigating a screening tool for mother with young children to detect post-natal depression. This will enable us to offer appropriate referrals to affected mothers.
Stroke
Stroke is among the top ten causes of death in children and over half of stroke survivors will experience long term disabilities. The problem is that strokes in children are often not recognized or treated quickly, which is a major concern for the child’s immediate survival and their future health and wellbeing. Together with the Department of Neurology we aim to better define the differences in symptoms between brain attacks / mimic and strokes in children, as diagnosis of stroke can be difficult. Quicker recognition has the potential to result in improved diagnosis and enrolment in appropriate treatment plans to reduce brain damage and enhance long term outcomes for children.
Large randomised control trials
PIMS Paediatric Intravenous Maintenance Solution study
The PIMS study is a blinded randomised controlled trial at RCH. It aims to determine whether an intravenous fluid with 140mmol/L of sodium is safer than our currently recommended fluid (77mmol/L of sodium) when used for maintenance hydration in paediatric patients. This is in response to ongoing concerns regarding hyponatraemic encephalopathies occurring in association with fluids containing low sodium concentrations.
Principal investigator is Dr
Trial coordinator Kate Laurie Kate.Laurie@rch.org.au
CRIB Comparative rehydration in Bronchiolitis study
Bronchiolitis is the leading cause of hospitalization during the first year of life and is a major cause of morbidity and mortality. The primary aim of this multicentre randomised trial is to investigate whether the type of fluid replacement – nasogastric versus intravenous – affects the duration of hospital admission, in children aged between 2 and 12 months admitted to hospital. The study is funded by the National Health and Medical Research Council (NHMRC).
Principal site investigator A/Prof
Trial coordinator
PREDICT
The RCH Emergency department is one of the founding sites of the Paediatric Research in Emergency Departments International Collaborative (PREDICT), formed in late 2004. This research network now includes all tertiary paediatric institutions in
Recent achievements
- Assoc. Prof.
- Assoc. Prof. Franz Babl is a co-investigator on the project “Biomarkers and quality of life in children with traumatic brain injury (TBI) (DCP08)” Ontario Neurotrauma Foundation /
- Assoc. Prof. Franz Babl is a co-investigator on the project “Improving short and long term outcomes for children who have suffered a stroke- strategies to decrease lag time in diagnosis” Collier Charitable Fund ($25,000)
- Assoc. Prof. Franz Babl is a co-investigator on the project “Outcome of head injuries in children injured in the first three years of life: Cognitive, behavioural and social implications”. Foundation for children ($69,500)
- Assoc. Prof. Franz Babl is a co-investigator on the project “Developing strategies to decrease lag time to diagnosis in paediatric stroke” National Stroke Foundation ($20,000)
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- Dr Peter Barnett is a member of the International Editorial Board, Pediatric Emergency Care
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For more information regarding projects and departmental publications see MCRI Emergency Research.
MCRI’s web-based randomisation system - click here
