A5027517631- Emergency and Acute Care Studies
- Traumatic Brain Injury and Neurovascular Disturbances
- Sepsis Diagnosis and Treatment
- Migraine and Headache Studies
- Healthcare Policy and Management
- Hemodynamic Monitoring and Therapy
- Radiation Dose and Imaging
- Ultrasound in Clinical Applications
- Legionella and Acanthamoeba research
- Neurosurgical Procedures and Complications
- Medical Malpractice and Liability Issues
- Trauma and Emergency Care Studies
- Ocular Infections and Treatments
- Respiratory Support and Mechanisms
- Patient Safety and Medication Errors
- Radiology practices and education
- Cardiovascular Syncope and Autonomic Disorders
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Venous Thromboembolism Diagnosis and Management
- Heme Oxygenase-1 and Carbon Monoxide
- Pleural and Pulmonary Diseases
- Maternal Mental Health During Pregnancy and Postpartum
- Child and Adolescent Health
- Ophthalmology and Visual Health Research
- Trauma Management and Diagnosis
The University of Queensland
2016-2024
Prince Charles Hospital
2017-2024
Family & Children’s Services
2024
Prince Charles Hospital
2015-2022
Griffith University
2022
Gold Coast Health
2020
Bond University
2020
Queensland University of Technology
2018
University of Glasgow
1996-2004
Western Infirmary
1995-1996
Whether conservative management is an acceptable alternative to interventional for uncomplicated, moderate-to-large primary spontaneous pneumothorax unknown.In this open-label, multicenter, noninferiority trial, we recruited patients 14 50 years of age with a first-known, unilateral, pneumothorax. Patients were randomly assigned immediate the (intervention group) or observational approach (conservative-management and followed 12 months. The outcome was lung reexpansion within 8 weeks.A total...
Abstract Objectives The objective of this study was to describe demographic and clinical characteristics including features that were consistent with subarachnoid hemorrhage ( SAH ), use diagnostic tests, emergency department ED ) discharge diagnoses, disposition adult patients presenting an acute headache s statewide across Queensland, Australia. In addition, potential variations in the presentation workup between principal‐referral city‐regional hospitals examined. Methods A prospective...
To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension.This was a prospective, multicentre, observational study conducted 70 hospitals Australia New Zealand between September 2018 January 2019. Consecutive adults presenting to the during 30-day period at each site, hypotension (systolic blood pressure <100 mmHg) despite least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical laboratory variables...
Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack evidence from clinical trials to support this. Accumulating observational data suggest harm associated the injudicious use fluids in sepsis. There currently equipoise regarding liberal or restricted fluid-volume resuscitation as first-line treatment sepsis-related A randomised trial comparing these two approaches is, therefore,...
Introduction Overuse of CT Pulmonary Angiograms (CTPA) for diagnosing pulmonary embolism (PE), particularly in Emergency Departments (ED), is considered problematic. Marked variations positive CTPA rates are reported, with American 4–10% yields driving most concerns. Higher resolution may increase sub-segmental PE (SSPE) diagnoses, which be up to 40% false positive. Excessive use and positives could harm vs. benefit. These issues have not been systematically examined outside America. Aims To...
Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there that conservative may be effective safe, it also reduce the risk recurrence. Significant questions remain regarding optimal initial approach PSP.
Abstract Objective To describe the epidemiology of nontraumatic headache in adults presenting to emergency departments (EDs). Background Headache is a common reason for presentation EDs. Little known about epidemiology, investigation, and treatment patients attending EDs internationally. Methods An international, multicenter, observational, cross‐sectional study was conducted over one calendar month 2019. Participants were (≥18 years) with as main complaint. Exclusion criteria recent head...
Abstract Objective The objective was to examine the safety and efficacy of high‐flow nasal cannula (HFNC) therapy for children with bronchiolitis in a non‐tertiary paediatric setting. Methods This single‐centre retrospective study conducted over 26 months (March 2013–April 2015) on aged 1–23 suspected bronchiolitis, who commenced HFNC either ED or ward. Changes respect baseline data were analysed effect work breathing (WOB), heart rate (HR) respiratory (RR). Data using linear mixed effects...
Objectives Only a small proportion of patients presenting to an ED with headache have serious cause. The SNNOOP10 criteria, which incorporates red and orange flags for causes, has been proposed but not well studied. This project aims compare the 10 commonly accepted flag criteria (singly in combination) between without diagnosis secondary large, multinational cohort headache. Methods Secondary analysis data obtained HEAD HEAD-Colombia studies. outcome interest was predictive performance from...
BackgroundEmergency department overcrowding impacts patients, staff, and quality of care, there is government pressure to optimize throughput reduce waiting times. One solution for improving patient flow the emerging 'navigator' role: a nurse that supports staff in care delivery; facilitating efficient timely movement through emergency department.MethodsA 20-week project was implemented evaluate an navigator role. A controlled trial used. The worked on week-on-week-off basis, eight hours per...
Abstract Objective To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed identify key factors influencing current provision of acute care within primary healthcare (PHC) explore policy system changes potentially required. Methods Semi‐structured interviews with stakeholders were audio‐recorded, transcribed verbatim analysed through content thematic approaches incorporating Walt Gilson health framework. Results Eleven conducted. Five...
Abstract Background Lung ultrasound experts claim that ‘B line’ artefacts herald pulmonary oedema, but links between early recognition and improved outcome are unconfirmed, particularly for non‐expert clinicians. Objective Assess individual system impacts of early, lung (LUS) in breathless older patients. Methods Prospective single‐blinded randomised controlled trial point care LUS by clinicians, augmenting ED assessment patients over 60 years, presenting with dyspnoea. After brief training,...
Objectives Sepsis is acute organ dysfunction in the setting of infection. An accurate diagnosis important to guide treatment and disposition. Tissue oxygen saturation (StO 2 ) can be estimated noninvasively by near-infrared spectroscopy (NIRS), may an indicator microcirculatory early sepsis. We aimed determine utility StO for sepsis recognition outcome prediction among patients presenting emergency department (ED) with Patients methods A multicentre, prospective, observational cohort study...
The case is described of a unilateral retinoblastoma in 7-year-old girl which was initially misdiagnosed because massive anterior segment involvement the apparent absence retinal lesion. Only on histopathological examination enucleated eye presence tumour established, this being confined to two minute foci at extreme periphery.
Abstract Objective To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care. Methods A retrospective analysis was conducted using Information System data from Metro North Hospital and Health Service Brisbane, Australia three consecutive financial years (2014–2015 to 2016–2017). The hospitals included two Principal Referral Public Acute hospitals. GP‐type were calculated Australian Institute Welfare (AIHW), Australasian...
Purpose Patient safety culture is a vital element to create patient in healthcare organisations. Emergency department (ED) professionals operate unstable conditions that may pose risk on day-to-day basis. The aim of this study was assess the status and quantify dimensions ED setting. Design/methodology/approach This descriptive cross sectional used validated questionnaire distributed staff working nominated EDs . Perceptions various were reported frequency positive responses for each...
Abstract Purpose To investigate the effect of IV fluid resuscitation on endothelial glycocalyx (EG) shedding and activation vascular endothelium inflammation. Materials methods A planned biomarker sub-study REFRESH trial in which emergency department (ED) patients) with suspected sepsis hypotension were randomised to a restricted fluid/early vasopressor regimen or later vasopressors if required (usual care). Blood samples collected at randomisation (T0) 3 h (T3), 6 (T6)- 24 (T24) for...
Migraine headache is commonly diagnosed in emergency departments (ED). There relatively little real-world information about the epidemiology, investigation, management, adherence to therapeutic guidelines and disposition of patients treated ED with a final diagnosis migraine. The primary aim current study get snapshot assessment management patterns acute migraine presentations different settings EDs view raise awareness.This planned sub-study prospective conducted 67 health services 10...
Safety culture in Emergency Departments (EDs) requires special attention due to unique operational feature of the ED environment. Which may influence a patients' safety ED.To identify factors that patient EDs.A qualitative study using semi-structured interviews with 12 staff was carried out two Australian EDs. The data thematically analysed and describe perceived by as influencing culture.The findings revealed four super-ordinate themes 19 categories. were following: (1) Environmental...