QAS Paramedic awarded inaugural KJM scholarship

Metro North paramedic Adam Rolley has been made a KJM Education and Research Foundation Fellowship Scholar after he was selected to receive a three‑year scholarship to complete a research doctorate (PhD).

Top photo - Benowa crash and above - helicopter rescue

Adam Rolley

Adam, who is working within the Information Support, Research and Evaluation unit within the Office of the Medical Director, is about seven months into his PhD.

The research is a collaboration between QAS, QUT and the Jamieson Trauma Institute (JTI) at the Royal Brisbane and Women’s Hospital.

“My work focuses on the identification of severe trauma in the pre‑hospital environment,” he said.

“This is a really challenging area and I’m hoping the work will allow us to improve not only the way we identify people presenting with severe trauma, but also our understanding of dispatch requirements and retrieval options.”

Each year in Australia, injury results in more than 500,000 hospitalisations, 13,000 deaths, and a direct health system expenditure of $8.9 billion (in 2015‑2016).

In 2018‑19, Australia reported 8,528 patients with major trauma (admitted at selected reporting hospitals), defined as an injury severity score greater than 12 or death following injury.

Seventy‑six per cent of major trauma patients are transported to hospital by road or air ambulance, therefore paramedics’ ability to effectively and accurately identify those at risk of severe injury to convey them to the most appropriate health service is fundamental.

“Numerous researchers have examined trauma triage and the associated reduction in morbidity and mortality,” Adam said.

“This work confirms the critical role triage has in the trauma system and the negative impact of over – and under – triage.

“Australia’s geographic size and population dispersion increases the complexity of this task, but, these barriers are mitigated by a complex network of hospital and health services, retrieval pathways and advanced pre‑hospital care.

“Four key issues impact the current trauma triage evidence base; moderate to high risk of bias, limited generalisability, variable triage accuracy and a scarcity of research with an Australian focus.”

Adam said international studies of trauma triage have historically focussed on typically younger people involved in transport‑related, penetrating and high impact blunt force trauma.

“Internationally there’s a wide variability in the ability of tools to identify the cohort of patients and there’s a significant amount of work being done to try to improve this – which we’ll be feeding into of course.

“We know individuals, particularly older people can present with just as severe trauma without requiring such a high mechanism – for example a fall from a standing height can result in just as severe trauma,” he said.

“So, part of this work is to try to identify how we can better identify these patients sooner to ensure they’re triaged appropriately.”

Adam said the project will link ambulance, hospital and death data to improve the understanding of the continuum of patient care, from the incident through to hospital admission.

Adam is working closely with principal supervisor from JTI and QUT Professor Kirsten Vallmuur, QAS’s Associate Professor Emma Bosley and Professor Kerrianne Watt, and QUT’s Professor Steven McPhail.

“The whole idea of the project is to try to enhance paramedics’ ability to triage trauma patients, in particular those in rural and remote Queensland – which essentially helps us do our job better.

“I’d like to take the opportunity to thank the KJ McPherson Education and Research Foundation for its ongoing support. The first grant I received was a Patron’s Research Grant, which is allowing our team to study the stability of cardiac related medicines in the pre‑hospital hospital environment. We will finalise this work over the next few months,” Adam said.

“As pre‑hospital care continues to develop, research is a key element.

“The KJM Foundation provides significant opportunities for professional development and research grants.

“I’d encourage people to form collaborations with researchers or others who are interested in this area and submit an application.

“While our medication stability study has taken about four years to get to this stage, it all started following a brief conversation with a colleague. Without the KJM Foundation, it wouldn’t have happened,” Adam said.