Deakin research into regional head trauma

March 2010

A research project has started in south-west Victoria to find out why people who suffer major trauma head injuries recover better in city areas than in country regions.

Deakin University Warrnambool Campus PhD student Ben Fisk said there was a common belief that people injured in metropolitan areas fared better than those with comparable injuries in country areas.

“Anecdotally there seems to be different outcomes between city and country regions so our first task is to identify and analyse the existing data to see if that is the case,” Mr Fisk said.

The research will consider the total range of trauma head injuries from car crashes and home falls to farm and industrial accidents.

Mr Fisk said his research would investigate and report on possible factors which could influence the apparent imbalance.

“The most obvious would seem to be the time delay in getting injured people to treatment but there hasn’t been a study into the whole situation which will make the findings important for future planning.”

“The goal for this year is to create a picture of what is happening in Western Victoria and compare it to Melbourne.”

Mr Fisk comes from a paramedic background and has worked with the Victorian Ambulance Service in Geelong and Warrnambool for the past nine years. He hopes to use his research to learn more about pre-hospital management systems and how rural and regional people access and utilise ambulance services.

The impact of an emergency rescue helicopter in south-west Victoria will be considered in the three-year study. “There are not enough statistics yet in the south-west area to judge what impact it is having,” Mr Fisk said.

The research will also look at the processes when head trauma patients are taken to small country hospitals.

The research has been funded by the Windermere Foundation which provides special grants for the development, introduction and/or evaluation of new practices, models and interventions to improve health in country Victoria

Deakin University’s Warrnambool Campus Pro Vice-Chancellor (Rural and Regional) Professor Sue Kilpatrick and the Director of the Centre Rural Emergency Medicine Tim Baker are joint supervisors of the research.

Deakin Medical School appoints director for Western Victoria’s Centre for Rural Emergency Medicine

April 2009

Deakin University has appointed a specialist emergency physician, Clinical Associate Professor Tim Baker, as the Director for the new Centre for Rural Emergency Medicine (CREM).

A joint initiative between the State Government, Alcoa of Australia and the Deakin Medical School, CREM will contribute to the coordination and delivery of effective emergency medical management in western Victoria and provide national leadership in emergency medicine research. It will operate through the Deakin Medical School’s new Greater Green Triangle Clinical School based at Warrnambool’s South West Healthcare (SWH) and Portland District Health (PDH), and through a network of regional doctors. The Centre has received financial support from Alcoa, the Victorian Government and both health services.

Associate Professor Baker said he was looking forward to working with healthcare providers in Warrnambool and western Victoria to respond to the emergency medical needs of rural and regional communities.

“This is a crucial time to be involved in rural emergency medicine,” Associate Professor Baker said.

“There is a difference between the emergency treatment outcomes for country patients and those in the city.”

“What we need to ensure is that country people have timely access to all the proven services available in the city, and have the same chance of a good outcome, no matter where they are in Victoria.”

“Through CREM we will explore the challenges in getting good outcomes for emergencies in rural and regional hospitals and work towards a robust and successful system here that we can export to the rest of rural Victoria and Australia.”

Professor Brendan Crotty, the Head of the Deakin Medical School, said he was delighted with Associate Professor Baker’s appointment.

“The establishment of CREM is a result of the medical school working with Alcoa, the State Government and the two regional health services, South West Healthcare (Warrnambool) and Portland District Health. For the south west, CREM is the first tangible benefit from the new Deakin Medical School and I think we can all look forward to significant improvements in emergency care in the region,” he said.

Victorian Health Minister Daniel Andrews said the Brumby Government was pleased that the Centre was able to select someone of Associate Professor Baker’s stature and experience to south west Victoria.

“Under Associate Professor Baker the Centre will play a key role in the provision of emergency medical services and undertake research and training in emergency medicine in rural settings.

“It is important that our front line emergency staff in rural areas have access to contemporary education to ensure the best level of care,” Mr Andrews said.

As well as heading up CREM, Associate Professor Baker will work in the emergency departments of SWH Warrnambool and PDH and will contribute to the Deakin Medical School teaching program. He hopes his broad experience will help the junior medical staff and the Deakin medical students who will train in western Victoria from next year.

“I have worked in emergency medicine for 15 years. My work has taken me to hospitals in remote Central Australia, in Gippsland where I grew up and to every continent, including hospitals in Kenya and Peru,” Associate Professor Baker said.

SWH Chief Executive Officer John Krygger said the establishment of CREM and the appointment of Associate Professor Tim Baker was a significant coup for the region.

“We are delighted that we have been able to recruit an emergency physician with the experience and expertise of Tim Baker who has both clinical and research strengths. The appointment is also a strong tangible benefit of our relationship with Deakin University and highlights our commitment to providing best practice emergency care,” he said.

Alcoa of Australia’s General Manager Victorian Operations Arnaud Soirat said Alcoa’s partnership with Deakin is a central plank in its efforts to create sustainable communities.

“Strengthening our communities is a part of core business at Alcoa and has never been more important as we face such challenging times.

“Strong rural health services are an essential part of a sustainable community and this partnership with Deakin is very important to help achieve this. We welcome Dr Baker and all he can bring to the role.”

Portland Hospital responds to a major challenge

April 2009

Portland District Health’s revamped emergency department has recorded a successful response to a major bus accident on Thursday night.

The hospital accepted all patients from the crash, including those with serious chest and spinal injuries.

Associate Professor Tim Baker, from the Centre for Rural Emergency Medicine (CREM), said the emergency department had successfully coped with the situation.

“On the night of the bus crash the system worked the way it was planned,” Associate Professor Baker said.

He said the department had undergone a transformation over the past 12 months, with recruitment of experienced doctors, installation of new equipment and emergency nurses gaining experience in Melbourne trauma centres.

“The terrible and unfortunate events of the Portland bus crash gave the hospital its first chance to fully demonstrate these changes,” Associate Professor Baker said.

“It succeeded because of the work done over the past few months. Months of preparation have gone into last night running smoothly,” he added.

Associate Professor Baker said the successful response showed the benefits of having rural doctors and a responsive emergency department at Portland.

The hospital has remodelled its emergency department as part of its commitment to improving services to the Portland region.

Two hospital doctors, two specialist emergency physicians, a general practitioner and many nurses trained specifically in trauma care were involved in the response on Thursday night.

Patients were stabilized and given pain relief. The most seriously injured patients had their injuries investigated by CT scan and were transferred to The Alfred and South West Healthcare in Warrnambool, where appropriate surgical units were expecting them. Stable patients were treated locally and admitted to Portland District Health or discharged.

At 2pm Friday … patients remain in PDH with minor injuries. Their conditions are stable. Nine passengers and the driver were taken to the hospital after the bus crash which claimed three lives at 6.40pm on Thursday

CREM is funded by Alcoa, Deakin University, Portland Hospital and Warrnambool hospital has also contributed. Funding from CREM provides a specialist emergency physician, Associate Professor Baker, to assist in the continuing improvement of emergency medicine in Portland.

He said two specialist emergency physicians work in the emergency department each week. “They have focused on staff training, working with local general practitioners, improving protocols, stocking of appropriate equipment and streamlining interaction with pathology and radiological services. In particular, they have worked on improving the way patients are transported from Portland hospital to city hospitals.”

Associate Professor Baker said recent media reports had highlighted the difficulties in getting country patients to the city for surgery.

“CREM has a voice on regional committees overseeing emergency transport of patients, and staff have been trained in the best way to have the system work for their patients.”