Emergency Medicine and Toxicology

• Arise Sepsis: early versus late vaspressors in sepsis. Site Lead: Dr R McNulty
• UNTIE MOH study looking at decreasing unnecessary pathology tests. Dec 2018. Site Lead: A/Prof Reza Ali.
• SINES study
• ID:ME project - pathology redesign
• Pharmacy team-based Medication Reconciliation in the Emergency Department. Site Lead: A/Prof Reza Ali.
• WSLHD Emergency Department Patients Who Leave Before Being Seen – a District Analysis. Site Lead: A/Prof Reza Ali.
• Use of video reflexive methods (VRM) to enhance ED preparedness for routine and high-level infectious disease transmission risks: Site Lead: A/Prof Reza Ali.
• The effects of emergency ultrasound service on the utilization of ionising radiation based imaging modalities. Site Lead: A/Prof Reza Ali
• Hession M, Melvin D, Ali R, Forero R, McDonnell G. The use of complex system science (CSS) methods in dynamic modelling and simulation to explore the impact of multiple variables and their interactions on patient flow in an Australian emergency department within the National Emergency Access Target (NEAT) policy framework. HREC reference number: LNR/14/WMEAD/424. SSA reference number: LNRSSA/14/WMEAD/449
• Understanding work as done in Blacktown Hospital Emergency Department: A Cognitive Work Analysis. Site Lead: A/Prof Reza Ali

1. Retrospective cohort study of the utility of head CT in toxicology patients. Dr R McNulty.
2. NACSTOP. Multi-centre trial of early cessation of NAC in low risk paracetamol overdose. Site Lead: Dr R McNulty.
3. 2NAC. The hepatotoxicity rate with the new -2bag NAC protocol in paracetamol overdose. Site Lead: Dr R McNulty.
4. Pharmacogenetics of serotonin toxicity. Principal investigator: Dr N Gunja.
5. Role of c-peptide in insulin overdose. Dr N Gunja.
6. Characterisation of recreational drugs which cause morbidity and mortality used at dance festivals in Western Sydney. Dr N Gunja.

Kelly, A., Holdgate, A., Keijzers, G., Klim, S., Graham, C., Craig, S., . . . Laribi, S. (2018). Epidemiology, treatment, disposition and outcome of patients with acute exacerbation of COPD presenting to emergency departments in Australia and South East Asia: An AANZDEM study. Respirology, 23(7), 681-686. Site Lead: Dr R McNulty

Stephen SS TEO , Arjun RAO and Jason ACWORTH. Paediatric acute care: Highlights from the Paediatric Acute Care–Advanced Paediatric Life Support Conference, Gold Coast, 2017. Emergency Medicine Australasia (2018) doi: 10.1111/1742-6723.12983

Shany T, Hession M, Pryce D, Roberts M, Basilakis J, Redmond S, Lovell N A small-scale randomised controlled trial of home telemonitoring in patients with severe chronic obstructive pulmonary disease Journal of Telemedicine and Telecare. In press.

Teo, S., Soma, M., Awad, J. and Rossi, M. (2017), A case report of epiglottitis. J Paediatr Child Health, 53: 202–203. doi:10.1111/jpc.13419

Keijzers, G., Kelly, A., Cullen, L., Klim, S., Graham, C., Craig, S., . . . Laribi, S. (2017). Heart failure in patients presenting with dyspnoea to the emergency department in the Asia Pacific region: An observational study. BMJ Open, 7(2), E013812. Site Lead: Dr R McNulty

Kelly, A. M., et al. (2017). "An Observational Study of Dyspnea in Emergency Departments: The Asia, Australia, and New Zealand Dyspnea in Emergency Departments Study (AANZDEM)." Academic Emergency Medicine 24(3): 328-336. Site Lead: Dr R McNulty.

Brown SGA, Ball EL, Perrin K, et al. Study protocol for a randomised controlled trial of invasive versus conservative management of primary spontaneous pneumothorax. BMJ Open. 2016;6(9):e011826. doi:10.1136/bmjopen-2016-011826. Site Lead: Dr J Kwan.

Kelly et al. Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: an observational study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2016) 24:113. Site Lead: Dr R McNulty.

Munroe, B., Curtis, K., Murphy, M., Strachan, L., Considine, J., Hardy, J., Wilson, M., Ruperto, K., Fethney, J. and Buckley, T. (2016), A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre–post study using full immersion simulation. J Clin Nurs, 25: 2262–2274. doi:10.1111/jocn.13284

Munroe B, Curtis K, Margerat M, Strachan L, Buckley T. HIRAID: An evidence-informed emergency nursing assessment framework. Australasian Emergency Nurses Journal. 2015;18(2):83-97.

Jayaweera D, Mitter S, Gunja N, Strachan L, et al. A comparison of emergency triage scales in triaging poisoned patients. Australasian Emergency Nursing Journal, 2014; 17: 184-9. 

Hochholzer K, Li W & Gunja N. A heavy burden: Remaining vigilant with herbal remedies. Australian Family Physician, 2014; 43(8): 545-6. 

Anselm Wong, Richard McNulty, David McD Taylor, Marco L.A. Sivilotti, Shaun Greene, Naren Gunja, Zeff Koutsogianis, Andis Graudins. The NACSTOP trial: A multi-center, cluster-controlled trial of early cessation of acetylcysteine following acetaminophen overdose. Hepatology (Baltimore, Md.), 69(2), 774-784.

McNulty R, Lim JLE, Chandru P & Gunja N. Fewer adverse effects with a modified two-bag acetylcysteine protocol in paracetamol overdose. Clinical Toxicology Vol. 0, Iss. 0, 2017

Wong A, Sivilotti MLA, Gunja N, McNulty R, Graudins A. Accuracy of the paracetamol-aminotransferase product to predict hepatotoxicity in paracetamol overdose treated with a 2-bag acetylcysteine regimen. Clinical Toxicology Vol. 56, Iss. 3, 2018

Wong A, Gunja N, McNulty R and Graudins A. Analysis of an 8-hour acetylcysteine infusion protocol for repeated supratherapeutic ingestion (RSTI) of paracetamol. Clinical Toxicology Vol. 56, Iss. 3, 2018

Jayaweera D, Islam S, Gunja N, et al. Chloroform ingestion causing severe gastrointestinal injury, hepatotoxicity and dermatitis confirmed with plasma chloroform concentrations. Clin Tox, Oct 2016

Hochholzer K, Li W & Gunja N. A heavy burden: Remaining vigilant with herbal remedies. Australian Family Physician, 2014; 43(8): 545-6. 

Belinda Munroe, Kate Curtis, Margaret Murphy, Luke Strachan, et al. Evaluation of an evidence-informed emergency nursing assessment framework using full immersion simulation. Emergency Tasmania, 2016.

Opening Pandora’s box?: A simulation model in the ED to achieve the National Emergency Access Target (NEAT) at a District Hospital in Sydney, Australia. Hession M. ACEM Annual Scientific Meeting, Brisbane, 2015.

Ahmad Shah Sayar. Profile of Emergency Deparment Pharmacy Clinical Service Utilisation from Referrals Received by ED Pharmacist. 8th Asian Conference of Emergency Medicine, Taipei, 2015.

Ahmad Shah Sayar. Pharmacist-facilitated Emergency Department Fast-track Discharge Reduced Length of Hospital Stay. International Conference Emergency Medicine, Hong Kong, 2014.

Xie Y, Redmond SJ, Mohktar MS, Shany T, Basilakis J, Hession M, et al. Prediction of Chronic Obstructive Pulmonary Disease Exacerbation Using Physiological Time Series Patterns. In: 31st Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Osaka, Japan: 3413-3416; 2013.

Jayaweera D, Mitter S, Gunja N. A Comparison of Emergency Triage Scales in the Assessment of Patients Presenting with Poisoning. Hong Kong Journal of Emergency Medicine, 2012; 19(6): 444-5. 

Shany T, Hession M, Pryce D. Home Telecare Study for Patients with Chronic Lung Disease in the Sydney West Area Health Service. In: Anthony C. Smith AJM, editor. Global Telehealth - Selected Papers from Global Telehealth 2010 (GT2010) – 15th International Conference of the International Society for Telemedicine and eHealth and 1st National Conference of the Australasian Telehealth Society.

Use of SNOMED CT in Emergency Departments – the Australian Experience (oral presentation) Hession M. 13th International Conference on Emergency Medicine. International Federation for Emergency Medicine. Singapore 2010. Leading IT-based Strategic Change in the Emergency Department. 13th International Conference on Emergency Medicine. (Poster) Hession M. International Federation for Emergency Medicine. Singapore 2010.

Cruikshank, Marilyn, Gotterson F, Hession M. Childrens Emergency Care Project Implementation and Education Toolkit. Clinical Excellence Commission; 2006.

McNulty R, Bandaranayake L, Garner A, Tahmid F, Wong T, Salter M, Symes E, Mohammad M, Gunja N. The utility of non-contrast head computed tomography in poisoned patients. Accepted for presentation at EAPCCT meeting May 2019, Naples, Italy

Wong A, McNulty R, Gunja N and Graudins A. Efficacy of a two bag acetylcysteine regimen to treat paracetamol overdose (2NAC study). Accepted for presentation at EAPCCT meeting May 2019, Naples, Italy

Wong A, McNulty R, Yarema M, Sivilotti M, Graudins A, Gunja N, Isbister GI, Chiew A. Comparison of adverse reactions to a two-bag versus three-bag intravenous acetylcysteine regimen during treatment of paracetamol overdose. Accepted for presentation at EAPCCT meeting May 2019, Naples, Italy

Richard McNulty, Adrienne Kirby, Naren Gunja. Fewer adverse drug reactions to acetylcysteine in paracetamol overdose using a reduced bolus 2-bag protocol compared to the traditional 3-bag protocol: a meta-analysis. Clinical Toxicology, 56(6), 524-525.

McNulty R, Lim JME, Chandru P, Gunja N. Fewer adverse effects with a modified 2-bag intravenous acetylcysteine protocol compared to the traditional 3-bag protocol in paracetamol overdose. EAPCCT 2017. Basel, Switzerland. CLINICAL TOXICOLOGY, 2017 VOL. 55, NO. 5, 380.

Wong A, McNulty R, Gunja N and Graudins A. Analysis of an abbreviated acetylcysteine infusion protocol for repeated supratherapeutic ingestion (RSTI) of paracetamol. EAPCCT 2017. Basel, Switzerland. CLINICAL TOXICOLOGY, 2017 VOL. 55, NO. 5, 419.

Mann G and Gunja N. QT prolongation in opioid poisoning is mostly due to methadone. EAPCCT 2017. Basel, Switzerland. CLINICAL TOXICOLOGY, 2017 VOL. 55, NO. 5, 473.

Jayaweera D, Islam S, Gunja N et al. Severe poisoning after ingestion of chloroform. Clinical Toxicology, 2016; 54(4): 420.

Mann G, Gunja N. Lack of serious cardiotoxicity in patients with desvenlafaxine overdose. Clinical Toxicology, 2015; 53(4): 384-5.

Mitter S, Jayaweera D, Gunja N. Hypoglycaemia Secondary to Sulthiame Overdose. Hong Kong Journal of Emergency Medicine, 2012; 19(6): 462-3.