Funded Research

Epidemiology and Outcomes of Combat-Relevant Prolonged Trauma Care: a Prospective Multicenter Prehospital Study in South Africa 
Funding AgencyU.S. Department of Defense 
Description / AimsThe overall objective of this proposal is to conduct an epidemiologic trauma study to assess the effect of time and early resuscitation on morbidity and mortality of trauma patients in the Western Cape Province of South Africa. There will be 10 research sites and about 30,000 patients enrolled. Findings will help fill civilian and military scientific gaps in trauma care and help strengthen the trauma care system in the Western Cape of South Africa. 
Outcomes from Tranexamic Acid (TXA) in Traumatic Intracranial and Torso Hemorrhage: A Prospective Cohort Study in a High Trauma, Austere, Prolonged Care Setting
Funding AgencyU.S. Department of Defense 
Description / AimsThe purpose of this proposal is to compare the morbidity and mortality of patients who receive TXA (administered within the first 24 hours post-injury) versus comparably injured patients who do not receive TXA. We propose to conduct this research in a ‘real-world’, military-relevant, prolonged care setting with a high incidence of severe polytrauma resulting in head and torso hemorrhage. Findings will help fill evidence gaps that can directly inform Clinical Practice Guidelines (CPGs) in both military and civilian contexts.
Early Tranexamic Acid to Improve Outcomes from Intracranial and Torso Hemorrhage: Prospective Pragmatic Evidence from an Austere, Prolonged Care, High Trauma Population 
Funding AgencyU.S. Department of Defense (Defense Health Agency) 
Description / AimsTo compare the resource consumption (primary outcome), and neurologic status and complication rates (secondary outcomes) of traumatically injured patients receiving TXA versus comparably injured controls. Subgroup analyses will provide TXA outcomes data in specific types of intracranial hemorrhage, torso hemorrhage, and both. Our primary hypothesis is that those who receive TXA will require fewer mililitres of blood products within the first 24 hours post-injury. We will also describe the differences in resources consumed delivering other life-saving interventions within the first 24 hours post-injury. Our secondary hypothesis is that there are better neurologic outcomes in the TXA group, and no difference in venous thromboembolic events between groups. 
(Pending) Mortality and Organ Failure Evidence to Guide Tranexamic Acid and Blood Product Resuscitation in Austere, Prolonged Casualty Care 
Funding AgencyU.S. Department of Defense 
Description / AimsTo evaluate for potential synergy in TXA and blood administration during hemorrhage resuscitation in a PCC setting. We will assess mortality and/or MOF when neither, one, or both TXA and blood products are used to treat injured patients with, or at risk for, hemorrhage in prolonged care cases. We will enroll patients from 12 established research sites in the Western Cape of South Africa during the 4-year period of performance (3months for preparatory work, 42 months for enrollment; and 3 months for analysis and dissemination). 
Early Antibiotics to Mitigate Post-Traumatic Infections: A Prospective, Multi-center Study in a Prolonged Care, High-Trauma, Austere Setting
Funding AgencyU.S. Department of Defense 
Description / AimsAssess the effectiveness of prophylactic antibiotics on mitigating infectious complications among trauma patients. We will evaluate outcomes in casualties experiencing prolonged casualty care, complex wounds including penetrating torso injuries, and those experiencing shock. 
(Pending) An Assessment of an Accelerated Clinical Protocol for Rapid Return to Duty after Pneumothorax or Hemothorax
Funding AgencyU.S. Department of Defense (Defense Health Agency) 
Description / AimsTo assess the safety and effectiveness of an existing accelerated, nurse-driven, physician-supervised clinical protocol to promote ambulatory discharge within 72 hours in a real-world, resource-limited, austere setting. We hypothesize that an accelerated PTX-HTX protocol will expedite self-ambulatory discharge (within 72 hours) for a majority (≥80%) of patients who are eligible for the protocol, and PTX-HTX complication and/or infection rates will be equivalent to standard inpatient care. 

Establishing the Epidemiology and Outcomes of Combat-Relevant Prolonged Trauma Care: a Prospective Multicenter Prehospital Pilot Study in South Africa

Funding Agency The Office of the Assistant Secretary of Defense for Health Affairs, through the Defense Medical Research and Development Program 
Description / Aims The overall objective of this proposal is to conduct a pilot study that will directly inform a future large-scale (primary) study to prospectively describe the outcomes of patients with combat-relevant injuries in an austere setting that features a high prevalence of penetrating injuries and long durations of field care. 

A Quasi-Experimental Trial of Pre-Hospital Bundled Care to Improve Outcomes in Hemorrhagic Shock 

Funding Agency NIH, Funding Institute is NHLBI. 
Description / Aims

Measure pre-hospital quality of traumatic shock care due to bundled versus non-bundled shock care. 

Assess in-hospital clinical outcomes due to bundled versus non-bundled pre-hospital shock care. 

Implementing an Evidence-Based Bundled Trauma Care Intervention (‘EMS-TruShoC’) to Reduce Heart, Lung, and Blood Organ System Failure in Resource-Limited Settings
Funding Agency NIH NHLBI K12 IMPACT (Implementation to Achieve Clinical Transformation (IMPACT): The Colorado Training Program) 
Description / Aims The overall purpose of this proposed research is to scale-up an evidence-based trauma intervention, termed Emergency Medical Services Traumatic Shock Care (EMS-TruShoC), in a resource-limited setting. 

‘EMS-TruShoC’ – A Prospective Trial of Low-Dose, High-Frequency, On-Site Training to Improve Trauma Field Care in Austere Settings

Funding Agency Defense Health Agency (J9, Research and Development Directorate; US Department of the Air Force (59th Medical Wing) 
Description / Aims EMS-TruShoC is a promising low-cost, high-impact, pragmatic solution for training of US Air Force, military, and civilian medics in resource-limited and remote settings, mirroring the austere combat environment with an emphasis on prolonged field care. This project seeks to implement EMS-TruShoC in an austere setting, and assess the resultant educational and clinical outcomes. 
Carnegie Africa Diaspora Program Fellowship 
Funding Agency Carnegie Corporation of New York 
Description / Aims Mini-grant to support travel and presentation to an academic conference 
Implementation of a Novel Prehospital Shock Care Intervention in a Resource Constrained African Setting
Funding Agency Emergency Medicine Foundation (EMF) 
Description / Aims The goal of this study is to formally develop an innovative prehospital shock trauma care (training) intervention to improve recognition and management of shock, then implement the package in an emergency medical services (EMS) system in South Africa while assessing implementation outcomes. 
Improving the Quality of Prehospital Traumatic Shock Care in Resource-Limited Settings 
Funding Agency Falck Foundation 
Description / Aims The goal of this study is to conduct a pilot intervention to assess the feasibility of implementing a novel educational on-site training program (EMS-TruShoC), and assessing educational outcomes, in a resource-limited ambulance station in the Western Cape Province of South Africa. 

Improving Early Traumatic Shock Care in Resource Limited Settings (Validation of a Quality of Traumatic Shock Care Chart Abstraction Instrument) 

Funding Agency University of Colorado, Department of Emergency Medicine (Pilot Grant) 
Description / Aims Validating A Novel Instrument to Quantify Prehospital Traumatic Shock 
Care. 

Epidemiology and Inpatient Management of Patients Hospitalized for Acute Asthma: 37th Multicenter Airway Research Collaboration (MARC-37) Study 

Funding Agency Novartis to the Massachusetts General Hospital 
Description / Aims Characterizing Hospitalized Asthma Patients To Determine Concordance Of Their Inpatient Care With National Asthma Guidelines, And To Characterize The Post-Hospitalization Asthma Care. 
Assessing the Effectiveness and Outcomes of an Emergency First Aid Responder (EFAR) System 
Funding Agency Carnegie Corporation of New York 
Description / Aims Studying the Effectiveness and Outcomes of the EFAR Program in Western Cape, South Africa. 

Assessing the Effectiveness and Outcomes of an Emergency First Aid Responder (EFAR) System 

Funding Agency University of Colorado, Department of Emergency Medicine (Seed Grant) 
Description / Aims Studying the effectiveness and outcomes of the EFAR program in Western Cape, South Africa. 

Emergency Medical Services (EMS) Assessment of Ashanti Region, Ghana 

Funding Agency NIH Fogarty International Center 
Description / Aims Conducting a mixed-methods regional EMS system assessment. 

Emergency Medicine (SOM)

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