The EMERGE team is very excited to introduce POEM – a retrospective multi-centre observational study.
Acute pain is one of the most common reasons for Emergency Department (ED) attendance yet adequate pain management remains an issue recognised as an area in need of improvement.
Recent Audits undertaken by The Royal College of Emergency Medicine (RCEM) in 2012 concluded that a wide variation of performance exists between EDs across the UK. They concluded that that the “timely administration of analgesia remains a challenge across the UK and that ongoing vigilance is required in this area”.
Numerous other studies have shown that ED overcrowding, patient’s ethnicity, socio-economic class, age, gender etc., are factors that can affect delivery of analgesia.
POEM aims to assess the adequacy of pain management in patients presenting to the ED with confirmed long bone fracture and/or dislocation isolated to a proximal or distal limb.
Its secondary aim is to assess the influence of pain management on the following factors; age, gender, ethnicity, socioeconomic class, departmental overcrowding and daily departmental quality indicators.
The data collected within this study will allow the assessment of the timing and delivery of analgesia during a typical ED period across major EDs within the UK. It hopes to highlight factors associated with the failure to provide effective and timely analgesia, in the hopes that the results will inform further targeted research, ultimately improving patient care within this group.
Trial Design: Retrospective Multi-centre, Observational Study
Eligibility Criteria: All Adult and Paediatric patients with confirmed long bone fracture and/or dislocation isolated to a single proximal or distal limb presenting to ED.
Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department
Identification and characterization of the clinical toxicology of novel psychoactive substances (NPS) by laboratory analysis of biological samples from recreational drug users.
Identification of Novel Psychoactive Substances (IONA)
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.