ANZCTR search results

We aim to investigate the time taken for medical and nursing anaesthesia staff to set up the Rapid-O2 oxygen insufflation device and compare this with the Manujet ventilator in a simulated ‘CICO’ (Can’t Intubate, Can’t Oxygenate) scenario. A Can’t Intubate/Can’t Oxygenate (CICO) scenario arises when attempts at oxygenation of the patient via the anatomical conduits of the upper airway have failed. In such a scenario, the creation of a patent airway via the front-of-neck either by cricothyroidotomy or tracheotomy remains the only option for rescue oxygenation. A variety of rescue techniques are advocated currently, including cannula-, or scalpel-based techniques as well as wire-guided techniques . Regardless of technique chosen the CICO scenario in anaesthetic practice is often poorly managed with potentially catastrophic outcomes. Important contributory factors include institutional ill-preparedness and equipment not fit-for-purpose. Delays in providing rescue oxygenation, even when appropriate equipment is available, is an additional factor implicated in poor outcome. Our hypothesis is that the Rapid-O2’s simplicity and intuitiveness allow for its setup by naive operators in a clinically acceptable timeframe versus the manujet during a simulated CICO scenario.

Women identified as having complex pregnancies are often advised to have continuous intrapartum fetal monitoring – commonly referred to as CTG monitoring. Conventional forms of CTG monitoring require the labouring woman to wear two tight elastic belts around her abdomen and to be tethered to a machine by wiring, thus restricting her mobility during labour and her choice of position whilst giving birth. In the Australian context, this affects over half of the 310,000 women giving birth each year. However, enabling women to have mobility during labour and birth results in a shorter labour, lower likelihood of caesarean section, fewer epidurals as well as providing psychological benefits by strengthening women’s sense of choice and control. A new wireless and beltless monitoring device, the transabdominal fetal electrocardiogram (referred to herein as TAM) will be released in Australia by Philips Healthcare in early 2019. Although there is a body of international evidence supporting the safety and efficacy of the device, and it has been registered by the Therapeutic Goods Administration (TGA) for clinical use in Australia, little is known about the implementation of TAM in authentic clinical settings. To investigate this, use of the device will initially be trialled in an Australian tertiary maternity care facility. This is the first stage of a broader investigation of the impacts of TAM in clinical practice.

Post-lung transplant bronchoscopy is a commonly performed diagnostic procedure, typically performed under sedation with Low Flow Nasal Cannula (LFNC) oxygenation. Procedural desaturations are not infrequent. Recently High Flow Nasal Cannula (HFNC) oxygenation has been demonstrated to be a safe alternative to LFNC oxygenation in a number of clinical scenarios. This trial will assess the use of HFNC oxygenation as an effective alternative to LFNC oxygenation in sedated lung transplant patients undergoing diagnostic transbronchial biopsy. We hypothesise there will be fewer, and shorter, desaturations in the HFNC group as well as fewer airway interventions.

This research proposal will explore the effectiveness of using the NPS MedicineWise mobile phone application in increasing the medication adherence in chronic heart failure. In increasing the medication adherence, it is expected that patients will be able to decrease the substantial burden on healthcare services.

This study aims to evaluate the safety and preliminary efficacy of a drug called Avelumab in combination with chemotherapy plus radiotherapy (CRT) in patients with resectable oesophageal/ gastro-oesophageal junction (GOJ) adenocarcinoma. Who is it for? You may be eligible to join this study if you are aged 18 years or more, and have a confirmed diagnosis of early or local gastro-oesophageal junction or oesophageal adenocarcinoma. Study details All participants in this study will receive the drug Avelumab in addition to chemoradiotherapy (CRT). Patients will receive 5 weeks of carboplatin-paclitaxel-Radiotherapy. Avelumab will be given as intravenous infusion at the dose of 10mg/kg over 60 minutes in 250mL Sodium Chloride 0.9% every 2 weeks concurrently with CRT and then for 2 more cycles (total 5 cycles of Avelumab; 3 concurrently and 2 cycles as single agent) pre surgery. Surgery will be carried out 6-8 weeks post completion of the CRT component. After surgery patients will then be followed up every 3 months for 2 years then 6 monthly for one year. Standard of care imaging results will be collected as well as blood tests. It is hoped that this research will show support for improved patient outcomes by using an immunotherapy.

Participants were ordinary patients of real world clinics. Participants in both groups received two follow-up hearing aid fitting consultations (face-to-face and remote respectively delivered at the clinic and at participant's home/office), and a third consultation at their homes for outcome assessment where interventions were applied to address their individual needs. A combination of measures were used to assess changes in participants' communication, fitting, aspects of quality of life, service and hearing aid aspects, outcomes that are already part of routine clinical procedures. Objective: To compare outcomes of the follow-up consultations for hearing aid fittings conducted remotely by telehealth to those conducted face-to-face by conventional consultations, utilizing subjective measures. The overall hypothesis of this study is that participants’ outcomes with remote consultation will not significantly differ from those with face-to-face consultation.

Following traumatic brain injury, patients frequently enter a state of post-traumatic amnesia and may become agitated. Agitation is threatening to staff and families, impacts access to treatment and is associated with longer hospital stays. Atypical antipsychotics are prevalent in the management of agitation despite a complete lack of well-designed studies underpinning their use in treating agitation in traumatic brain injury. We hypothesise that patients in post-traumatic amnesia, exhibiting agitation who are administered the atypical antipsychotic olanzapine will show lower levels of agitation than those administered placebo.

Iron-deficiency anaemia (IDA) affects approximately 1 in 7 Australian pregnant women, and optimal treatment for improving maternal wellbeing and decreasing blood transfusion remains uncertain. An issue with prior randomised trials of IV versus oral iron is lack of patient and clinician blinding to treatment received, so the primary aim of this study is therefore to determine the feasibility and effectiveness of blinding treatment allocation to IV iron or saline placebo infusion. Participants will be pregnant women with iron deficiency anaemia between 26 weeks and 33 weeks gestation, and will either be given IV iron and placebo capsules or iron capsules and placebo IV. It is expected that using an opaque sleeve covering the syringe and giving set when administering IV iron or saline placebo, followed by matching placebo or active iron oral tablets, respectively, is feasible and effective.

This project tests whether a structured medicines reconciliation service (DCMedsRec) delivered by a community pharmacy soon after hospital discharge may reduce the risk of re-admission within 30 days. This randomised controlled trial will compare the rates of readmission of those receiving the DCMedsRec with others receiving usual care after discharge. Participants receiving the DCMedsRec service will have a structured interview with a pharmacist in a community pharmacy where, using My health record and other sources, the correct medicines and doses will be identified, old medicines and prescriptions may be disposed of, understanding of when and how to take medicines may be confirmed and any questions be answered. It is expected that DCMedsRec will improve medicines use and adherence and reduce the risk of problems that lead to re-admission.

Patients with kidney failure on haemodialysis machines depend on a well-functioning surgically-created enlarged blood vessel in their arm, known as an arterio-venous fistula (AVF). These AVF can develop narrowings, which may progress to complete closure and failure, creating a surgical emergency. Every dialysis, the patient and their nurse check that the fistula is well-functioning by simple physical examination: i.e. can they feel a strong vibration and pulse; can they hear a loud noise with a stethoscope? If concerned, then a patient is referred for a formal Doppler study appointment by a trained technician, using a specialised machine. This study aims to assess whether a simple electronic skin sensor known as an accelerometer (similar to a "FitBit") can detect narrowings inside the AV fistula, by comparing the accelerometer signal waveforms with a concurrent formal Doppler study. We aim to study 60 patients with a range of well- and poorly-functioning AVF's to establish whether the technique is feasible and reliable (i.e. sensitive and specific).