Local Research
One might have expected research to take a back seat after recent budget cuts, but the opposite is true. Practical research, or 'putting evidence into practice' has become hot property. Research differentiates a small ‘service providing' institution from an academic hospital. Kudos and finance follow. As competition for jobs increases, research experience becomes a valuable addition to any resume.

Ipswich ED participates in several single centre and multicentre trials. Information and packs for the larger ones are in Ed Clin Info, or in the handover office. Your involvement will benefit you even more than us.

CURRENT RESEARCH - SINGLE CENTRE
We are in the process of publishing papers from lung ultrasound data collected in 2011-2012 LUS trial, and are about to reopen an extension of that trial- 'LUS +'.

LUS + adds a cardiac view to the prior LUS protocol. The aim of this research is to give ED registrars a rapid, cheap and more precise tool for diagnosing the cause of breathlessness in older people, particularly at night when xray is delayed.

LUS + is also a way to give our registrars a good start in ultrasound using its most simple and yet value-adding form. Registrars will be allowed to make treatment decisions from their scanning. Lung ultrasound skills are easily extended to recognise pneumonia and local disease, and will start to replace chest xray in the near future. We want Ipswich to lead this change, and it is a great way to get into scanning.

We have also applied for a QEMRF grant to commence our own multicentre trial in 2014, putting LUS into practice.

CURRENT RESEARCH -MULTICENTRE
Ipswich recruits for the ARISE trial, of early goal directed therapy in sepsis- our role is simply to recognise potential participants, start fluids and antibiotics, and then to phone ICU with an early referral. Dr Walsham in ICU is the lead for this trial, and there are some handy lanyard attachments with inclusion and exclusion criteria. This is a great way to get our sick septic patients up and out of the department quickly, so keep the ARISE trial in mind.

Ipswich has recently joined the PRIMARY SPONTANEOUS PNEUMOTHORAX trial. Dr Baker is the site investigator for this trial, and Dr Sarwar is also up to speed on the details (taking over from Dr Soobratty). This is a randomised trial comparing conservative versus interventional treatment in pneumothorax. This is more work for the ED doctor, but benefits in three ways.
1. The doctor is guided through a very clear but detailed and safe management plan for a PNTX, this is a great lesson in itself.
2. The doctor is stepped through the process of recruitment, randomisation and consent. This is also a useful learning experience and goes towards the ACEM - OTA domain of 'participation in research'.
3. The patient benefits from expert followup with the respiratory physicians, no matter whether they get conservative or interventional treatment.

The RAVE II trial is just concluding, which looked at the use of antivenom in redback bites. Dr Bitmead was the site investigator for this trial.

Ipswich has also been entered into the high flow nasal oxygen trial in children with bronchiolitis. CNC Kelly Foster is the lead in this multicentre trial, just awaiting final paperwork. 

Articles
Limited Lung USS
EEO
Chronic Pain
Advances Chronic Pain