Dr Rebecca Broomfield
As a member of PERUKI and a representative for WREN I attended the update day at the RCPCH London office on June 4th 2018.
What is PERUKI?
Paediatric Emergency Research in the United Kingdom & Ireland (PERUKI) brings together clinicians and researchers who share the vision of improving the emergency care of children through high quality multi-centre research.
PERUKI also takes an active role in encouraging and mentoring new investigators in the acquisition of research skills, regarding this as a key area for the sustainability of PEM research going forward
Why is it important?
Paediatric Emergency Medicine,Can strengthen their research activities by working together across the nations. Enabling co-ordination of research activities, and focus on common goals and agendas will help to achieve stronger outcomes.
Large scale robust multi-centre clinical research will be developed and delivered over time, and translation into practice will be achieved throughout the health regions.
Can I become a member?
If you are interested go to the website (http://www.peruki.org/) and complete the sign up form.
What is going on?
So much fantastic research in a variety of states. Some studies have completed recruitment such as the ECLiPSE study (http://www.eclipse-study.org.uk/) which we were involved in at the University Hospital of Wales - I have never been as excited about research as when I managed to randomise the first patient we recruited.
Others are established and ongoing such as the CAP-IT study which we are also involved in recruiting for in Wales. Even more are just about to begin such as the FORCE study on Torus fracture management by Mr Dan Perry (@DanPerry), the NOVEMBR study on the use of non invasive ventilation in Bronchiolitis, Paul Macnamara and the SCIENCE study.
But the day was also to present problems and potential research ideas. Professor Steve Cunningham presented the problems with research into pre-school wheeze and need for clarification of the grey areas between the ages of 2-4 years and the conflicting evidence base which we currently have.
We had a reminder from Dr Tom Waterfield (@DrTomWaterfield) about the importance of establishing the clinical features which make a child with a non-blanching rash and a temperature more likely to have a meningicoccal sepsis than another illness. The rates of meningitis are falling - do we need to act now and progress this research before we miss the opportunity to capture this information. Which features make the child more likely to be unwell and which can differentiate those who are sick with those who are not.
Information was presented on the HEEADSSS tool and discussion led by Dr David James (@DrDaveJames) about the definition of adolescence - should it be defined as the ages 10-24 years? and they would rather be 'young people'. Young people presenting to the emergency department are a big group, and this is increasing. As emergency paediatricians can we do something for this group of the population and should we be. The HEEADSSS tool (Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety) is useful but only if you know what services are available in your area and how to signpost people to them.
Could we also utilize PERUKI to reduce variation in practice? An example discussed on the day was the use of metal detectors for ingested objects. There was no consistency about the level of training which people had to use the equipment as well as the areas of the body which were scanned. Also there was an inconsistency about what people did with the information when they used the equipment.
There was also discussion about findings elsewhere which have not been replicated in the UK data. For example the rotavirus vaccination has been associated with a reduction of seizures elsewhere but the data from the UK does not show this. Why is this? We use a different vaccine could this be the reason or are we not collecting the right data. This demonstrates to me an important feature of research which is to know what is going on and be able to pick up trends in data and potential secondary outcomes which may be unexpected.
Is bright! We've taken a few ideas forward for projects within UHW and I am excited to hear the results of the ECLiPSE study.
If you are interested; become a member, follow the twitter feed and attend an update day for more information. If you have any interest in collaborative working, getting involved in research or providing the best care for your patients I would suggest it's worth a look.
Dr Annabel Greenwood