Emergency Medicine

Clinical Professor Meredith Borland | Consultant, Emergency Department
Meredith.Borland@health.wa.gov.au

Departmental Overview

The Emergency Department currently manages over 65,000 patients per year with a wide variety of acute conditions in children from birth to 16 years. There are a number of research projects running within the ED, some solely within ED and some in collaboration with PCH inpatient teams (immunology, anaesthetics, general paediatrics, respiratory medicine, orthopaedics and oncology), TKI and multicentre studies through our involvement in the Paediatric Research in Emergency Department International Collaborative (PREDICT) network and the international Paediatric Emergency Research Network (PERN). 

Current Active Research Projects

BiPED - Bronchiolitis in infants Placebo versus Epinephrine and Dexamethasone - an international multicentre clinical RCT to determine if treatment of infants presenting with bronchiolitis to the ED with nebulised adrenaline (epinephrine) and 2-day course of oral dexamethasone is effective in reducing the need for hospitalisation (due to bronchiolitis) by day 7 compared to placebo.

SEPSIS studies: PROMPT Bolus and SENTINEL – PROMPT Bolus is an international randomised controlled trial which is determining whether fluid resuscitation with balanced fluids will improve clinical outcomes compared to fluid resuscitation with Normal Saline in paediatric septic shock in children aged 6 months to 18 years. SENTINEL is the Australasian prospective observational arm examining the outcomes of potential sepsis in any age group.  

WA Implementation Bronchiolitis Improvement project – Review of bronchiolitis management at PCH and 3 West Australian secondary and regional hospitals in line with the Australasian Bronchiolitis Guideline. Data collection completed and in analysis

STOP – Study of Tranexamic acid On Post tonsillectomy haemorrhage - A pilot trial studying an alternative method of managing secondary post tonsillectomy haemorrhage (sPTH) within the Emergency Department (ED).  Commencing early 2022.

SONIC – Study of Neck Injuries in Children – Multicentre Australasian derivation and validation of imaging rules for children with neck injuries. Commencing early 2022

PATRIC RCT and registry – Pragmatic Adaptive Trial for Respiratory Infections in Children – Prospective observational study of outcomes in children presenting with respiratory tract infections to ED. In 2022 commencing a RCT comparing outcomes relating to different length of treatment in those requiring antibiotics. 

PEAChY O and M Two RCTs assessing different sedation medications (given orally or intramuscularly) for the management of severe behavioural disturbance in children 

Research Projects in Planning

Study of Paediatric Appendicitis Scores and Management Strategies (SPASMS) - This project aims to validate the three most commonly used paediatric appendicitis scores (PAS, AS and pARC) in Australian and New Zealand EDs providing evidence that will be relevant for local use outside their derivation healthcare settings.