research

emergency research

summary

The Emergency Research Group is located in the Royal Children's Hospital's Emergency Department which provides urgent medical care to children and adolescents.

Approximately 69,000 children are seen annually, ranging from newborns to teenagers. The hospital is a paediatric tertiary referral centre and also the only paediatric trauma service for Victoria, receiving trauma patients directly from the accident scene, as well as transfers from other hospitals in Victoria, southern New South Wales and Tasmania.

Our team has a very strong commitment to clinical research. Areas of interest include analgesia and sedation, trauma, mental health and neurological disorders.

We have medical students and post-graduate nursing students completing projects on a yearly basis. Senior paediatric trainees from the Royal Australasian College of Physicians and senior emergency trainees from the Australasian College of Emergency Medicine undertake research projects and, in conjunction with other departments and the University of Melbourne, it is possible to conduct higher degree studies (MD, PhD) in emergency related topics.

group leader(s)

Franz Babl  A/Professor Franz Babl
  Paediatric Emergency Physician
  Associate Professor, University of Melbourne
  Emergency Research
  Royal Children's Hospital
  Flemington Rd
  Parkville
  Victoria 3052

  T +61 3 9345 6160
  F +61 3 9345 5938
  E franz.babl@rch.org.au

  group leader biography

current research projects

Project 1: Trauma

As the only paediatric trauma centre in Victoria we are aiming to improve care for children with trauma on a number of levels. Together with the orthopaedic service we are investigating optimal management strategies for upper and lower limb fractures (Dr Sandy Hopper, Dr Peter Barnett). 

CT scans of the head (brain scans) are vital tools for children after head injuries to detect if there are skull fractures or any bleeding inside the head which might require an urgent operation. At the same time CT scans should only be used when necessary to avoid unnecessary radiation. We are investigating who should receive a CT scan and who can safely be observed in hospital or at home. These studies are conducted In collaboration with leading international head injury researchers (Dr John Cheek, A/Prof Ed Oakley, A/Prof Franz Babl)

Growing out of a project with neuropsychologists from the Department of Psychology we are investigating if blood tests can help determine the presence and severity of head injuries. (Prof Vicki Anderson, A/Prof Franz Babl)

Project 2: Sedation and Analgesia

The aim of the sedation program is to provide safe, effective sedation for procedures that are painful or distressing for children. We developed and evaluated a program to educate and accredit emergency department staff in paediatric procedural sedation which has been adopted by many other emergency departments. Ongoing quality improvement data from the program have created a large prospective data set for the analysis of different sedative agents. We are also investigating how to measure pain and distress in pre-verbal and early verbal children, to be able to reduce the experience of pain in a number of paediatric procedures. (Ms Dianne Crellin, A/Prof Franz Babl)

Project 3: Mental health

We are targeting two vulnerable groups in our emergency department, adolescents in mental health crisis and mothers with post-natal depression. In a multi-faceted program we set out to improve care for the many adolescents presenting to the emergency department with acute mental health problems. We are improving process and policy, staff education, links with mental health professionals and the protection of patients and staff through improved practice. We have established and evaluated changes in practice such as a hospital wide "Code Grey" response team and a 'Safe room' in the emergency department. (Dr Sandy Hopper)

Many young babies present with irritability and feeding problems. Sometimes the issue is more maternal exhaustion and depression rather than a physical problem with the babies. We are currently investigating a screening tool for mother with young children to detect post-natal depression. (Dr Cath Bevan, Dr Amanda Stock)

Project 4: Stroke

Stroke is among the top ten causes of death in children and over half of stroke survivors will experience long term disabilities. The problem is that strokes in children are often not recognised or treated quickly, which is a major concern for the child's immediate survival and their future health and wellbeing. Together with the Department of Neurology we aim to better define the differences in symptoms between brain attacks / mimic and strokes in children, as diagnosis of stroke can be difficult. Quicker recognition has the potential to result in improved diagnosis and enrolment in appropriate treatment plans to reduce brain damage and enhance long term outcomes for children. (Dr Mark Mackay, A/Prof Franz Babl)

Project 5: Large randomised controlled trials

PIMS Paediatric Intravenous Maintenance Solution study. This study is a blinded randomised controlled trial. It aims to determine whether an intravenous fluid with 140mmol/L of sodium is safer than our currently recommended fluid (77mmol/L of sodium) when used for maintenance hydration in paediatric patients.  This is in response to ongoing concerns regarding hyponatraemic encephalopathy occurring in association with fluids containing low sodium concentrations. (Dr Sarah McNabb, A/Prof A Davidson, A/Prof Simon Young, A/Prof Franz Babl)

CRIB Comparative rehydration in Bronchiolitis study. Bronchiolitis is the leading cause of hospitalisation during the first year of life and is a major cause of morbidity and mortality.  The primary aim of this multicentre randomised trial is to investigate whether the type of fluid replacement - nasogastric versus intravenous - affects the duration of hospital admission, in children aged between two and 12 months admitted to hospital. (A/Prof Ed Oakley, A/Prof Franz Babl)

POUT Painful Oral Ulcer Treatment is a double-blinded randomised control trial comparing 2% lignocaine vs placebo in the treatment of children who present with decreased oral intake in direct relation to oral mouth ulcers. (Dr Sandy Hopper, Ms Michelle McCartney, A/Prof Franz Babl)

team members

  • Imogen Ackerly - Data Entry Assistant
  • Eva Alisic - HONORARY FELLOW
  • Jacqueline Bakhit - Administrative Assistant
  • Peter Barnett - HONORARY FELLOW
  • Cath Bevan - RESEARCH AFFILIATE
  • Penny Bolt - RESEARCH ASSOCIATE
  • Fiona Brown - RESEARCH ASSOCIATES
  • Trusha Brys - RESEARCH ASSOCIATE
  • Davina Buntsma - Research Administrator
  • John Cheek - RESEARCH ASSOCIATE
  • Vi Chong - RESEARCH ASSOCIATE
  • Dianne Crellin - RESEARCH ASSOCIATE
  • Amanda Fry - Research Coordinator
  • Joanne Grindlay - RESEARCH ASSOCIATE
  • Sandy Hopper - RESEARCH ASSOCIATE
  • David Krieser - HONORARY FELLOW
  • Stuart Lewena - RESEARCH ASSOCIATE
  • Ed Oakley - HONORARY FELLOW
  • Divya Radhakrishnan - Research Administrator
  • Amanda Stock - RESEARCH ASSOCIATE
  • Brenton Ward - Research Assistant
  • Nicola Williams - RESEARCH ASSISTANT
  • Adriana Yock - RESEARCH AFFILIATE
  • Simon Young - HONORARY FELLOW

publications

  • Babl FE., Oakley E., Young S. Developing academic paediatric emergency medicine in Australia and New Zealand. EMERGENCY MEDICINE AUSTRALASIA 23 (1) : 1 - 3(2011) PubMed
  • Babl FE., Theophilos T., Palmer GM. Is There a Role for Intravenous Acetaminophen in Pediatric Emergency Departments?. PEDIATRIC EMERGENCY CARE 27 (6) : 496 - 499(2011) PubMed
  • Bates-Smith J., Crellin D. Paediatric elbow injuries. Part 1: Assessing the elbow, identifying and managing a pulled elbow. Australasian Emergency Nursing Journal 14 (2) : 115 - 119(2011)
  • Bates-Smith J., Crellin D. Paediatric elbow injuries. Part 2: Assessment of paediatric elbow X-rays, identification and management of supracondylar fractures. Australasian Emergency Nursing Journal 14 (3) : 196 - 201(2011)
  • Beauchamp MH., Ditchfield M., Babl FE., Kean M., Catroppa C., Yeates KO., Anderson V. Detecting Traumatic Brain Lesions in Children: CT versus MRI versus Susceptibility Weighted Imaging (SWI). JOURNAL OF NEUROTRAUMA 28 (6) : 915 - 927(2011) PubMed
  • Bevan C., Buntsma D., Stock A., Griffiths T., Donath S., Babl FE. Assessing bladder volumes in young children prior to instrumentation: Accuracy of an automated ultrasound device compared to real-time ultrasound. Academic Emergency Medicine 18 (8) : 816 - 821(2011) PubMed
  • Clausen H., Theophilos T., Jachno K., Babl FE. Paediatric arrhythmias in the emergency department. EMERGENCY MEDICINE JOURNAL (2011) PubMed
  • Crellin D., Babl FE., Sullivan TP., Cheng J., O'Sullivan R., Hutchinson A. Procedural Restraint Use in Preverbal and Early-Verbal Children. PEDIATRIC EMERGENCY CARE 27 (7) : 622 - 627(2011) PubMed
  • Deasy C., Gabbe B., Palmer C., Bable FE., Bevan C., Crameri J., Butt W., Fitzgerald M., Judson R., Cameron P. Paediatric and adolescent trauma care within an integrated trauma system. Injury (2011) PubMed
  • Hopper SM., Babl FE., McCarthy M., Tancharoen C., Lee KJ., Oakley E. A double blind, randomised placebo controlled trial of topical 2% viscous lidocaine in improving oral intake in children with painful infectious mouth conditions. BMC PEDIATRICS (2011) PubMed
  • Oakley E., Robinson J., Deasy C. Using 0.45% saline solution and a modified dosing regimen for infusing N-acetylcysteine in children with paracetamol poisoning. EMERGENCY MEDICINE AUSTRALASIA 23 (1) : 63 - 67(2011) PubMed
  • Powell CVE., Priestley SJ., Young S., Heine RG. Randomized clinical trial of rapid versus 24-hour rehydration for children with acute gastroenteritis. PEDIATRICS 128 (4) (2011) PubMed
  • Yock-Corrales A., Babl FE., Mosley IT., Mackay MT. Can the FAST and ROSIER adult stroke recognition tools be applied to confirmed childhood arterial ischemic stroke?. BMC PEDIATRICS 11 (93) (2011) PubMed
  • Yock-Corrales A., Barnett P. The role of imaging studies for evaluation of stroke in children. PEDIATRIC EMERGENCY CARE 27 (10) : 966 - 977(2011) PubMed
  • Yock-Corrales A., Mackay MT., Mosley I., Maixner W., Babl FE. Acute childhood arterial ischemic and hemorrhagic stroke in the emergency department. Annals of Emergency Medicine 58 (2) : 156 - 163(2011) PubMed

competitive funding

2011 Pilot study for Australasian Paediatric Head Injury Study (APHIRST) Principal investigator Murdoch Childrens Research Institute Theme Grant.

Convulsive Status Epilepticus Paediatric Trial (ConSEPT) pilot study" A+ Trust Research Grant, Auckland District Health Board CI Stuart Dalziel.

Comparative Rehydration in Bronchiolitis (CRIB) Perpetual Philanthropic Services Application ID: 725 Ed Oakley and Franz Babl.       

2010-2013 Career Development Grant, Murdoch Childrens Research Institute (0.4 FT as principal research fellow).

collaborations & affiliations

Department of Anesthesia PIMS Study
NICS/NHMRCED Pain Project
Department of Human Services Sedation Program
Dept of Immunology PHD Probiotics (Dr Valerie Sung)
Neuropsychology PHD Cognitive effects of head injury (Ms Vicky Manikas)
Neurology PHD Stroke in Children (Dr Mark Mackay)
Hospital for Sick Children, Toronto Canada Biomarkers study