CCREM

The Centre for Clinical Research in Emergency Medicine (CCREM) is a unique unit established at Royal Perth Hospital, Perth, Western Australia that brings together clinical staff working in the Emergency Department (ED) and laboratory scientists using immunological and molecular biological techniques. CCREM investigates a number of conditions within the spectrum of disease treated by EDs including:

• Sepsis and septic shock (Critical Illness)
• Emerging and illicit drugs (Emerging Drugs Network of Australia)
• Concussion and traumatic brain injury
• Anaphylaxis
• Geriatric syndromes
• Chest pain as potential acute coronary syndrome
• Snake and spider envenoming

Clinical information and special blood samples are collected from patients while they are in the ED, providing an invaluable tool for investigating the underlying mechanisms of disease.

CCREM is the leading clinical trials centre for Emergency Medicine in Australasia, with the only wet lab within an Emergency Department. As such, its core research themes are:

• Determining the cellular mechanisms that amplify septic, anaphylactic, and haemorrhagic shock
• Improving outcomes from severe sepsis and respiratory emergencies (specifically septic shock, pneumonia, anaphylaxis, pneumothorax and thromboembolic disease) through a series of multicentre clinical trials informed by ongoing mechanistic research
• Admission avoidance for elderly patients and others with complex needs
• Evaluating the effectiveness of systems of care.

Over the last five years, research by CCREM has resulted in major changes and/or justifications for clinical approaches to chest pain, critical illness, anaphylaxis, snake envenoming and redback spider bite. Ongoing studies are expected to have similar impacts in the management of sepsis, respiratory emergencies and acute presentations in the elderly. CCREM studies also address economics and avoiding unnecessary (or even harmful) use of drugs and interventions.