2008 BTCCRC Research Report - School of Medicine

Transcription

The School of Medicine
Burns Trauma & Critical Care
Research Centre
2008 Research Report
BTCCRC
2008 RESEARCH REPORT
Mission and Aims
1
Report - Chair
2
Researcher profiles
3
BTCCRC Research
12
Research Showcase 18
Emergency Medicine
19
Research Support
23
Research Students
25
Visiting Researchers
27
Conferences
28
Conferences/Workshops
29
Professional Activities
30
Publications
31
Publications and Achievements
33
Teaching Activities
34
UQ Research Week Contribution
35
BTCCRC Facilities
36
BTCCRC Collaborators
37
Enquiries
39
Research Centre
Level 3 Ned Hanlon Building and Level 8 UQ Centre for Clinical
Research
Royal Brisbane & Women’s Hospital
Herston QLD 4029
Proudly supported by
OUR MISSION
AND
OUR AIMS
In 2002, the devastation and
tragedy of the Bali bombings
focused national and international
attention on burns victims and
emphasized that there was a critical
need to improve the treatment and
outcomes of burnt and critically ill
patients. The outstanding response
from the critical care and burns staff
of Royal Brisbane & Women’s
Hospital (RBWH) and University of
Queensland highlighted the skill
and expertise we possess in this
area. Six years down the track, we
continue to build on these
attributes.
Our Aims
The main aims of our research centre are to:
Improve both the survival and outcome
of patients by conducting high quality
research in the area of Burns, Trauma
& Critical Care in general.
Our Mission
The Burns Trauma & Critical Care
Research Centre was established to
further advance and improve the level of
treatment and care given to burns and
critically ill patients through world-class
research-based clinical practice.
It began as a collaborative venture
between the RBWH Burns and Intensive
Care Units, the University of Queensland
and this year, has
incorporated the
Department of Emergency Medicine.
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Provide a research - driven evidence
base for clinical practice in the Burns,
Trauma & Critical Care areas.
Establish national and international
collaboration in
Burns, Trauma &
Critical Care, thus increasing research
opportunities.
Enhance the research training and
knowledge base of postgraduate
students and staff in the Burns,
Trauma & Critical Care clinical areas.
REPORT FROM THE CHAIR
The year 2008 has been one of continuing success and growth for the
BTCCRC. This year the Department of Emergency Medicine joined our
research centre and we also increased our role as a major trauma
research centre.
These additional areas of interest were reflected by success in funding
in the area of emergency medicine, sepsis and trauma prevention. Dr
Julian Williams was successful in a large project on sepsis, and A/Prof
Michael Muller was successful in a grant from the Trauma Foundation on
prevention of burns. The department of renal medicine has also joined forces
with us leading to many interesting collaborations and new projects.
Our staff continued to be in high demand nationally and internationally and
Professor Jeffrey Lipman, Dr Andrew Udy, Jason Roberts, Dr Andrew Holley
and Dr Jennifer Paratz presented either workshops or invited papers at
international venues.
An increased number of doctoral and honours students have also enrolled in
our centre, including existing staff including Dr Julian Williams, Dr Andrew
Udy and Kellie Stockton. This year advanced medical sciences candidates
from the MBBS degree of the University of Melbourne have also completed
projects here with great success.
The growth of our research centre is reflected by the formation of an advisory
board, including Professor Keith McNeil, District CEO Metro North Health
District, Professor David Wilkinson Head, School of Medicine, Dr Ian Wilkey
former medical superintendant of RBWH and Mr Gilberto Maggiolo. The role
of the board will be to review the aims, policies and governance of the
BTCCRC and the ensuing role and interaction with hospital, University and
community.
We also welcomed the arrival of our Research Manager Dr Sia AthanasasPlatsis from the Australian Institute for Bioengineering and Nanotechnology at
St Lucia. Sia has taken a large load from our shoulders with respect to
administrative duties.
Thank you to everyone for the continuing hard work and dedication and we
look forward to a successful year in 2009.
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Professor Jeffrey Lipman
MBBCh DA (SA) FFA (SA) FFA (CritCare) (SA) FJFICM MD
Director of BTCCRC, Director of Department of Intensive Care Medicine (DICM), RBWH
Professor, Anaesthesiology & Critical Care University of Queensland
Jeff is a co-director of the BTCCRC, Director of Department of Intensive Care (DICM), RBWH and
Professor of Anaesthesiology & Critical Care, University of Queensland and Honorary Professor,
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong. He has
qualifications in anaesthesia and intensive care and has set up and run a number of Intensive Care and Trauma Units
in South Africa before coming to Australia in 1997. He is the author of over 170 peer reviewed publications, 20 book
chapters, has been invited to present at many national and international conferences and is a reviewer for 11 high
quality international journals and granting committees, including the NHMRC. He is involved with a large number of
committees, including ANZICS clinical trials group. Jeff has been instrumental in developing the anaesthesiology &
critical care component of the new graduate medical program for Queensland and continues to lecture to medical and
postgraduate students. He is site Principal Investigator for numerous multinational trials. Research interests include all
aspects of management in intensive care, resuscitation of burns and pharmacokinetics of antibiotic dosage. His
research into antibiotic usage in acute situations has received international recognition. Jeff is involved in most research
projects, oversees the direction of the research centre, mentors staff and supervises postgraduate students attached to
the research unit.
Dr Michael Rudd
MBBS FACS OAM PhD
Co-Director BTCCRC, Director of Burns Unit, RBWH
Michael is the other Co-Director of the BTCCRC and the current director of the Adult Burns Unit at
the Royal Brisbane and Women‘s Hospital. He has fellowships in Burns and General Surgery.
Michael has completed a PhD in transplantation immunobiology. His research interests are in all
aspects of burn management, burn pathophysiology and immunobiology. His clinical and research
background make him uniquely qualified to work as a burns surgeon and scientist at both the bedside and in the
laboratory. Michael is involved as an investigator on many projects and also supervises postgraduate students and
laboratory work. He has recently been awarded a Golden Casket Grant as part of a team to investigate autologous skin
transplantation.
Dr Jennifer Paratz
MPhty FACP PhD Grad Cert Ed (Medical & Health Sciences)
Chair BTCCRC, Research Fellow
Jennifer has qualifications in clinical physiotherapy, medical education and research. She has
completed a masters, PhD and postdoctoral work in intracranial dynamics in the brain injured adult
and neonate and also a fellowship specializing in cardiopulmonary physiotherapy. She was previously
director of a cardiopulmonary research centre at Alfred Hospital/La Trobe University, Melbourne and
has a large amount of experience in clinical work, research and teaching at both undergraduate and postgraduate
levels. Jennifer has six completed doctoral students, five current and four new doctoral students in 2008, she is
currently reviewer for a number of high level international journals and granting bodies and examiner for doctoral
awards. She frequently is invited to present at international conferences and workshops. Jennifer is currently running
four randomized controlled trials, is responsible for overall supervision of postgraduate students, liaison between
School of Medicine postgraduate co-ordinator and BTCCRC. She is also responsible for overseeing the direction and
themes of the research centre, large grant applications, statistical advice, mentoring with grants, manuscript writing and
systematic reviews.
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Associate Professor Michael Muller
MBBS FRACS MMedSc
Senior Staff Specialist, RBWH, Associate Professor University of Queensland
Michael is a staff specialist general and burns surgeon as well as an Associate Professor at the
University of Queensland. He has a major national and international reputation due to his
extensive clinical research in burns. Michael is the author of a large number of publications,
invited presentations and book chapters and the recipient of large amounts of grant funding for Burns research. He
has presented by invitation at many national and international conferences and is also on the Editorial Board for
several high quality international journals and granting committees. He has held visiting professorships at the US
Army Institute of Surgical Research, Texas, and the University of Southern California. Michael is involved in all
projects as chief or main investigator and his clinical and research expertise is a major factor in the success of this
research centre.
Dr Robert Boots
MBBS (Hons) FRACP FJFICM PhD Grad Dip Clin Epi MMedSci MHealth Admin IS
Deputy Director , DICM
Rob has qualifications in respiratory medicine, general medicine and intensive care. He has a strong background in
clinical epidemiology and research with his main interests in management of burns and prevention of ventilator
associated pneumonia. He is Deputy Director of Clinical Training at RBWH and has training in clinical education
from the Harvard Macy Program for Physician Educators in Boston USA and the Bulstrode and Hunt program of the
Royal College of Surgeons (Edin). He is Chairman of the Queensland Regional Committee of the JFIC, national
examiner for RACS and a local examiner for the RACP. He lectures for the RACP training program and is the
Australian Coordinator and member of the international steering committee for the Basic Assessment and Skills in
Intensive Care training course. Rob is principal investigator on many projects and supervises postgraduate students.
He provides mentoring and assistance in research design, statistical analysis and epidemiological issues.
Dr Jeremy Cohen,
MBBS BSc MRCP FRCA FJFICM
Staff Specialist, DICM
Jeremy works at both RBWH and Ipswich Hospital. He trained in the UK and has specialist
qualifications in medicine, anaesthesia, and intensive care. He is an expert in adrenal function in
critical illness, and has several publications in this field. He is the principal investigator in a RBWH
based study and a co investigator in a nationwide study on cortisol levels in this population. He
has also contributed to several book chapters, including work on antibiotic treatment in ICU, in
collaboration with Professor Lipman. Jeremy is a member of the Queensland Regional Committee of the Joint
Faculty of Intensive Care, takes part in arranging and running the Brisbane Skills Workshop and is a regular
examiner on the Brisbane ICU course.
Dr Kersi Taraporewalla
MBBS FANZCA MClinEd
Director of Education & Research, Department of Anaesthesia and Perioperative
Medicine (DAPM)
Kersi‘s primary qualification is in anaesthesia and he now works entirely within the public
sector. His other qualifications include Master of Clinical Teaching from the University of
New South Wales. His current work extends to teaching anaesthesia to various groups, predominantly trainees of
ANZCA, medical students, anaesthetic technicians and anaesthetic nurses. Kersi is also involved in high fidelity
simulation training for crisis management with various groups. He is a representative at committees at the Australian
and New Zealand College of Anesthetists‘ and is currently undertaking his PhD in the field of medical education.
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Dr Joel Dulhunty
BSc(Hon) MBBS MTH(Tropical Health) PhD
Research advisor / clinical epidemiologist, DICM
Joel is currently working as a Research Registrar in the Department of Intensive Care Medicine.
Current and past research projects include fluid resuscitation practices in major burns, adult burn
injury prevention, negative outcomes associated with hypothermia in trauma injury and the
epidemiology of serious infections in critically ill patients. He is a medical graduate with a public
health background, having completed previous research at the Master and PhD level in the areas of
malaria, cancer care and patient quality of life. He views strengthening clinical research opportunities at RBWH and
developing collaborative research with other Centres as an important role. His role in the Department of Intensive Care
Medicine is as a research advisor and he provides advice and mentoring on statistical analysis, epidemiology and
research design. He is responsible for the statistical analysis on a number of local and collaborative (national and
international) research projects.
Dr John Gowardman
BSc BHB MBChB FRACP FJFICM
Senior Staff Specialist, DICM
John is currently Senior Staff Specialist in Intensive Care Medicine at the RBWH and a Senior
Lecturer with the School of Medicine, University of Queensland. John has worked in several
ICUs in both Australia and New Zealand after having initially trained in Auckland, NZ. He is
qualified in both Internal medicine and Intensive Care Medicine and prior to a career in Medicine
completed a BSc with a major of Mammalian Physiology at the Victoria University of Wellington,
NZ. John has several research interests and has published in all these. Current interests include intra vascular access
devices, weaning and extubation from mechanical ventilation, aspects of enteral nutrition and sepsis. He is Chair of the
Department of Intensive Care Quality Committee and has experience in postgraduate supervision. He is main
investigator on a number of projects and supervises the registrars in their research. John is also an examiner for the
Joint Faculty of Intensive Care Medicine (JFICM).
Adjunct Associate Professor Michael Steyn
MBChB DRCOG MRCGP FFARCSI FANZCA MSc
Director, DAPM
Michael was trained in the UK in both General Practice and Anaesthesia prior to specialising in
Burns Anaesthesia. He has completed an MSc in Public Health which focused on Education and
Training in the Conduct and Utilisation of Public Health Research. In the UK Michael was the Royal
College of Anaesthetists & Association of Anaesthetists of Great Britain & Ireland Representative
for the British Burn Association (BBA) National Review, National Specialist Commissioning
Advisory Group (Burns) and the National Framework Team for Paediatric Intensive Care in Burns.
As a practicing Burns Anaesthetist Michael is active in supporting research within the RBWH both in the clinical
environment and as a core component of the provision of anaesthetic services. He is the Director of the Department of
Anaesthesia & Perioperative Medicine, RBWH and Chair of the Statewide Anaesthesia & Perioperative Medicine
Clinical Network and member of the Statewide Clinical Networks Council. He is also a member of the Australian
eHealth Research Centre Research and Investment Advisory Committee.
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Dr Paul Gray
MBBS FANZCA FFPMANZCA
Senior Staff Anaesthetist and Doctoral Student
Paul holds a Fellowship in Anaesthesia and a Fellowship in Pain Medicine through the
Australian and New Zealand College of Anaesthetists and is senior staff specialist at the
RBWH. Paul is involved in extensive clinical duties within the Professor Tess Cramond
Multidisciplinary Pain Centre, which include inpatient and outpatient care and performing
pain medicine interventions on patients with persistent cancer and non-cancer pain. Paul
is also enrolled in a PhD, studying the mechanism and treatment of neuropathic pain following burn injury. To this
end, he recently completed a trial examining the efficacy and safety of pregabalin in the treatment of acute pain
after burn injury which suggests that pregabalin successfully reduces pain and itch. Paul is the chairman of the
Qld Regional Committee of the Faculty of Pain Medicine and examiner for the Faculty of Pain Medicine Fellowship
Examinations.
Dr. Keith Greenland
MBBS FANZCA FHKAM
Senior Staff Specialist, DAPM
Keith has qualifications in Anaesthesia and has spent 8 years working in Hong Kong in a
number of hospitals including United Christian Hospital and Caritas Medical Centre. He has
published a number of articles on upper airway management during anaesthesia with a
particular focus on split airways used during fibreoptic intubation. Keith also conducted a
study examining the use of personal protection equipment during airway management of
patients suffering from severe infectious respiratory diseases such as bird flu and SARS.
Current research projects include examining the clinical application of airway devices
(Levitan and Shikani scopes), as well as a measuring the tracheal length of anaesthetised
patients and relating it to current tracheal tube design. Keith's special interest is promoting a structured approach
to difficult airway management. He has recently published a suggested classification of difficult airways.
Dr Andrew Udy
BHB MBChB PGCert(AME)
Senior Registrar, DICM
Andrew is a new member and is also Qld Health Research Skills Development Registrar
2008. He graduated from the University of Auckland in 2001 and has subsequently
completed postgraduate training in ICM. He has worked in New Zealand, the United
Kingdom and Australia in anaesthesia, critical care and retrieval medicine. He is currently
enrolled in a PhD programme at UQ and is investigating the impact of augmented renal
clearance on the prescription of antibiotics in the critically ill. Research interests include:
acute kidney injury, microcirculation, severe sepsis/septic shock and measurement techniques in ICU. He is the
local trainee representative of the Qld Regional Committee and has an active role in teaching undergraduates and
postgraduates.
Dr Judith Bellapart
MD FJFICM
Judith originally trained in Barcelona as an intensivist and has completed a fellowship in Neurotrauma in Toronto,
Canada. Her primary interest include intracerebral dynamics and she is undertaking projects on to major research
interests include Cerebral blood flow haemodynamics in patients on an intra-aortic counterpulsation balloon pump
and Endothelin, as a marker of severity in subarachnoid hemorrhage vasospasm. She has previously published on
humidification in mechanical ventilation.
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Dr Rajeev Hegde
MBBS MD EDICM FJFICM
Rajeev has worked in a number of ICUs in Australia after starting his initial training in Intensive
care in Royal Perth Hospital. He was the Director of ICU, Logan Hospital Jan 2002 to June 2005
before joining RBWH as Staff Intensivist. The Logan Hospital was recognised for advanced
training in Intensive Care by the Joint Faculty of Intensive Care Medicine during his tenure.He is
presently an examiner for the Fellowship exam of the JFICM and the Supervisor of Training for
JFICM with an active role in shaping the career of future Intensivists.
Dr Siva Senthuran
MBBS BSc FRCA FJFCIM
Siva originally qualified in the UK and had a large amount of clinical experience in intensive
care, and anesthetics. He is especially interested in critically ill patients with previous renal
dysfunction and in 2007 won the Felicity Hawker medal for the best JFICM research project.
He is also investigating the effect of changes in cerebral perfusion pressure in acute head
injury patients on creatinine clearance.
Dr Anthony Holley
BSc MBBCh DipPaeds DipDHM FACEM FJFICM
Anthony has fellowships in both intensive care and emergency medicine and works as a staff
intensivist at RBWH. He has an increasing number of publications in peer reviewed journals.
Anthony‘s current research interests include identifying alterations in microcirculation during shock
using side stream dark field imaging. He is both a CCriSP and EMST instructor. Anthony is
currently a commissioned officer in the Royal Australian Navy and his military career has given him
the opportunity to serve on several overseas deployments, including Angola, Bougainville and East
Timor.
Dr Neil Widdicombe
MBBS FRCA (UK) FJFICM
Neil has qualifications in both anesthesia and intensive care and has worked at Charing
Cross and Westminster Medical School, UK University of Hospital of Wales in Cardiff Royal
Adelaide Hospital and the Flinders Medical Centre Royal Adelaide Hospital, Redcliffe
CareFlight Queensland and RBWH. He has experience in emergency medicine, trauma and
air medical retrieval and has previously held a trauma fellowship. Research interests include
burns management, trauma, ethics in intensive care and air medial retrieval. Neil is involved
as site investigator for Multicentre projects and has a special interest in documentation of
death for transplants.
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Dr Alex Douglas
BMedSc MBBS FANZCA
Alex is employed as a specialist at both RBWH and Redcliffe Hospital. After completing her
MBBS (Tas), Alex completed several years as a general medical officer within the Australian
Defence Force where she was deployed several times, providing emergency relief, trauma
and retrieval services to personnel. For this, she was awarded the Medal for Gallantry. She
has completed her FANZCA and is completing her research requirements for the FJFICM.
Her research interests are in current practice in Anaesthesia & Intensive Care Medicine and education. Currently in
preparation is a synopsis of the introduction of the BASIC course to Australasia, and the AORTIC trial which is
studying the pharmacokinetics of routine antibiotics used in abdominal aortic aneurism surgery.
Dr Steve O’Donoghue
MBChB FANZCA FJFICM
Steve received his undergraduate and postgraduate training in New Zealand. He has
completed anaesthesia training in 2007 and ICU training in New Zealand and Australia in
2008. His areas of interest include the outcomes of haematology patients admitted to ICU
after bone marrow transplant and the role of echocardiography in ICU. Steve is co-investigator
in research projects investigating the microcirculation in shocked critically unwell patients
during resuscitation and determining if heparin can prevent ventilator associated pneumonia.
Hiran Bandeshe
BSc BEng
Database Manager
Hiran initially qualified as a Biomedical Engineer and has experience in a number of areas
including equipment maintenance and research engineering. Hiran is currently working as
our database manager and considerable expertise in extracting data from the Clinical
Data Warehouse, expertise in management of the Data Quality of data entered into the
Data Warehouse. She is planning her PhD in the area of data mining to commence in
2009.
Melissa Lassig-Smith
Dip App Sc (Nursing) Grad Dip (Adv Nursing) Grad Dip (Crit. Care) MNursing (Crit Care)
Research Co-ordinator, DICM
Melissa graduated from QUT, Brisbane in 1988 and has completed a Graduate Diploma in
Critical Care, Graduate Diploma in Advanced Nursing and a Masters of Nursing in Critical
Care. As well as working in the roles of clinical nurse, clinical learning facilitator and acting
clinical nursing consultant in intensive care at RBWH, she has experience at overseas sites
including Ealing General Hospital, UK and St Paul‘s Hospital, Canada. Melissa has
received The Sir Ian McFarlane Award for Clinical Excellence. For the last year she has
been seconded to a research role within DICM. Her role includes involvement in all aspects
of studies in intensive care from initial proposal to completion.
8
Dr Peter Thomas
BPhthy (Hons) PhD
Senior Physiotherapist, DICM
Peter‘s main interests are in intensive care and acute care physiotherapy. Peter completed his PhD in 2007,
investigating patient positioning in intensive care and its effect on oxygenation, respiratory mechanics and
haemodynamics. Peter is a Faculty member of the Queensland Skills Centre and has developed and
continues to deliver intensive care and cardiopulmonary courses to postgraduate physiotherapists.
Anita Plaza
BPhty (Hons I)
Senior Physiotherapist, Burns Unit
Anita is the senior burns physiotherapist within the RBWH Burns Unit and has over ten years
clinical and research experience in paediatric and adult burn injuries. She has previously
completed large audits and publications on the incidence and functional outcome of patients
with heterotopic ossification, axillary contractures, and polyneuropathy after burn injuries and
has been an invited speaker at national and international burns conferences. She has
previously been awarded a scholarship to visit burns units in Canada and the US and has
recently been awarded the Queensland Health Allied Health Research Scholarship to
investigate exercise and metabolism following adult burn injuries.
Renae Deans
BNurs Cert Crit Care
Senior Research Co-ordinator, DICM
Renae holds additional qualifications of advanced training in hyperbaric nursing and critical care
nursing as well as her basic nursing qualifications. Renae is the senior research co-coordinator of
the BTCCRC. She is involved in all projects from protocol writing to publication, subject recruitment,
data collection, communication and liaison with other study co-coordinators and study sponsors.
Renae has managed a number of large trials in the unit and regularly attends the clinical trials
group meetings.
Cheryl Fourie
BNurs Cert Crit Care
Cheryl has worked with Queensland Health since 1989 during which time she specialized in
both Anaesthetics and Intensive Care. She has attained a Bachelor of Nursing, a Grad Cert in
Critical Care, and an Assoc. Dip in Anaesthetic Techniques. Cheryl has also previously held the
position of Clinical Learning Facilitator for new nursing staff within ICU. In her role as Research
Co-ordinator, Cheryl is involved in research studies taking place within the ICU, from proposal to
completion as well as communication and liaison with study sponsors and other co-ordinators.
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Janine Stuart
BNurs
Janine has worked at RBWH, specializing in Neurosurgical Intensive Care from 1991, as
clinical nurse and acting clinical nurse consultant from 1996. She has completed the
Graduate Certificate in Critical Care at QUT. Since 2004 she has been active in the role of
research co-ordinator and is involved with all research currently being completed with the
unit. She assists in writing proposals, obtaining ethics approvals, writing grants, data collection and publishing
research articles.
Paul Jarrett
Dip (He) Nurs
Paul moved to Australia in 2004 from the UK where he initially studied Biomedicine at the
University of Greenwich. Towards the end of his course he focussed more on the clinical
aspect of the industry and transferred to a nursing course at Greenwich University. Upon
arriving in Australia he commenced work at the RBWH on medical wards both as a nurse
and discharge case manager and after that transferred to ICU. After 2 years clinical
experience, he became a Research Co-ordinator. In 2009, he will be involved in several
ICU projects while studying a Master of Applied Science (Research) at QUT. He is
currently working on his proposal for submission to the academic board.
Sharon Forbes
BSc Grad Dip Nut & Diet
Dietitian, RBWH
Sharon has 18 years experience as a clinical dietitian in hospitals in the UK and Australia
and has worked at RBWH since 1996 covering various clinical areas including renal,
oncology and ICU. Her research interests focus on studies investigating the energy
requirements of adult burns patients. In the last 5 years, Sharon has worked in the burns
unit at RBWH where her current research aims to measure energy expenditure during the
acute and recovery phases post burn, using indirect calorimetry. She is the founding
member of the Australian & New Zealand Burns Dietitians Interest Group.
Kellie Stockton
BAppSc (Physio) Post Grad Dip (Cardiothoracic)
Research Assistant, BTCCRC
Kellie‘s expertise is in the area of physiotherapy, intensive care and exercise physiology, pre
and post transplantation. During the past year, she has predominantly been involved with
studies investigating exercise capacity in patients following burn injury including commencing a
new trial to measure the physiological response to maximal exercise testing in the burn
population. Kellie has a keen interest in exercise in disease states and will be commencing
her PhD in the area in 2009 through UQ School of Medicine.
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Dr Andrew Dalley
BSc(Hons) PhD
Research Officer, BTCCRC
Andrew is a practical research scientist with post-doctoral experience of cell biology and
analytical techniques. Formerly based in the UK, he studied pharmacology and completed his
PhD at The University of Sheffield. He performs microdialysis, sample analysis via liquid
chromatography mass spectrometry (LCMS) and ELISA and pharmacokinetic modeling of
antibiotic distribution in burns patients as part of an ongoing NHMRC funded project. Andrew
provides laboratory and logistical support to a variety of clinical and in vitro studies within
Centre and the Therapeutics Research Unit at the Princess Alexandra Hospital. Research interests include drug
distribution in the critically ill , pathophysiology of burn wound healing, extracellular matrix biology and its application
to tissue engineering and epithelial/mesenchymal interactions during the healing of cutaneous wounds.
Jason Roberts
BAppSc BPharm (Hons I)
Clinical Pharmacist RBWH, Doctoral Graduate
Jason currently holds an appointment as a Clinical Pharmacist at RBWH and is a doctoral
candidate. His thesis aims to devise pharmacokinetic models for various antibiotics in critically-ill
patients with sepsis using a technique known as microdialysis. Jason‘s Principal Supervisor is
Professor Jeffrey Lipman with Dr Sheree Cross and Professor Michael Roberts acting as
associate supervisors.
Dr Steve Wallis
BSc (Hons) PhD
Laboratory Manager
Steve has over a dozen years of bioanalysis experience since developing his first HPLC
method during his PhD. In 1998-2000 he ran the BTCCRC (then Anaesthesiology and Critical
Care) research laboratory, measuring antibiotic levels in a number of pharmacokinetic studies
with Jeff Lipman. Steve recently spent 6 years managing the throughput of a commercial
bioanalysis facility conducting clinical trials for pharmaceutical companies, working to standards
of GLP, ISO17025 and the requirements of regulators such as the TGA, FDA and EMEA. Steve
took the position of BTCCRC Laboratory Manager in mid-2008. His focus is to build on the lab‘s past successes and
advance its bioanalysis capabilities and reach.
Dr Sia Athanasas-Platsis
BSc MSc (Qual) PhD
Research Manager
Sia completed her PhD studies in 1993 with the Department of Surgery, UQ where she
investigated the immunoregulatory and growth regulatory properties that early pregnancy factor
(EPF, aka XTOL) exerted on the mouse embryo. During her post-doctoral years, she studied
EPF‘s immunotherapeutic properties against an animal model of multiple sclerosis which paved the
way for Phase I and II clinical trials managed by biotech company, CBio. Sia worked for 4½ years
at the Australian Institute for Bioengineering and Nanotechnology, where she engineered red
blood cells from hematopoietic stem cells. She currently provides research co-ordination, research
support and management support to the Centre whilst maintaining research and financial
databases.
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Since it‘s inception in 2002, the BTCCRC has expanded from 3 staff to an impressive 46 staff and students in
2008. With this growth, the research focus on burns, critical care and trauma over the years has expanded to
include anaesthesia and more recently, emergency medicine.
Our clinical research is based on a solid foundation of multidisciplinary expertise, including intensivists, burns
surgeons, anaesthetists, cardiologists, neurosurgeons, emergency physicians, scientists, physiologists,
nutritionists, physiotherapists and intensive care nurses. The collaboration and cross fertilization in these
teams increases the enthusiasm and skill of these personnel. A number of hospital staff have undertaken or
are currently undertaking postgraduate degrees within our centre or combine clinical work with research.
RESEARCH
THEMES
Our laboratory research is closely allied with our clinical research. The major themes developing within the
centre are:
1.
2.
3.
4.
5.
6.
7.
8.
Antibiotic resistance and infection control in the critically ill.
Pharmacokinetics and drug distribution in the critically ill.
Management and outcome of
critically ill, trauma, head injury
and long stay ICU patients.
Critically ill patients with renal
dysfunction.
Management and outcome of burns patients including pain
control, myocardial dysfunction, exercise and metabolism and
fluid and nutritional management post burn.
Anaesthesia.
Emergency medicine.
Multi-centre trial collaborations.
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2. Pharmacokinetics and drug distribution in the
critically ill
1. Antibiotic resistance and
infection control in the critically ill
In hospitals today, especially in intensive care units, there
are a number of pathogens or infections emerging which
are resistant to most drugs. These commonly occur in
long stay, debilitated patients and contribute to increased
risk of death, longer ICU and hospital stay, further
weakness and long term dysfunction. This problem also
contributes to patients being unable to be discharged
from intensive care and/or hospital and so exacerbating
the shortage of acute hospital beds and increases in
surgery waiting time.
Projects related to antibiotic resistance and infection in
the critically ill include:
Predicting the risk of invasive candidiasis in critically ill
patients. Sorrell TC, Lipman J, Playford EG, Jones M,
Iredell JR, Paterson D, Marriott D
Fundor: NHMRC
Multi-centre Australian and New Zealand study of
antibiotic utilisation in the ICU. Lipman J, Dulhunty J,
Paterson D
Antibiotic cycling in intensive care. Iredell J, Gallagher J,
Lipman J, Boots R, Gilbert L
Fundor: RBWH Foundation
An International Epidemiological Study of Candidaemia in
a Critical Care Population Holley A, Dulhunty J, Lipman J,
Dancer C
Fundor: RBWH Foundation
Multi-drug resistant Acinetobacter: an emerging
noscomial pathogen. Schembri M, Lipman J, Nimmo G,
McEwan A, Jennings M
Fundor: RBWH Foundation & RBWH
Transmissible resistance in bacteria: effect of antibiotic
selection pressure. Iredell JI, Partridge S, Lipman J,
Gilbert GL
Is empiric anti-enterococcal therapy necessary?
Implications and outcome from an Antibiotic Cycling
Study in the ICU. Chatterjee I, Dulhunty J, Lipman J
Critically ill patients often require different dosages of
antibiotics and other drugs, particularly if they are on
renal replacement therapies. Professor Jeff Lipman has
pioneered work that demonstrates that patients in
intensive care are not receiving enough antibiotics to
achieve optimal levels to kill pathogens. There is also a
controversy over whether bolus dosing or continuous
infusion of β-lactams is more effective in antibiotic
delivery in critically ill patients. This centre is using the
technique of microdialysis in an attempt to answer this
controversy.
Microdialysis is an in vivo
technique that permits
monitoring of local
concentrations of drugs and
metabolites at sites in the
body other than within the
blood stream. The
technique is based on the passive diffusion of a
compound along its concentration gradient from the
tissue through the membrane into the dialysate.
Samples can be easily obtained from the interstitial
space and can provide numerous data points from a
relatively small number of samples to determine detailed
pharmacokinetic information.
Projects which are investigating pharmacokinetics and
drug distribution in the critically ill are:
Drug dosing in the ―at risk‖ critically ill patient. Lipman J,
Roberts MS, Paterson D, Kirkpatrick CMJ, Kruger P,
Roberts JA
Fundor: NHMRC
Estimation of drugs, peptides and metabolites using
HPLC- Mass-spectrometry-microdialysis. Roberts M,
Cross S, Lipman J, Colditz P, Rudd M, Dalley A
Fundor: Mayne Bequest Fund
Microdialysis for pharmacokinetic modeling of
Piperacillin Tazobactam & Meropenem (continuous
infusion or intermittent bolus dosing) in critically ill septic
patients. Roberts J, Lipman J, Cross S, Dalley A,
Do intra ICU bed movements increase the risk of cross- Roberts M
infection? R Deans, J Stuart, M Lassig-Smith & M Woods Fundors: Australian and New Zealand College of
Fundor: Qld Health Nursing Research
Anaesthetists, RBWH. Foundation
13
Pharmacokinetics of cephalothin, vancomycin and
gentamycin used for antimicrobial prophylaxis during
elective abdominal aortic aneurysm surgery. Douglas A,
Roberts J, Lipman J
Reduction of cardiac complications of non cardiac
surgery patients during surgery. Marwick T, Lipman J,
Venkatesh B, Walker P, Atherton J
Fundors: NHMRC
The collection and use of excised surgical tissue from
burns patient during grafting procedures for antibiotic
distribution analysis. Lipman J, Rudd M
Optimal pattern of manual hyperinflation in the
ventilated patient. Paratz J, Thomas P, Savian C,
Lipman J
Microdialysis analysis of interstitial antibiotic
concentrations in burn and other critically ill patients.
Lipman J, Muller M, Roberts M, Cross S, Deans R,
Dalley A, Venkatesh B
Fundors: NHMRC, RBWH Foundation
A point prevalence survey of venous thromboembolism
prophylaxis management in the critically ill and an
epidemiological observational audit of venous
thromboembolism prophylaxis management in critically
ill patients with severe sepsis (VTE AUDIT).
Gowardman J
Imaging of the microcirculation using the Microscan
(orthogonal polarization spectral imaging) and providing
improved quality of drug analysis for PK studies in
critically ill patients. Lipman J, Paratz J, Boots R, Muller
M, Dalley A
Fundors: NHMRC/UQ
The clinical experience of nitric oxide use in the adult
ICU at the RBWH. Boots R
An audit of select indices of injury severity including the
Injury Severity Score; the Trauma and Injury Severity
Score and the Revised Trauma Score of trauma
Investigation of the distribution of antibiotics by patients managed in the Royal Brisbane & Women‘s
microdialysis in renal failure particularly during Hospital from 2003-2005 to establish the potential to
continuous renal replacement therapy. PhD topic Magid determine a requirement for Intensive Care Unit
H, Lipman J
involvement. Holley,A, Douglas A
3. Management and outcome of critically ill, head
injury and long stay ICU patients
Patients who survive intensive care often are weak,
debilitated and with a poorer quality of life compared to
their pre morbid status. We are actively investigating
methods to prevent weakness and loss of function in
long stay intensive care patients. There are also many
projects investigating the optimum delivery of standard
procedures to ensure that the best quality of care is
offered to intensive care patients.
The damage occurring to the central nervous system in
head injury and subarachnoid haemorrhage often
impacts on other systems. For this reason we are
investigating how active management of cerebral
perfusion pressure impacts on renal function
Projects which are investigating management of head
injury, critically ill and long stay intensive care patients
are:
Does active management of cerebral perfusion
pressure in head injury patients effect creatinine
clearance? A prospective observational study using
self controls. Senthuran S & Lipman J
11-β-hydroxysteroid dehydrogenases activity in critical
illness. Cohen J
Fundors: Australian and New Zealand College of
Anaesthetists
Early proactive rehabilitation in intensive care: RCT
Paratz J Boots R, Chang A, Lingwood B, Thomas P,
Lipman J
Fundors: University of Queensland, RBWH Foundation
Developing a research base for intravenous peripheral
catheter resites. The DRIP trial. Rickard C, Webster J,
Gowardman J, Wallis M, McCann D
Fundor: NHMRC
SAVED - Study of practices and complications
associated with central venous and arterial
catheterisation in an ICU population. Gowardman J,
Rickard C
14
Readmission to Intensive Care – analysis of baseline &
emergent risk factors and outcomes. Gowardman J,
Dulhunty J, Bandeshe H, Makris N, Paratz J
Cardiac arrest and hypothermia. McLoughlin S, Dulhunty
J, Gowardman J
Incidence and outcome after Hypernatraemia in ICU
patients. O‘Donoghue S, Dulhunty J
Endothelin, a marker of severity in subarachnoid
hemorrhage vasospasm. Bellapart J, Fourie C, Stuart J,
Boots R, Paratz J
but in the long term cosmetic and functional issues. There
is a critical need to improve the treatment and outcomes of
burnt and critically ill patients. The burns unit at RBWH is
one of the largest in Australia and has instituted a large
number of studies investigating initial cardiac function with
large burns, management of pain, antibiotic efficacy,
nutrition issues, exercise post burns, prevention of
heterotopic ossificans. With increased collaboration with
other burns units in Australia, this unit should be able to
improve both the survival and outcome of burns patients.
Projects which aim to improve the management and
outcome of burns patients include:
Cerebral blood flow haemodynamics in patients with
Effects of resuscitation fluids (hypertonic saline and
cardiogenic shock treated with intra-aortic counterpulsation Hartman solution) and oncotic agents (albumin and
balloon pump (IABP). Bellapart J
dextran) on both physiological parameters (tissue pH,
transepidermal water loss, erythema) and antibiotic
Correlation of SVCvO2 and IVCvO2 values in a general
pharmacokinetics in blood and tissue in burns.
ICU/HDU patient group. Comadira G, Lipman J, Deans R Ranasinghe K, Cross S, Roberts M, Dalley A, Venkatesh
B, Lipman J
4. Critically ill patients with renal dysfunction
This is a relatively new area of collaboration with the
Department of Renal Medicine. Patients with existing
renal dysfunction can have additional problems if they
become critically ill especially with issues of drug dosage,
weaning from mechanical ventilation and overall
outcome.
Projects associated with this area are:
Outcomes of end stage renal failure patients on dialysis
admitted to intensive care. Senthuran S, Bandeshe H,
Ranganathan D, Boots R
The collection and use of excised surgical tissue from
burns patient during grafting procedures for antibiotic
distribution analysis. Lipman J, Rudd M
Randomised placebo controlled trial of pregabalin in the
treatment of neuropathic pain following severe burn injury
in humans. Gray P, Williams B, Lipman J, Cramond T
Neurotransmitters and pain receptors following burn injury
in a pre-clinical model and assays of pain medicines and
their metabolites both in the clinical and pre-clinical model.
Gray P, Lipman J, Cramond T
The analysis of morphine perfusion in burned and normal
tissue using microdialysis in burn injured patients. Gray P,
Cross S, Dalley A, Muller M, Lipman J, Cramond T
Inspiratory muscle training in renal failure. Paratz J,
Thomas P, Nataatmadja M, Kark A
Investigation of the distribution of antibiotics
by microdialysis in renal failure particularly
during continuous renal replacement therapy. PhD
topic Magid H, Lipman J
A survey of patients with healed burn injury to determine
the incidence and impact of persistent pain. Gray P
5. Management and outcome of burns patients
including pain control, myocardial dysfunction,
exercise and metabolism and nutritional
management post burn.
Indirect Calorimetry to monitor changes in energy
requirements of adult burn patients. Forbes S, Ash C,
Muller M, Paratz J, Rudd M, Lipman J
Metabolism and exercise post-burn injury. Muller M, Paratz
J, Rudd M, Lipman J, Plaza A, Boots R
Thermal injury is a devastating injury, not only for the
immediate concern of risk of loss of life and extreme pain,
15
Myocardial function post-burn injury. Paratz J, Lipman J,
Boots R, Muller M, Rudd M, Deans R, Widdicombe N,
Parsonage W
6. Anaesthesia
Se Troponin in ASA 3 – 5 Patients Predictive Ability.
Tooth J, Taraporewalla K
Feedback Performance for Clinicians . Taraporewalla K
Competence Assessment of Basic Clinical Skills in Critical Care of Medical Students. Taraporewalla K, Cox L
Phenomenology of the Ways BTY 1 & BTY 2 Perceive
the Act of Learning Anaesthesia. Culwick M, Cumpston
P, Taraporewalla K
Impact of Single Episode of Knowledge Retrieval Skills.
Michener K, Taraporewalla K, and Reynolds H
tients with community-acquired infection. Williams J,
Paterson D, Lipman J, Greenslade J, Brown A, Paratz J,
Dulhunty J, Chu K.
Accelerated pathway in the assessment of acute coronary syndrome in the DEM. Cullen L, Brown A, Than M,
Greenslade J, Hammett C, Hou X-Y, Ungerer J, Chu K,
Parsonage W.
Evaluation of a new massive transfusion protocol for exsanguinating trauma patients. Hurn C, Muller M, Cook S,
Chu K, Greenslade J, Hou X-Y, Campbell D, Holley A,
Rowell J.
Triaging older major trauma patients in the Emergency
Department. Lukin W, Chu K, Greenslade J, Hou X-Y,
Brown A.
Haemodynamic change associated with positioning of the A randomized controlled trial comparing patient controlled
Andrew‘s Spinal Table . Cumpston P, Antoniazzi P
sedation (PCS) versus physician controlled sedation with
propofol in patients requiring procedural sedation in the
The Vocal Cord – Carina Distance in Anaesthetised
ED. Bell A, Chu K, Lipp T, Duncan A, Rothwell S.
Adults and Its Clinical Implication on Tracheal Tube Design. Pang G, Greenland K
Validation of CARING criteria: A diagnostic accuracy
study for predicting who should have an Advance Health
Comparison of the C-Trach, Classic Laryngeal Mask and Directive (AHD). Richardson P, Chu K, Greenslade J.
Proseal Laryngeal Mask with the Aintree Catheter against
Direct Laryngoscopy with the Single-Use Bougie for
End-of-Life Issues – Withdrawal of treatment/Decision not
Simulated Unstable Cervical Spine Injuries. Greenland
to treat in the Emergency Department: A retrospective
K, Edwards M, Tan H, Donaldson A, Irwin M, Reynolds H multi-centre review. Richardson P, Chu K, Greenslade J.
An Evaluation of Three Levels of Personal Protective
Equipment (PPE) For Avian Influenza in a Negative Pres- 8. Multi-centre trial collaborations
sure Environment. Burke J, Greenland K, Brazil V
The RBWH Department of Intensive Care Medicine and
Survey of Rural Anaesthetists‘ Management of Tracheal the Burns, Trauma and Critical Care Research Centre are
Intubation for Patients With Difficult Airways. Eley V,
site investigators for the following multi centre trials.
Greenland K, Lloyd B, Reynolds H
Normoglycaemia in Intensive Care Evaluation (NICE) –
Randomised controlled trial of two target ranges for gly7. Emergency medicine
caemic control in intensive care unit patients.
Principal Site Investigator: J Lipman
New to our research centre this year, the Department of
Emergency Medicine‘s (DEM) research focus centres
The extended study on prevalence of infection in intenaround improving outcomes and evaluating new procsive care: EPIC II.
esses for treating patients in the ED.
Principal Site investigator: J Lipman
Projects include:
The Sepsis Registry: A prospective database to characterise and facilitate improved outcome for admitted pa
16
Multi-centre trial collaborations (cont’d)
Multicentre, unblinded, randomised, controlled trial to assess the effect of augmented vs. normal continuous renal
replacement therapy (CRRT) on 90-day all-cause mortality of intensive care unit patients with severe acute renal
failure (ARF) (RENAL study).
Principal Site Investigator: R Boots
Testing a home based rehabilitation program for the survivors of a critical illness or injury: A randomised controlled trial.
Principal Site Investigator: J O‘Sullivan, L Aitken
Safe translation of research into practice study (SAFE
study).
Principal Investigator: J Lipman
ASia Pacific Evaluation of Chest pain Trials (ASPECT
study).
Principal Site Investigator: L Cullen
17
MYOCARDIAL FUNCTION IN CRITICALLY ILL BURNS PATIENTS
Paratz J, Muller M, Boots R, Lipman J
The process of injury following a severe burn is
multifaceted and complex, with large amounts of fluid
resuscitation required in the first 48 hours. Current
scientific evidence suggests that the heart is
damaged directly during this time, by chemicals that
are leaked into the body from the burn during this
critical time. This study documented cardiac
changes in the first seven days post burns and
investigated if excess fluid loading causes
myocardial damage and whether alterations in
cardiac function relates to percentage of total burn
surface area (%TBSA) or presence of sepsis.
On admission to the ICU, haemodynamic monitoring
was applied and cardiac index (CI), systemic
vascular resistance index (SVRI), stroke volume variation (SVV) and central venous oxygenation saturation (ScvO 2)
were monitored, together with blood which was assayed for B type natriuretic peptide (NTproBNP) and troponin
(cTnI). Fluid volumes and inhalation injury were also documented.
So far sixteen patients have been studied ranging from 22-80 %TBSA (16 males, mean age 39, 18-62 years). A
Friedman test indicated there were significant changes in CI (p<0.001), SVV (p<0.01) and SVRI (p<0.001) between
the 2nd and 3rd days post burn, with haemodynamics altering from hypodynamic with systemic vasoconstriction to
hyperdynamic with systemic vasodilatation. ScvO2 was above lower limits of normal at all times. There was no
Troponin leak in any patient post burn, however there was a significant increase in NTproBNP between Day 3 and
Day 4 post burn (p<0.001). There was no significant correlation between fluid volumes, %TBSA and
haemodynamic changes or increases in NTproBNP, however presence of proven sepsis was associated with
increased CI (p<0.01) and decreased SVRI (p<0.01).
Understanding what happens to the
heart after a burns injury will provide
important guidelines towards
management of the heart and overall
management of the burns patient.
Preliminary results of this study indicate that
haemodynamics alter abruptly during the 2nd and 3rd
days after burns, initating haemodynamic changes in
septic shock, but unrelated to the size of burn or fluid
volumes. If the patient develops proven sepsis, there are
further significant alterations in CI, SVRI and NTproBNP.
This information will guide management in these patients
and assist in developing further interventional studies.
This study won the prize for best clinical research at the RBWH 2008 symposium and will be presented at the
American Burns Association Annual Scientific meeting in Texas, USA, 2009
18
We welcome to our research centre, the researchers and research physicians from the
Department of Emergency Medicine (DEM), RBWH. They have added a new dimension to our
research profile, bringing with them skills and experience in trauma, emergency care, early
diagnosis of coronary conditions and sepsis, to name a few.
WELCOME ON
BOARD
The Sepsis Registry: A prospective database to characterise
and facilitate improved outcome for admitted patients with
community-acquired infection. Team Leader Dr Julian
Williams
The accelerated pathway stratifies individuals into low or high
risk of acute coronary syndrome 2 hours after presentation to the
ED. To do so, it uses ECG, formally published risk stratification
tools (the Vancouver chest pain rule) and cardiac biomarkers
(Troponin I, creatine kinase-MB-isoenzyme, B-type natriuretic
Infection cost the Australian healthcare system millions of dollars peptide and myoglobin). To assess the pathway, 1000
every year and imposes a significant burden of illness on the
consecutive patients presenting to the RBWH ED with greater
Australian community. Serious infections can cause tragedy at a than 5 minutes chest pain will be recruited. Patients will be
much more personal level, with lethal outcomes possible even in managed and investigated as per standard care. However,
young previously healthy individuals. Despite the significant
additional data will be obtained at two hours to assess the
consequences of these illnesses, we have very limited
pathway.
information about the best way to identify and treat infection in
Australian Emergency Departments (ED).
The sensitivity and specificity of the accelerated pathway will be
assessed against the patients‘ final diagnosis, which will be
This study aims to improve our understanding of infection in ED. made by a cardiologist who is blinded to the index test results.
The cornerstone of the project is a large database which will
Receiver operator characteristic curve analysis will be conducted
capture detailed information on all patients presenting to the ED to establish the discriminatory power of the accelerated pathway
who are subsequently admitted with infection. The database will for the diagnosis of major cardiac events during hospital
be used for a variety of projects. However, initially it will be used admission and at 45 days. This project has the potential to
to 1) identify the number of patients presenting to hospital each markedly reduce the time taken to diagnose chest pain and thus
year with severe infections and the outcome, 2) analyse the
enable early diagnosis or discharge from ED.
factors and information available to doctors in the ED that are
associated with overall prognosis in patients with infection, 3)
Evaluation of a new massive transfusion protocol for
build a comprehensive picture of the spectrum of infective agents exsanguinating trauma patients. Team leader Dr Catherine
that cause patients to be admitted to a typical Australian hospital Hurn
and 4) identify the most appropriate combination of antibiotics
which should be used in the early treatment of the most severely In the most severely injured trauma patients, early use of packed
ill patients with infection. The findings from the studies will
red blood cells in combination with fresh frozen plasma, platelets
ultimately enable doctors to identify severe infection earlier and and coagulation factor concentrates can limit early post traumatic
treat such infections most appropriately.
coagulopathy. However, there are no widely accepted guidelines
or consistency of practice in massive transfusion.
Accelerated pathway in the assessment of acute coronary
syndrome in the DEM. Team Leader Dr Louise Cullen
This project aims to compare physiological and clinical outcomes
of massively transfused patients receiving the new protocol with
those receiving standard care. Specifically, the project will
Chest pain is one of the most common ED presentations, but
establishing a diagnosis remains challenging and resourceexamine if 1) the new protocol results in lower levels of
intensive. Thus, in this study we aim to assess the diagnostic
coagulopathy whilst controlling for other contributing factors such
accuracy of an accelerated pathway for assessing chest pain.
as hypothermia and acidosis and 2) the new protocol results in
19
improved clinical outcomes such as reduced intensive care unit
length of stay, reduced hospital length of stay and improved
survival.
This research has the potential to alter clinical practice in the
transfusion of the massively bleeding patient leading to
improved outcomes for trauma victims in Queensland.
Triaging older major trauma patients in the ED. Team
Leader Dr William Lukin
Older major trauma patients suffer a higher rate of morbidity
and mortality than younger patients despite similar degrees of
injury. Preliminary analysis of major trauma data at the RBWH
suggests that one potential explanation for poorer outcomes in
the elderly is that older patients are triaged to a lower urgency
category on the Australasian Triage Scale (ATS) compared with
younger patients. However, the extent of this under-triaging
across the state of Queensland is unknown. Moreover, the
outcomes of this under-triaging are unclear and have never
been investigated. With the aging of the Australian population,
trauma care of older patients will take on greater significance.
The purpose of this study is to investigate whether older trauma
patients were under-triaged across Queensland and whether
the ATS category is a predictor of outcome. State-wide data will
be attained from the Queensland Trauma Registry. Clinical and
outcome data will be compared between the ≥55 year and <55
year age groups and the effect of age on ATS category will be
sought. Possible reasons for under-triaging will be further
investigated.
The project will examine whether under-triaging of elderly
trauma patients is occurring across Queensland and whether
under-triaging contributes to higher mortality. It will have
implications for the future trauma care delivery in elderly
patients across the state.
A randomized controlled trial comparing patient controlled
sedation (PCS) vs physician controlled sedation with
propofol in patients requiring procedural sedation in the
ED. Team Leader Dr Anthony Bell
Procedural sedation with propofol is frequently used in ED for
reduction of fractures and dislocations, electrical cardioversions
and other painful but brief procedures. Presently, propofol is
administered by the Emergency Physician. However, recent
evidence suggests that PCS may have a number of potential
benefits over physician controlled sedation.
Despite arguments for the benefits of PCS, no studies have
examined its efficacy within an ED setting. Thus, we are
conducting a randomised controlled trial to compare PCS with
doctor administered sedation for painful procedures performed
in the ED. The study will compare depth and length of sedation,
patient satisfaction and adverse events between the two
groups. The project has the potential to improve safety and
satisfaction for patients requiring procedural sedation in the ED.
Validation of CARING criteria: A diagnostic accuracy
study for predicting who should have an Advance Health
Directive (AHD). Team Leader Dr Philip Richardson
AHD are legal documents that outline patients‘ desires for endof-life care. They are an important part of a dying patients‘
treatment plan but very few patients hold these documents.
This study looks to see whether we can identify individuals
who are nearing the end of their lives, and therefore, should
have an AHD. In identifying people nearing the end of their
lives, a clinical tool called CARING criteria will be used. This
tool was designed in the United States and uses demographic
and clinical information to identify patients who are likely to die
within 12 months. In its original setting, the CARING criteria
was highly accurate. However, no research has examined
whether this tool is valid in the Australian ED setting.
This study will assess the tool by looking at charts of 1000
patients. Those meeting the CARING criteria will be identified.
After 12 months, a search of the state death register will be
conducted to determine whether individuals have deceased.
Accuracy of the CARING criterion for predicting mortality will
be determined. If the tool is accurate, we can apply it to all
patients presenting to the ED and provide AHD counselling to
those who meet the criteria. This will ensure that the care
provided to patients at the end of their lives is sensitive and
meets their needs.
End-of-Life Issues – Withdrawal of treatment/Decision not
to treat in the ED: A retrospective multi-centre review.
Team Leader Dr Philip Richardson and Dr Neil
Widdicombe
Not infrequently, ED physicians have to decide on how they
are to provide treatment to dying patients. Specifically, they
have to decide whether to actively treat or limit/withdraw
treatment on patients who are not anticipated to live. Such
decisions should be governed by legislature as well as
standards set by the Australian Council on Health Care
Standards. However, research conducted at RBWH has
indicated that doctors consider a wide variety of factors
including patient‘s and family‘s wishes when making such endof-life decisions. We therefore raise the following questions. 1)
What factors do doctors take into account when they
withdrawal/withhold treatment in the ED? 2) Are such
decisions made in accordance with legislative requirements?
To date, no research has examined this issue.
This study addresses this gap by focussing on the decisions
leading to withdrawal of treatment in the ED. It is a multi-centre
review of patients in a number of Australian and New Zealand
hospitals. The primary aim is to describe the factors that
doctors consider when making decisions to withdraw/withhold
life-sustaining treatment. The secondary aims are to determine
1) whether Australian doctors are conducting such processes
in line with guidelines, 2) whether Queensland doctors are
making such decisions in accordance with Queensland
legislation.
20
Professor Anthony FT Brown
MBChB FRCP FRCSEd FACEM FCEM
Senior Staff Specialist and Professor of Emergency Medicine
Tony received his medical education and training in the UK. He was recently promoted to full Professor of
Emergency Medicine. He is a founding member of Emergency Medicine Evaluation and Research Group Queensland (EMERG-Q), a group of QLD-based emergency clinicians interested in promoting, organising and
running emergency medicine research in QLD and founding member of MoLIE (More Learning In
Emergency) Project at the RBWH for QLD Health, a focussed modular learning system in emergency
medicine for first year ED Interns. Tony‘s particular research interests are in chest pain pathways, the epidemiology of anaphylaxis
and clinical reasoning in medical education. He is the recipient of numerous awards including Excellence in Teaching awards, the
QuARRIE award and the Foundation 20 Medal. He is also Editor-in-Chief of Emergency Medicine Australasia, is on the Editorial
Board of and peer reviewer for the Emergency Medicine Journal in England, as well as the Medical Journal of Australia.
Dr Kevin Chu
MBBS MS FACEM
Senior Staff Specialist & Director of Research
In addition to his above mentioned roles, Kevin is Senior Lecturer with the School of Medicine, UQ.
He received his undergraduate training at UNSW and specialist training in Sydney. He has worked in
the USA where he completed a Master of Science in Clinical Research Design and Statistical
Analysis at the University of Michigan. He is a reviewer for the Emergency Medicine Australasia
Journal and a member of the EMERG-Q. He is an adjudicator for the Australasian College for
Emergency Medicine trainee research papers and a member of the College‘s Clinical Trial Subcommittee. Kevin has several
research interests and holds several research grants. His current interests include the utility of diagnostic tests in clinical
decision making, building a research culture within DEM and collaboration with other Emergency Medicine investigators across
the state and country.
Dr Jaimi Greenslade
BPsych (Hons) PhD
Research Officer
Jaimi Greenslade undertook a PhD in psychology and conducts research focussing on how workplace stress,
culture and fatigue on one hand influences on nurses performance and patient outcomes on the other hand.
Since commencing at the RBWH ED, she has been involved in a broad range of projects aimed at optimising
care within the ED.
Dr Catherine Hurn
MBBS FACEM
Staff Specialist
Cath is an emergency physician and trauma specialist. She trained in the UK and Australia, and
has recently been appointed as consultant to the Trauma service at RBWH. She has
considerable experience as an aeromedical retrievalist and in clinical co-ordination of interhospital
transfers in Queensland. Cath‘s experience in medical education includes 3 years as the Director
of Emergency Medicine Training at RBWH. Her current research interests include massive
transfusion and team training for trauma. She was the recipient of an inaugural Statewide Trauma
Network Research Grant for her work in massive transfusion in trauma.
Dr Louise Cullen
MBBS FACEM
Staff Specialist
Dr Louise Cullen is a staff specialist with a research focus on acute coronary syndromes and has recently
commenced a PhD in this area. She has also been awarded $200 000 to conduct a two year study into the
early diagnosis of Acute Coronary Syndrome. She also is investigating intern modelling tools.
21
Dr Janet Hou
BMed MMed PhD
Research Fellow
Janet is a Research Fellow at RBWH DEM, as well as a full-time Senior Lecturer in Epidemiology in
School of Public Health at QUT and Associate Lecturer in School of Medicine at UQ. Janet graduated
with a Bachelor of Medicine from Shandong University, a Masters of Medicine from Peking University
(PKU) and a PhD from QUT. Janet worked as a team doctor at the China National Athlete Training
Centre in Beijing and an Associate Professor at PKU. Her current research interests include emergency system management,
ED overcrowding, triage and trauma. She is a co-investigator on a number of projects and supervises four PhD students and
one MPH student.
Dr William Lukin
MBBS FACEM
Senior Staff Specialist
In addition to his role as Senior Staff Specialist, Bill is also acting Deputy Director of the Department of
Emergency Medicine at RBWH. Bill received his training in Emergency Medicine at the RBWH. His primary
research focus is in trauma and to advance this research he recently was awarded a grant by the Statewide
Clinical Trauma Network to investigate the following project "Triage of Older patients in Trauma". Bill‘s other
area of research interest lies in Aged Care. He is a member of The Australasian Trauma Society.
Dr Philip Richardson
MBChB FACEM LLB
Senior Staff Specialist
Philip is an emergency physician with interest and expertise in medico-legal issues confronting the
medical field today. He is the recipient of 2 inaugural Queensland Emergency Medicine Research
Foundation (QEMRF) grants, one investigating the medico-legal concerns surrounding End-of-Life
Issues and the other, a diagnostic study to determine who should have an AHD.
Dr Anthony Bell
MBBS FACEM
Staff Specialist
Anthony is the recipient of a QEMRF grant to investigate patient controlled sedation with propofol, an anaesthetic frequently
used in ED. Recent evidence suggests that patient controlled sedation may have a number of potential benefits over physician
controlled sedation. Firstly, with a suitable dose and lockout interval, patients can self-administer an appropriate level of
sedation without risk of over dose. Secondly, patient comfort and therefore satisfaction maybe imparted by patient controlled
sedation as patients experience a greater sense of control.
Dr Victoria Brazil
MBBS FACEM MBA
Staff Specialist
In additional to her role as a staff specialist in DEM, Victoria is the Director of Medical Education and
Training for Queensland Health, and is the Director of Medical Education Solutions, a teaching and
learning-focussed company. Her research interest is education and training and she was integral in
conceiving and implementing a structured training program for interns in the ED known as MoLIE.
Dr Julian Williams
MBBS FACEM
Staff Specialist
Dr Julian Williams is a staff specialist in DEM and PhD student with the UQ . His research interest is sepsis
and he is conducting a large study aimed at collecting data on all individuals admitted to the hospital with
infection. In 2008 he was awarded $200 000 from the QEMRF to fund his sepsis research over the next
two years.
22
GRANT FUNDING FOR 2008
Grant Title
Granting Body
Investigators
Amount
Predicting the risk of invasive
candidiasis in critically ill patients
NHMRC
512307
Sorrell T, Lipman J, Playford EG,
Jones M, Iredell J, Paterson D, Marriott D
$1 200 350
Drug dosing in the "at risk" critically ill patient
NHMRC
519702
Lipman J, Roberts MS, Paterson D,
Kirkpatrick CMJ, Kruger P, Roberts
JA.
$589 000
NHMRC Training
Fellowship
569917
Roberts J
$199 500
Development and evaluation of
an adult burns prevention program
QLD Health Statewide Trauma
Clinical Network
Muller M, Paratz J, Dulhunty J,
Harris J
$88 000
Evaluation of a new massive
transfusion protocol for exsanguinating trauma patients
Clinical Network
Hurn C, Chu K, Muller M, Greenslade J, Hou X-Y, Cook S, Rowell J,
Campbell D, Ward D, Lowe B, Holley A.
$87 000
Triaging older major trauma patients in the emergency department
Clinical Network
Lukin W, Chu K, Greenslade J,
Hou X-Y, Brown A
$38 000
Antibiotics in critically ill patients
– dosage adjustments in renal
failure and during continuous
veno-venous hemaodialysis
QLD Health – Health
Practitioner Research Scheme
Roberts J, Lipman J
$44 000
Pharmacokinetics of cephalothin/
cephazolin, vancomycin and
gentamicin used for antimicrobial
prophylaxis during elective abdominal aortic aneurysm surgery
RBWH – New specialist
research grant
Douglas A, Lipman J, Roberts J,
Taraporewalla K
$30 000
Antibiotic PK/PD in critically ill
patients undergoing CVVHDF –
using plasma vs subcutaneous
tissue microdialysis to optimize
dosing of β-lactams
UQ Research
Scholarship
Varghese JM
$60 000
Antibiotic dosing in the ―at risk‖
critically ill patient
Glaxo Smith Kline Post Graduate Support grant
Roberts J
$15 000
Glomerular Hyperfiltration in ‗at
risk‘ patients on Admission to the
Intensive Care Unit (GHAU)
Study.
RBWH Foundation
Udy A, Boots R, Roberts J,
Lipman J
$15 000
Assessment of the Microcirculation in Shocked Critically Unwell
Patients during the First 24 hours
of Resuscitation
RBWH Foundation
Holley A, Udy A,
Boots R, Paratz J,
O’Donoghue S, Douglas A, Roberts J, Hurn C, Lukin W, Lipman J
$20 000
Does inhaled heparin prevent
ventilator associated pneumonia?
RBWH Foundation
Boots RJ, Lipman J, Paterson D,
Paratz JD
$20 000
Personalizing β-lactam therapy in
hospitalized patients
23
Grant Title
Granting Body
Investigators
Amount
A phase 2b study to evaluate the
safety and efficacy of intravenous
paracetamol in reducing body
temperature after traumatic brain
injury.
Australian and New Zealand
College of Anaesthetists
Saxena MK, Myburgh JA,
Gowardman JR
$30 000
Pharmacokinetics of cephalothin,
vancomycin and gentamicin used
for antimicrobial prophylaxis during elective abdominal aortic
aneurysm
Australian and New Zealand
College of Anaesthetists
Douglas A, Lipman J, Roberts J,
Taraporewalla K
$45 000
The Sepsis Registry: A prospective database to characterise and
facilitate improved outcome for
admitted patients with community
-acquired infection.
QLD Emergency Medicine Research Foundation
Williams J, Lipman J,
Paterson D, Brown A, Paratz J,
Dulhunty J, Chu K
$200 000
Validation of CARING criteria: A
diagnostic accuracy study for
predicting who should have an
Advance Health Directive (AHD).
Richardson P, Chu K, Greenslade
J
$47 000
A randomized controlled trial
comparing patient controlled
versus physician controlled sedation with propofol in patients requiring procedural sedation in the
Emergency Department.
Bell A, Chu K, Lipp T, Greenslade
J, Duncan A, Rothwell S
$25 250
Accelerated pathway in the assessment of suspected acute
coronary syndrome in the Emergency Department
Cullen L, Brown A, Than M,
Greenslade J, Hammet C, Hou XY, Ungerer J, Chu K, Parsonage W
$175 300
End-of-Life Issues – Withdrawal
of treatment/Decision not to treat
in the Emergency Department: A
prospective multi-centre review.
Richardson P, Chu K,
Greenslade J
$50 000
OTHER FUNDING
RBWH
Foundation
Wormald
Security
QLD Health Smith &
Clinical Re- Nephew
search Skills
Development
Registrar
Astra Zeneca Edwards Life Mayne Be- TOTAL
Sciences
quest Fund
$50 000
$50 000
$60 000
$10 000
$15 000
24
$10 000
$75 000
$270 000
Our students
are
endeavouring
to improve
patient
outcomes
through
innovative,
world class
research.
Here’s what
they have to
say about
their research
projects and
study through
the BTCCRC.
Jason Roberts
Brooke Winzer
Paul Gray
Clinical Pharmacist
PhD Graduate
Physiotherapist
PhD Student
Anaesthetist
PhD Student
Antibiotic concentrations are a
major consideration in the treatment of infectious diseases. Low
concentrations at the site of the
infection will predispose to
therapeutic failure and the development of antibiotic resistance, an area of particular concern for critically ill patients.
Barrett‘s oesophagus is an
acquired condition in which
cells lining the oesophagus
transform into cells resembling
the lining of the intestines. The
condition is a risk factor for
cancer of the oesophagus and
is therefore considered a premalignant condition.
My PhD project has sought to
determine the concentrations of
two beta-lactam antibiotics,
piperacillin and meropenem, in
plasma and subcutaneous tissue of intensive care unit patients. The pharmacodynamic
indices of these antibiotics suggest that maintaining concentrations above the minimum inhibitory concentration will optimise
drug exposure and lead to better
patient outcomes.
My PhD study will determine
whether exercise can influence
the progression of Barrett‘s
oesophagus to oesophageal
cancer via reducing cancer
biomarkers—factors that have
been indicated in cancer development. An increase or
decrease in biomarkers will be
used to indicate whether exercise is beneficial in reducing
cancer risk.
The principal findings of this
research show that administration of these drugs by continuous infusion, achieves target
pharmacodynamic endpoints, in
both plasma and subcutaneous
tissue, far more successfully
than intermittent dosing which
remains the current standard of
practice.
STUDENT
SHOWCASE
25
We hypothesise that participating in a 6 month exercise program will alter biomarker levels. Such changes would indicate a reduced risk of developing oesophageal cancer.
As a senior staff specialist in
pain medicine and anaesthesia, I have been involved in the
pain management for patients
following burn injury.
The lack of research in this
challenging area prompted me
to enrol part-time in a PhD candidature with the project title of,
‗Neuropathic pain following
burn injury - an examination of
mechanism and treatment in
the pre-clinical model and in
the clinical setting‘.
The research has progressed
well with recent completion of a
randomised placebo controlled
trial of pregabalin in burns patients. This trial focussed on
the neuropathic-like pain after
burn injury - early analysis of
the data suggests that pregabalin is effective at reducing
the burning element of the pain
and also itch after burn injury.
Other projects that are planned
include an animal study examining the mechanism of pain
after burn injury and an epidemiological study that examines
the long term incidence of neuropathic pain after burn injury.
Study within BTCCRC is great.
My supervisors are excellent
and I have access to a great
work environment and resources. I would recommend
study through the centre to any
It is hoped that research in this
potential student.
area will improve pain management strategies and long-term
outcome for people with burn
injury.
Greg Orchard
Julie Varghese
Julian Williams
3rd Year Medical Honours
Student
Clinical Pharmacist
PhD Student
Emergency Physician
PhD Student
Continuous Venovenous
Haemodiafiltration (CVVHDF),
a form of dialysis is commonly
used in ICU. Recent studies
have highlighted the importance of antibiotic dosing of
critically ill patients with renal
failure showing inappropriate
dosing of patients, exposing
them to treatment failure and
higher mortality rates. My project aims to study the distribution and clearance of β-lactam
antibiotics in critically ill patients
with renal failure undergoing
CVVHDF, in an effort to optimise drug dosing.
Infection, cost the Australian
healthcare system millions of
dollars every year and impose a
significant burden of illness on
the Australian community. Serious infections can cause tragedy at a much more personal
level, with lethal outcomes possible even in young previously
healthy individuals. Despite the
significant consequences of
these illnesses, we have very
limited information about the
best way to identify and treat
infection in Australian Emergency Departments (ED).
Heterotopic Ossificans (HO)
after severe burn injury often
occurs at the elbow, with decreased range of motion or joint
fusion resulting in impaired
Students Enrolled in
functional activity and daily livOther Schools who are ing skills.
co-supervised by our
staff
The overall aim of my study is
Lawrence Caruana (SOMC) MPhil
to investigate factors associated
Electrical impedance tomography &
with HO in burns patients at
positioning. Supervisors - A/Prof J
RBWH Burns Unit. I will review
Fraser, Dr J Paratz, Dr A Chang
the charts of patients who deBrooke Wadsworth (SHRS, UQ)
veloped HO and those of paMPhil Abdominal bracing in spinal
tients without HO who had been
patients. Supervisors - Dr J Paratz,
admitted to the RBWH. Data
Dr T Haines
analysis will be used to i) highAlison Mandrusiak (SHRS, UQ)
light possible risk factors for
PhD Exercise testing in CF patients. development of HO, ii) explore
Supervisors - Dr P Watter, Dr J
outcomes/consequences from
Paratz
its development and iii) formulate a disodium etidronate comHelen Nicolson (Vet Science, UQ)
PhD CPAP in a canine model of
mencement profile in relation to
respiratory distress. Supervisors - Dr burn, clinical and radiological
J Paratz, Dr P Mills
signs of HO; dosage, route and
duration of treatment; adverse
James Walsh (SHRS, UQ) PhD
Which factors predict success in
effects; interacting medications;
pulmonary rehabilitation? Supervimedication cessation and reasors - Dr J Paratz, Dr A Chang
sons why.
David Koh (University of Tasmania)
PhD Vascular access. Supervisor Dr J Gowardman
Risk factors that are likely to
lead to HO development will be
further defined in relation to our
Niall Higgins (Skills Development
population group so that future
Centre) PhD Videoconferencing
education and overseas trained spe- patients may be monitored for
cialists. Advisors—A Prof M Steyn, the occurrence of HO or the pre
A Prof K Taraporewalla
-emptive initiation of preventative therapies. Appropriateness
of disodium etidronate therapy
in HO patients, adverse effects
complicating treatment and the
significance of these will be
determined.
I will use a technique called
microdialysis to measure tissue or ‗target site‘ drug concentrations and compare this
with concentrations in plasma.
This study will be using the
population pharmacokinetic
approach which utilizes pharmacokinetic (PK) computer
software to develop a PK
model that describes the significance of the many clinical
and demographic variables
that can have an influence on
the PK of drugs in patients
undergoing CVVHDF. Dosing
recommendations for β-lactam
antibiotics in critically ill patients with renal failure undergoing CVVHDF will be developed.
26
I am completing a PhD thesis
focusing on patients who present to the ED with community
acquired infection. This research aims to identify the factors that are apparent early during the course of infection that
may predict a poor outcome. In
addition, I also aim to improve
the immediate treatment of sepsis syndromes by determining
and optimising various aspects
of care, including antibiotic administration and fluid resuscitation. This ground breaking body
of research is likely to have a
significant impact on the way
that sepsis is identified and
managed in the emergency
setting in Australia.
Paula Jeffries
Suhasini Singh
Hamza Mahmoud
Medical Student 4th Year
Medical Student 4th Year
Visiting Anaesthetist
I am a fourth year medical student from the University of Melbourne undertaking a research
year with the BTCCRC. During
my time here, I have been working with Dr John Gowardman
and the ICU research nurses on
the SAVED Study. This is a pilot
study investigating two different
in-situ methods of diagnosing
Catheter Related Bloodstream
Infection (CR-BSI), a common
diagnostic challenge in modern
Intensive Care Units today.
The SOFA score is an indicator
of organ dysfunction severity and
is widely used in critical care
medicine. A multitude of studies
have documented correlations
between SOFA scores and mortality however the predictive
power of the SOFA score at admission to ED has not yet been
assessed. It is hypothesised that
this early SOFA score at ED admission will have a significant
relationship with outcome. This
ED assessment of illness severity would provide a true reflection
of patient physiology and illness
severity without the distorting
influence of ICU resuscitation.
Numerous studies have also
demonstrated the correlation of
delta SOFA with outcome. This
study differs in that the initial
SOFA score, used as the baseline in delta SOFA calculation, is
determined at ED admission
rather than at ICU admission.
I am an Anaesthetist and lecturer
at the Sohag University Hospital
in Egypt and have accepted a
Research Fellowship within the
centre. My research interests lie
in Cardiothoracic Anaesthesia
and ICU. Whilst visiting the
BTCCRC, I am working on the
SAVED (Sepsis Associated with
Vascular-devices; Easier Diagnosis) project. This study is investigating the feasibility and effectiveness of a new diagnostic
strategy for intra-vascular devices sepsis in ICU patients with
both Intra Arterial Lines (AL) and
Central
Venous
Catheters
(CVC).
Upon clinical suspicion of infection, current practice is to remove the catheter and culture
the tip to diagnose CR-BSI.
However, approximately 75% of
central catheters that are removed from patients due to
suspicion of infection are found
to be clean. This results in unnecessary removal leading to
additional risks to patients as
well as extra burden on an already stretched workforce.
I am a fourth year medical student undertaking my advanced
It is hoped that the data collected medical science program with
from this surveillance study will the BTCCRC. I have thoroughly
assist in gaining more funding to enjoyed my time here, not only
run a larger study, ultimately
because of the world-class facilileading to reducing wastage and ties but most importantly, beimproving clinical practice.
cause of the wonderful people
with whom I have worked.
I have greatly appreciated the
knowledge and experience
gained while working with the
team at BTCCRC.
27
Patients with a CVC and AL will
be screened daily for suspicion
of device related infection. IVDs
suspected of sepsis will still be
removed as per current practice;
however, additional skin, blood
and hub cultures will be performed to determine (1) if device
removal was necessary and (2)
effectiveness of new techniques
to diagnose infection expeditiously.
Papers
Brazil V, Brown AFT, Markwell A. The MoLIE Project: Enhancing capacity for intern training in the Emergency Department
(Poster). 25th Annual Scientific Meeting, ACEM, Wellington, New
Zealand. Nov 2008.
Brazil V, Brown AFT, Greenslade J, Markwell A. Measuring the
impact of an Emergency Medicine term on interns‘ knowledge
and skills (Poster). 25th Annual Scientific Meeting, ACEM, Wellington, New Zealand. Nov 2008
Forbes S, Gillen L, Lipman J, Muller M, Paratz J. Measured
vs predictive energy requirements in adult burns patients Australian and New Zealand Burns Association ASM Melbourne,
September, 2008.
Roberts JA, Kirkpatrick CMJ, Field J. Population pharmacokinetics of gentamicin in critically ill patients with renal failure undergoing slow low efficiency dialysis. Society of Hospital Pharmacists of Australia National Conference, Adelaide,
September 2008.
Roberts JA, Descourvieres L, Hine B, Schmidt P. Venous
thromboembolism and stress ulcer prophylaxis in neurosurgical patients admitted to a tertiary hospital: results of a QA
audit. (Poster) Society of Hospital Pharmacists of Australia
National Conference, Adelaide, September 2008
Forbes S, Forbes M, Giumelli L, Green J, Hickey G, Jeffrey R,
Kumis R, Mills L, Nicholls C, Young V. Predictive energy equations – which should we use? Australian and New Zealand
Burns Association ASM Melbourne, September, 2008.
Gray P. (Poster) International Association for the Study of Pain
– triennial meeting. Glasgow, August, 2008.
Gray P. (Poster) Pain After Burn injury. Faculty of Pain Medicine ASM. Sydney, May 2008.
Holley A. Autumn Symposium ACEM Queensland Faculty.
Massive transfusion, Gold Coast., 2008.
Holley A. Blood substitutes: Science fiction or coming to an
ICU near you? Annual Scientific Meeting , JFICM & ANZICS.
Melbourne, June 2008.
Holley A. Getting the BASICs of critical care right: a model for
military medical education. Australian Military Medicine Association ASM. Hobart, October 2008.
Ranasinghe K, Venkatesh B, Lipman J, Dalley A, Robertson
T, Roberts M and Cross S. (Poster) The effect of choice of resuscitation fluid on interstitial tissue antibiotic distribution in
acute thermal injury in rats.14th Congress of the International
Society for Burn Injuries. Canada, Oct, 2008.
Paratz J, Lipman J, Boots R, Muller M. Myocardial dysfunction in burns Australia and New Zealand Burns Society Melbourne, September, 2008.
Steer MW, Lewis PA , Wright K, Webster A, Cinco R, Gardner G, Rudd M . A randomized controlled trial comparing
aqueous crème and bees wax crème in the provision of relief
from post burn itch. Australian and New Zealand Burns Association ASM Melbourne, September, 2008.
Thomas P. Ventilated and in intensive care - a demanding
arena for the standardised patient. SimTech Healthcare
Simulation Conference, Brisbane Australia.
Finnane A , Hou X-Y : Emergency Department Performance
in Australian Hospitals in 2004 – 2007, ACEM Annual Conference, Wellington, New Zealand 2008
O’Donoghue S. Acquired hypernatraemia is an independent
predictor of mortality in ICU patients. JFICM ASM
Paratz J, Lipman J, Boots R, Muller M. Myocardial dysfunction in burns. RBWH Symposium, October, 2008 .
Plaza A, Paratz J, Stockton K, Boots R, Muller M. Exercise
and metabolism post burn injury Australian and New Zealand
Burns Association ASM Melbourne, September, 2008.
28
Xiang-Yu Hou: The different university teaching approach between Australia and China – from a Chinese academic‘s perspective, in Proceedings of the Second Australia-China SymLipman, J. 14th World Congress of Anaesthesiologists. Cape
posium on Science, Technology and Education. The FederaTown, South Africa. Mar 2008.
tion of Chinese Scholars in Gold Coast, Australia. Oct 2008.
Invited papers
Lipman, J. Australasian Society for Infectious Diseases. Sunshine Coast, Australia. Apr 2008.
Lipman, J. 21st Annual European Society of Intensive Care
Medicine meeting. Lisbon, Spain. Sept 2008.
Lipman, J. 33rd Australian and New Zealand Annual Scientific
Meeting on Intensive Care. Sydney. Oct 2008.
8th
Lipman, J.
National Chinese Critical Care Society Meeting.
Guangzhou, China. Nov 2008.
Paratz J. Septic shock, do we have a role? Australian and New
Zealand Intensive Care Society Asia Pacific Critical Care conference, Sydney, Australia. Oct, 2008.
Paratz J. Invited by Kasturba Medical School, Manipal University, India. Care of the Critically Ill patient. May, 2008.
Roberts JA, Kirkpatrick CMJ, Roberts MS, Lipman J. Piperacillin dosing in ICU patients – New magic for old bullets. Ehrlich II World Conference on Magic Bullets, Nuremberg, Germany. Oct 2008.
Greenland KB. A Reappraisal of Difficult Airway Management. ANZCA Scientific Meeting. May 2008.
Greenland KB. The origins of the sniffing position. Combined
Australian Society of Anaesthetists and New Zealand Society
of Anaesthetists Meeting. Oct 2008.
Greenland KB. A Reappraisal of Difficult Airway Management. Hong Kong College of Anaesthesiologists Scientific
Meeting. Nov 2008.
Workshops/Courses
Udy, A. Blood, and Blood Product Usage in the ICU. JFICM
ASM, Melbourne Australia Jun 2008.
Udy, A. Australasian Donor Awareness Programme Medical
ADAPT Course. Brisbane Australia Sept 2008.
Udy, A. Queensland Skills Development Centre. Crisis Resource Management - Train the Trainer. Brisbane Australia
Oct 2008.
Brown AFT. Anaphylaxis. EMCON 2008. 10th Annual Conference, Society for Emergency Medicine, Salem, India. Nov 2008.
Udy, A. Intensive Care Crisis Event Management course
(ICCEM)
Brown AFT. Acute Severe Asthma. EMCON 2008. 10th
Annual Conference, Society for Emergency Medicine, Salem,
India. Nov 2008.
Udy, A. Brisbane Intensive Care Refresher Course
(Instructor).
Brown AFT. The Art of Writing a Paper. EMCON 2008. 10th Annual Conference, Society for Emergency Medicine, Salem, India.
Nov 2008.
Brown AFT. Writing a medical education text. School of Medicine Colloquium, University of Queensland, Brisbane, Aug 2008.
Brown AFT. Low risk chest pain: Pathways and practice.
(Keynote address). ACEM / CENA Qld Faculty Autumn Symposium, Gold Coast, Apr 2008.
Boots RJ. Anaemia in ICU Study. ANZICS Clinical Trials Group
Conference, Noosa Qld Australia.
Boots RJ. Uses and Abuses of Prevelance Studies. ANZICS
Clinical Trials Group Conference, Noosa Qld Australia.
Zhihong Xu, Yonghong Wang and Xiang-Yu Hou (Editor):
Proceedings of the Second Australia-China Symposium on
Science, Technology and Education. . The Federation of Chinese Scholars in Australia. Gold Coast, Australia. Oct 2008
29
Roberts, J.A. Safe Medication Practice Unit Clinical Pharmacist Up skilling Workshop (facilitator). Brisbane 2008.
Roberts, J.A. Pharmacy Practice Preceptor Course – Victorian College of Pharmacy, Monash University, Melbourne.
Douglas, A. Refresher in Military Anaesthesia, Australian
Defence Force, Brisbane Australia.
Boots, R.J. Critical Care and Anaesthesia Ultrasound and
Basic Echocardiology Workshops. Australian Institute of Ultrasound.
Boots, R.J. BASIC Instructors Course. Sydney. Nov 2008
Rudd, M. Royal Australian College of Surgeons. Trauma
Committee Workshop. Medical Administration of Trauma
Care, Melbourne. Nov 2008.
Muller M. Emergency Management of Severe Burns. Brisbane,
Nov 2008 (Director).
Workshops/Courses cont’d
Muller M. Emergency Management of Severe Burns. Adelaide,
Jul 2008 (Director).
Paratz J. Physiotherapy and Critical Care Management, QH
Skills Development Centre (Instructor).
Thomas, P. Physiotherapy and Critical Care Management,
QH Skills Development Centre (Instructor).
Thomas, P. Introduction to Physiotherapy Cardiorespiratory
Management for Medical and Surgical Settings, QH Skills
Development Centre (Instructor).
Thomas, P. Cardiorespiratory Physiotherapy for Overseas
Qualified Physiotherapists, QH Skills Development Centre
(Instructor).
Thomas, P. Intensive Care Update Course, Rockhampton
Base Hospital (Instructor).
Gray P. Education of Health Professionals in the care of patients with persistent pain. Australian Pain Society ASM,
Perth. Mar, 2008.
Trauma service RBWH (founding director).
Bellapart, J.
EURONEURO Conference, Maastrich, Netherlands, January 2008 (organiser).
Roberts, J.A.
Committee member – University of Queensland Clinical
Pharmacy Management Committee
Committee member – Queensland Health Drugs and Therapy Protocol Steering
Committee (Population Health Branch) Hon. Secretary,
Society of Hospital Pharmacists of Australia (Qld Branch)
Boots, R.L.
Chair Queensland Regional Committee JFICM
Member QHealth Intensive Care Workforce Committee
Convenor ASM JFICM Brisbane 2009
Chair Medical Emergency Response Training Program
RBWH
Member Point Prevalence Group Clinical Trials Group
Hou, X-Y.
Australasia epidemiology Association, teleconferences
(organiser)
Brown AFT, Holzhauser K. Science and Art of Writing a Paper
(Workshop). ACEM / CENA Qld Faculty Autumn Symposium,
Gold Coast. Apr 2008.
Thomas, P.
Clinical Case Study, Australian Critical Care Nurses ICE
Conference, Brisbane Australia (panel session).
Physiotherapy Research Foundation Grants (reviewer).
Faculty Member—Qld Skills Development Centre
Greenland KB. Hong Kong examination technique workshop
for the ANZCA final examination. Nov, 2008.
Brown, A.F.T.
Professional Organisation
Activities
Grants Advisory Committee of the Queensland Emergency
Medicine Research Foundation (QEMRF).
Scientific Advisory Committee of the QEMRF.
Trainee Research Committee, Undergraduate Education
Committee — Australasian College for Emergency Medicine.
Editor-in-Chief - Emergency Medicine Australasia
Editorial Board & reviewer - Emergency Medicine Journal
Lipman, J.
ICU Management (Editorial Board)
The Open Respiratory Medicine Journal (Editorial Board)
Anaesthesia and Intensive Care (Editorial Board)
Intensive Care World Monitor (Editorial Board)
Australian Red Cross blood advisory committee
Rudd M
Treasurer of Australian and New Zealand Burn Association
Medical Director of Queensland skin banking service
Paratz, J.
Chief censor for Australian College of Physiotherapists
President Cardiopulmonary Physiotherapy Australia (Qld
branch)
Faculty Member—Qld Skills Development Centre
Steyn M
Chairman, Anaesthesia and Peri-operative statewide network
Medical Advisory Panel for Queensland Health
eHealth Research Investment and Advisory Committee
Muller, M.
Queensland Trauma Symposium convenor and session
chair. " Bleeding blood blunt force trauma" (panel session).
Trauma review committee RBWH (co-chair).
Gray P
Interim chair of the Queensland regional committee of
the faculty of pain medicine ANZCA
Honorary secretary of Medical Benevelont Association of
Queensland
30
Journal Articles
Aitken LM, Hendrikz JK, Dulhunty JM, Rudd MJ.
Hypothermia and associated outcomes in seriously
injured trauma patients in a predominantly subtropical climate. Resuscitation. 2008 (ePub Dec 9).
Beckman LA, Edwards MJ, Greenland KB.
Differences in two new rigid indirect laryngoscopes.
Anaesthesia. [Journal Article Correspondence].
2008;63:1385-6.
Boots RJ, Egerton W, McKeering H, Winter H. They
just don't get enough! Variable intern experience in
bedside procedural skills. Intern Med J. 2008 (ePub
date Sept 2).
Boots RJ, Phillips GE, George N, Faoagali JL.
Surveillance culture utility and safety using lowvolume blind bronchoalveolar lavage in the
diagnosis of ventilator-associated pneumonia.
Respirology. 2008 Jan;13(1):87-96.
Boots RJ, Weedon ZJ. Fire-eater's lung. Anaesth
Intensive Care. 2008 May;36(3):449-53.
Brown AFT Embracing the power and challenge of
change. Emerg Med Australas 2008; 20:449-450.
Brown AFT. Current management of anaphylaxis.
Emergencias. Accepted for publication 2008.
Brown AFT. What makes for a good journal?
Emergencias. Accepted for publication 2008.
Cartner M, Holley A, Allworth A. False impressions
from clear cerebrospinal fluid and a normal
computed tomography scan: the pressure is still on
for a diagnosis. Emerg Med Australas. 2008 Jun;20
(3):276-9.
Chu K, Brown AF, Lukin W. Local trends in
emergency department attendances by older
patients in an aging national population. Aus Health
Rev. Accepted for publication 2008.
Chu K, Brown AFT. Association between access
block and time to parenteral opioid analgesia in renal
colic: A pilot study. Emerg Med Australas. Accepted
for publication 2008.
Chu K, Evans R, Emerson G, Greenslade J, Brown
AFT. Magnesium sulfate vs placebo for paroxysmal
atrial fibrillation: A randomized clinical trial. Acad
Emerg Med. Accepted for publication 2008.
Crit Care Resusc. 2008 Sep;10(3):253-6.
31
Ducan AL, Bell AJ, Chu K, Greenslade JH. Can a
non-contact infrared thermometer be used
interchangeably with other thermometers in an adult
emergency department? Australasian Emergency
Nursing Journal. 2008;11:130-14.
Dulhunty JM, Boots RJ, Rudd MJ, Muller MJ,
Lipman J. Increased fluid resuscitation can lead to
adverse outcomes in major-burn injured patients, but
low mortality is achievable. Burns. 2008 May; 34:
1090-97.
Publications
Powered
Ahead
in
2008
Dulhunty JM, Lipman J, Finfer S. Does severe non
-infectious SIRS differ from severe sepsis? : Results
from a multi-centre Australian and New Zealand
intensive care unit study. Intensive Care Med. 2008
May: 34: 1654-61.
Eley V, Lloyd B, Scott J, Greenland K. Availability
of difficult airway equipment to rural anaesthetists in
Queensland, Australia. Rural and Remote Health
8:1020 (Online) 2008, pp. 1-9, available from http://
www.rrrh.org.au.
Gowardman JR, Robertson IK, Parkes S, Rickard
CM. Influence of insertion site on central venous
catheter colonization and bloodstream infection
rates. Intensive Care Med. 2008 Jun;34(6):1038-45.
Gray P, Williams B, Cramond T. Successful use of
gabapentin in acute pain management following
burn injury: a case series. Pain Med. 2008 Apr;9
(3):371-6.
Gray P. Acute neuropathic pain: diagnosis and
treatment. Current Opinions in Anaesthesiology.
[Review]. 2008;21(5):590-5.
Greenland KB, Eley V, Edwards MJ, Allen P, Irwin
MG. The origins of the sniffing position and the
Three Axes Alignment Theory for direct
laryngoscopy. Anaesth Intensive Care. [Journal
Article]. 2008;36(Suppl 1):23-7.
Greenland KB, Pang G, Donaldson AE, Frouws
MW. Failure of the classic LMA and Aintree catheter
with bronchoscope for tracheal intubation while
performing manual inline stabilisation. Anaesth
Intensive Care. 2008 Mar;36(2):279-80.
Greenland KB. A proposed model for direct laryngoscopy
and tracheal intubation. Anaesthesia. 2008 Feb;63(2):15661.
Roberts JA, Lipman J, Blot S, Rello J. Better outcomes
through continuous infusion of time-dependent antibiotics to
critically ill patients? Curr Opini Crit Care. 2008;14(4):390-6.
Greenland KB. The sniffing and extension-extension
position: the need to develop the clinical relevance.
Anaesthesia. 2008;63(9):1013-4.
Roberts JA, Lipman J. Pharmacokinetic issues for
antibiotics in the critically ill patient. Crit Care Med 2008
(accepted September 9th 2008)
Holley A. Synthetic blood products: science fiction or
coming to an ICU near you? Crit Care Resusc. 2008 Sept;
10 (3):253-56.
Roberts JA, Paratz JD, Lipman J. Continuous infusion of
beta-lactams in the intensive care unit--best way to hit the
target? Crit Care Med. 2008 May;36(5):1663-4.
Koh DB, Gowardman JR, Rickard CM, Robertson IK,
Brown A. Prospective study of peripheral arterial catheter
infection and comparison with concurrently sited central
venous catheters. Crit Care Med. 2008 Feb;36(2):397-402.
Roberts JA, Paratz JD, Paratz E, Boots RJ, Lipman J.
Continuous Infusion of Time-dependent Antibiotics: Lung
Pharmacokinetics and Pharmacodynamics. Clin Pulm Med.
2008;15(3):167-72.
Makris N, Bellapart J, Boots RJ. An unusual case of intraabdominal apoplexy. Anaesth Intensive Care. 2008 Mar;36
(2):257-9.
Roberts JA, Roberts MS, Robertson TA, Cross SE,
Lipman J. A novel way to investigate the effects of plasma
exchange on antibiotic levels: use of microdialysis. Int J
Antimicro Agents. 2008 Mar;31(3):240-4.
Myburgh JA, Higgins A, Jovanovska A, Lipman J,
Ramakrishnan N, Santamaria J. A comparison of
epinephrine and norepinephrine in critically ill patients.
Intensive Care Med. 2008 Dec;34(12):2226-34
O'Donoghue SD, Dulhunty JM, Bandeshe HK,
Senthuran S, Gowardman JR. Acquired hypernatraemia is
an independent predictor of mortality in critically ill patients.
Anaesthesia (2008), in press.
Omar S, Burchard AT, Lundgren AC, Mathivha LR,
Dulhunty JM. Increased lactate production in septic shock:
a marker of survival? Intensive Care Med (2008), in press
Pang G, Edwards MJ, van der Westhuizen R, Greenland
KB. Vocal Cords-Carina distance in anaesthetised
caucasian adults and its clinical implications. British Journal
of Anaesthesia (2008), in press
Paratz JD, Thomas PJ. A case of near fatal laryngospasm.
Aust J Physiother. 2008;54(4):291-2.
Senthuran S, Bandeshe H, Ranganathan D, Boots R.
Outcomes for dialysis patients with end-stage renal failure
admitted to an intensive care unit or high dependency unit.
Med J Aust. 2008 Mar 3;188(5):292-5.
Swor RA, Compton S, Domeier R, Harmon N, Chu, K.
Delay prior to calling 911 is associated with increased
mortality after out of hospital cardiac arrest. Prehospital
Emergency Care. 2008;12(3): 333-335.
Tuppin MP, Paratz JD, Chang AT, Seale HE, Walsh JR,
Kermeeen FD, O‘Neil K. Predictive utility of the 6-minute
walk distance on survival in patients awaiting lung
transplantation. J Heart Lung Transplant. 2008 Jul;27
(7):729-34.
Wadsworth BM, Haines TP, Cornwell PL, Paratz JD.
Abdominal binder use in people with spinal cord injuries: a
systematic review and meta-analysis. Spinal Cord (2008), in
press
Putt MT, Watson M, Seale H, Paratz JD. Muscle stretching
technique increases vital capacity and range of motion in
patients with chronic obstructive pulmonary disease. Arch
Phys Med Rehabil. 2008 Jun;89(6):1103-7.
Roberts DM, Roberts JA, Boots RJ, Mason R, Lipman J.
Lessons learnt in the pharmacokinetic analysis of the effect
of haemoperfusion for acute overdose with sustainedrelease diltiazem. Anaesthesia. 2008 Jul;63(7):714-8.
Roberts JA, Kruger P, Paterson DL, Lipman J. Antibiotic
resistance-What's dosing got to do with it? Crit Care Med.
2008 Jul; 36:2433-40.
32
Book Chapters
Udy A, Roberts JA, Boots R, Lipman J. Dose Adjustment
and Pharmacodynamic Considerations for Antibiotics in
Severe Sepsis and Septic Shock. In Sepsis:New Strategies
for Management. Rello J, Restrepo MI, editors. SpringerVerlaag, London; 2008. p. 97-102.
Brown AFT, Lipman J. Pre-hospital Care. In Mechanical
Ventilation: Clinical applications and pathophysiology. Eds
Papadakos PJ, Lachmann B.
Saunders Elsevier,
Philadelphia, 2008.
Jones A, Ntoumenopoulos G, Paratz J. Management of the
Critically Ill Patient. In Cardiopulmonary Physical Therapy.
Eds Pryor J and Prasad A . Churchill Livingstone Elsevier,
London; 2008. p. 270-312.
Lipman J. Tetanus. In Oh’s Intensive Care Manual 6th Edition,
Elsevier, London (in press).
Lipman J. Principles of antibiotic use. In Oh’s Intensive Care
Manual 6th Edition, Elsevier, London (in press).
Savian C, Paratz J, 1. Positive end-expiratory pressure in the
manual resuscitation bag 2. Manual hyperinflation as a
secretion manoeuvre technique. In International Respiratory
Care Clinics and Technology, Editorial Mason/
GrupoAulamedica (in press).
Venkatesh B, Cohen J. Adrenocorticol insufficiency in critical
illness in Oh’s Intensive Care Manual 6th Edition, Elsevier,
London (in press).
Holley A, Lipman J. Principles of Pharmacology in the
Critically Ill. In Critical Care Nephrology. Second edition. 2007.
Editors; Claudio Ronco, Rinaldo Bellomo, John Kellum. In
Press.
Xiang-Yu Hou: Chapter 13: The Impact of Globalisation on
Health. In Fleming and Parker, Introduction to Public Health,
page 307 – 331, Elsevier Australia, Melbourne, October 2008.
Brown AFT. ―Acute Pulmonary Oedema‖. Chapter in
―Emergency Medicine. The Principles of Practice‖, 5th edition,
ed Fulde GWO. Elsevier, Sydney. In press 2008.
Brown AFT. ―Anaphylaxis‖. Chapter in ―Oxford Textbook of
Medicine‖ 5th Edition, eds Warrell DA, Cox TM, Firth JD, Benz
EJ. Oxford University Press, Oxford. In press 2008.
Brown AFT. Section Editor for sections on Resuscitation;
Critical Care; Endocrine; Metabolic; Rheumatology;
Dermatology; O&G and Pain in ―Textbook of Adult Emergency
Medicine‖ 3rd edition, eds Cameron P, Jelinek G, Kelly A-M,
Murray L, Brown AFT. Churchill Livingstone, Edinburgh. In
press 2008.
33
Brown AFT. Chapters on ―Diabetes Mellitus and
Hypoglycaemia: An Overview‖ chapter 11.1; ―Musculoskeletal
and Soft Tissue Emergencies‖ (with Dr A Tzannes) chapter
14.4; ―Abnormal Vaginal Bleeding in the Non-pregnant
Patient‖ (with Dr S Bryan) chapter 19.4; ―Local
Anaesthesia‖ (with Dr T Ercleve) chapter 22.2; and
―Anaphylaxis‖ chapter 28.7. In ―Textbook of Adult Emergency
Medicine‖ 3rd edition, eds Cameron P, Jelinek G, Kelly A-M,
Murray L, Brown AFT. Churchill Livingstone, Edinburgh. In
press 2008.
Taraporewalla K. Surgery in the elderly patient. In Making
choices in anaesthesia. Eds Tucker A, Allori Melbourne,
2008
Academic Achievements and
Awards
Anthony Brown. Appointed as a full professor – Professor
of Emergency Medicine, Discipline of Anaesthesiology and
Critical Care, School of Medicine.
Anthony Brown. Selected for Grants Advisory Committee of
the Queensland Emergency Medicine Research Foundation
(QEMRF).
Anthony Brown. Elected to Scientific Advisory Committee of
the QEMRF.
Jenny Paratz. RBWH symposium 2008 – Best clinical
research paper.
Brooke Winzer. University of Queensland Women's College
Postgraduate Residential Scholarship, 2008.
Teaching
Jeffrey Lipman
Specialties II, Critical Care Course, MBBS Year 4,
Sepsis Symposium, MBBS Year 2
Basic Assessment & Support in Intensive Care
(BASIC) course — intensive care trainees, senior
nurses, medical officers
Jenny Paratz
PHTY 2230, PHTY 3250, PHTY 7825 (Adjunct Lecturer, SHRS, UQ)
QLD Skills Development Centre—Physiotherapy &
Critical Care Management (PACCMan )
Examiner for Australian College of Physiotherapy
Jason Roberts
Adjunct lecturer, School of Pharmacy, Queensland
University of Technology
Invited lecturer, Monash University, Victorian Pharmacy College of Practice
Michael Muller
1st Year MBBS, Burns Lectures
3rd Year MBBS, Burns Clinic
2nd Year MBBS, Burns Lectures
Intensive Care Paramedics students, Burns Lectures
Brooke Winzer
PHTY 3250, PHTY 4304, PHTY 7825 (UQ)
John Gowardman
Examiner for JFICM, RACP, ANZCA
Andrew Udy
BASIC Course, Skills Centre
Undergraduate Medical Education
Robert Boots
BASIC Course , Skills Centre
Transcranial Doppler Training Course
Examiner RACP
Queensland Ambulance Transport Ventilation
QHealth Telemedicine Intensive Care Tutorial
Xiang-Yu Hou
Epidemiology, undergraduate and postgraduate
program (School of Public Health, QUT)
Alex Douglas
Medical Emergency Response Team [MERT] course
Military Critical Care Air Transport [MCAT] course
BASIC course, Skills Centre
In addition, many of the
staff employed by or
affiliated with BTCCRC
are involved in registrar
and senior registrar
teaching and provide
extensive in-service
education programs.
Anthony Brown
Examiner, ACEM
MBBS Program , UQ
Year 4 Specialties Iand Specialties II
Year 2 Large Group Teaching
Year 1 students in interactive clinico-pathological
Peter Thomas
PHTY 3250 (UQ)
QLD Skills Development Centre—Physiotherapy &
Critical Care Management (PACCMan )
Australian Physiotherapy Association Cardiorespiratory Update Course
Physiotherapy post-graduate masters program, Griffith University
Masters of Cardiorespiratory Physiotherapy program,
University of Sydney, Clinical Tutor
Intensive care clinical placement, RBWH, for UQ
BPhty course
Steve O’Donoghue
BASIC Course, Skills Centre
34
Inaugural BTCCRC
Contribution to
UQ Research Week
This year we hosted a poster and talk session alongside a catered lunch to celebrate UQ Research Week (22 – 26
September 2008). The sessions focussed on the theme ‗What Does it Take to Keep Critically-Ill Patients Alive?‘ The
event was held in the Education Centre at RBWH where attendees heard a talk from our Chair, Dr Jenny Paratz, who
spoke on the various research projects within the centre and clinical pharmacist/PhD graduate, Jason Roberts, whose
talk addressed the importance of antibiotic dosing in ICU patients with renal failure requiring dialysis. The poster session showcased the diversity and quality of both our clinical and lab-based research.
35
BTCCRC Bioanalysis Facility
The BTCCRC boasts research level bioanalysis capabilities that
are out of the reach of most ICU‘s worldwide. For over a decade,
the laboratory has been measuring drug levels in plasma, ultrafiltrate, urine and microdialysate by techniques of HPLC and ELISA,
as well as supporting internal research in other ways.
In 2008, exclusive access has been gained to an Applied Biosystems API2000 LC-MS/MS sited in BTCCRC‘s Block 6 laboratory,
allowing analysis of smaller and less concentrated samples. Additionally, the laboratory has expanded into the new University of
Queensland Centre for Clinical Research (UQCCR) building, enhancing access to equipment and state-of-the-art facilities; fitting
accommodation for our new Shimadzu Prominence HPLC system (pictured right).
Collaborations outside of the RBWH are thriving, with long-standing relationship with the Therapeutics Research
Unit at the Princess Alexandra Hospital who have complementary capabilities in bioanalysis and other techniques
remaining strong. Samples have been received from collaborators in the Northern Territory and plans are underway to extend the bioanalysis services of the BTCCRC to collaborating ICU‘s worldwide.
State-of-the-Art Tissue Culture Facility
This year saw the BTCCRC Science Laboratory move
into the stylish, advanced facilities of the new UQCCR.
The move has helped facilitate collaborations between
the centre and other researchers within UQCCR and
has allowed us access to state-of-the-art equipment
and facilities, such as the tissue culture suites. This,
together with our links to the Tissue Banking Facility
at the RBWH, will help to align our clinical research in
tissue burns with our lab-based cell culture research.
36
QUEENSLAND
Dr Peter Kruger, Prof Bala Venkatesh, ICU
Dr Geoff Playford, Infectious diseases
Princess Alexandra Hospital
Dr Helen Healy, Dr Adrian Kark,
Dr Dwarka Ranganathan
Department of Renal Medicine
A/Prof John Fraser- Intensivist
ICU & Animal Research Centre
The Prince Charles Hospital
Dr Merilyn Banks, Dr Lynda Gillen, Sharon Forbes
Dept of Nutrition and Dietetics
Dr Jonathan Field,
Intensive Care Unit,
Gold Coast Hospital
Prof David Paterson
Consultant Infectious Diseases Physician and Microbiologist
Professor of Infectious Diseases,
University of Queensland
Dr Angela Chang, Dr J Nitz, Dr S Brauer
SHRS
Dr Carl Kirkpatrick
School of Pharmacy
Prof Rob Fassett, Dr Vincent D'Intini
Department of Renal Medicine,
Dr James Lind
Dept of Emergency Medicine
Gold Coast Hospital
School of Medicine
Griffith University
NATIONAL
A/Prof Paul Mills
Vet Pathology & Anatomy
Prof Nick Taylor
La Trobe University, Melbourne
A/Prof David Tuxen, A/Prof Carlos Scheinkestel,
Dr Andrew Davies - ICU
A/Prof Denis Spelman – Microbiology
Dr Alex Padiglione – ID
A/Prof Anne Holland, Carol Hodgson—Physiotherapy
Alfred Hospital, Melbourne
Prof Paul Colditz, Dr Barbara Lingwood
Perinatal Research Centre
Prof Alastair McEwan, Prof Michael Jennings,
A/Prof Mark Schembri , Dr Scott Beatson
Molecular & Microbial Sciences
Prof Rinaldo Bellomo,
Ms Sue Berney - ICU
Prof Lindsay Grayson - ID
Dr Barrie Mayall - Microbiology
Austin & Repatriation Hospital,
Melbourne
A/Prof Graham Nimmo
Queensland Health Pathology Service
Prof Michael Roberts, Dr Greg Medley
Dr Sheree Cross, Dr Thomas Robertson
Therapeutics Research Unit
Prof John Myburgh, Professor Simon Finfer
The George Institute for International Health, Sydney
Prof Zee Upton
Professor and leader of the Tissue Repair & Regeneration
Program, School of Life Sciences.
Queensland University of Technology
37
Dr George Kotsiou
ID/Microbiology
Royal North Shore Hospital, Sydney
Dr Joshua Davis,
Menzies School of Health Research
A/Prof Steve Webb, Dr Geoff Dobb,
Dr KM Ho ICU
Royal Perth Hospital
A/Prof Debbie Marriott - ID/Microbiology
Dr Sam Rudham – ICU
St Vincent’s Hospital, Sydney
Dr Shane Patman
Notre Dame University, Perth
A/Prof Jon Iredell, Professor Tania Sorrell, Dr Heather Giddings
Centre for Infectious Diseases and Microbiology,
Dr Catriona Halliday - Molecular Mycology Laboratory
Dr John Gallagher - ICU
Westmead Hospital, Sydney
INTERNATIONAL
A/Prof Charles Gomersall, Prof Gavin Joynt, Dr Gordon Choi
Anaesthesiology & Intensive Care
Chinese University of Hong Kong
Prof Alice Jones
Hong Kong Polytechnic University
Dr George Ntoumenopolous
St Thomas & Guys Hospital Trust,
London, UK
Prof Andries Gous
School of Pharmacy
University of Limpopo, South Africa
Dr Noelle Lim,
Dept of Anaesthesia & Surgical Intensive Care,
Changi General Hospital, Singapore
Prof Jordi Rello
Critical Care Department
Joan XXIII University Hospital,
University Rovira & Virgili, Spain
Prof Satish Bhagwanjee,
Ms Juan Scribante
Dept of Anaesthesia
University of Witwatersrand, South Africa
Prof Mervyn Singer
Bloomsbury Institute of Intensive Care Medicine
University College London, UK
Dr Alberto Corona
Bloomsbury Institute of Intensive Care Medicine
Dr Guido Bertolini
Laboratory of Clinical Epidemiology,
Institute of Pharmacological Research
Italy
Dr A Peter Wilson
Department of Microbiology,
Dr Martin Than
Dept of Emergency Medicine
University of Otago, New Zealand
Prof Andrew Shorr
Pulmonary & Critical Care Medicine
Washington Hospital Center, USA
Prof Paul Marik
Pulmonary and Critical Care Medicine,
Thomas Jefferson University
Philadelphia, USA
Prof Wolfgang Krueger
Department of Anesthesiology and
Intensive Care Medicine,
Tübingen University Hospital,
Germany
38
Projects for Honours, postgraduate (Masters and PhD) and postdoctoral researchers are possible
through the Burns Trauma and Critical Care Research Centre. There is high expertise in postgraduate
supervision within our research centre.
The centre is also keen to support clinical staff who wish to undertake research projects.
Prospective candidates can obtain further information about postgraduate study from the UQ Graduate
School home page at http://www.uq.edu.au/research/grad-school. This page contains application forms,
scholarship details and information for international students.
Enquiries about research areas and projects that are available should be directed to the Director or Chair:
Professor Jeffrey Lipman
Director, Intensive Care Unit, Royal Brisbane and Women‘s Hospital and
Director, Burns Trauma and Critical Care Research Centre.
Email [email protected]
Phone 61 7 3636 1852
Fax 61 7 3636 3542
Dr Jenny Paratz
Chair, Burns Trauma and Critical Care Research Centre.
Email [email protected]
Phone 61 7 3636 4113
Fax 61 7 3636 3542
Postal Address
Department of Intensive Care Medicine
Level 3 Ned Hanlon Building
Royal Brisbane & Women‘s Hospital
Herston 4006 QLD Australia
39
Research Centre
MAJOR SPONSOR
SUPPORTING SPONSORS
Your donations, gifts and bequests can and will
help save lives and improve the quality of those
lives by supporting our Research Centre
To help fund clinical research contact:
Royal Brisbane & Women‘s Hospital Foundation,
PO Box 94
Royal Brisbane & Women‘s Hospital QLD 4029
Phone (07) 3636 7588 or free call 1300 363 786
Email: [email protected]
Web site: www.rbwhfoundation.com.au

2008 BTCCRC Research Report - School of Medicine

Transcription

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