We caught up with Dr Samer Elkhodair, research lead for emergency medicine at UCLH, whose team within the emergency department (ED) is working with UCLH specialties and GP services on research in areas including paediatrics, orthopaedics, surgery, haematology, and intensive care medicine.
The emergency department research team is expanding the amount of research it is involved in thanks to funding from the UCLH Research Directorate aimed at growing clinical trials in under-researched areas.
What are the challenges of doing research in an emergency department (ED) setting?
Conducting research in the ED is challenging due to the need for rapid decision-making, a high turnover of patients and limited time for informed consents and follow-up.
Research in ED is often hard to balance as it has to compete with the acute care of critically unwell patients. EDs have been under-researched in the past since, traditionally, departments emphasise immediate clinical action over long-term observation.
How will the funding from the Research Directorate for research time help address these challenges?
With more time in my job plan being allocated to research since this award was made, our team in ED has been able to collaborate with other specialties in the hospital and provide assistance in recruiting patients to research studies.
Can you tell us about some of the studies you are working on?
We are currently working alongside Orthopaedics on a study called DRAFT-3 to compare use of a removable splint for wrist fractures, compared with current standard of care which is a cast. Use of a removable splint could be more convenient for patients and would mean they don’t have to return to hospital once their fracture is healed.
With GP colleagues, we are working on a study called COAT which is comparing 5 days versus 7 days of oral flucloxacillin in primary care patients with lower limb cellulitis.
In a future collaboration with the Infection Division, a trial called Dexacell will look at whether adding dexamethasone to standard cellulitis treatment leads to improved recovery rates, reduces swelling and speeds up healing time for ED patients.
Why are these studies needed?
These studies are meant to address gaps in ED care through better, efficient, and effective treatment protocols that are patient centred. Each of the projects re-evaluates standard practices that have been in place and defines whether current treatments can be advanced to realize larger recovery rates, reduce healthcare costs, and streamline resources.
Considering the sudden changes and high demand within EDs, these studies also place focus on quick, evidence-based responses to some common presentations like cellulitis, fractures, and UTIs.
How could your work benefit patients in future?
The research outcomes could lead to faster recoveries, reducing treatment duration, and an overall reduction in the cost of healthcare for the patient.
For instance, a course of antibiotics for lower limb cellulitis – as we are looking at in the COAT trial – might be able to be shorter than what clinicians prescribe today. Or the splint used for a fracture might be removable to minimise discomfort and reduce recovery times.
About the funding from the UCLH Research Directorate
A funding call from the Research Directorate launched in 2024 is giving clinicians protected time to deliver research – both commercial and non-commercial – that they would otherwise not have capacity to do. Applications to the funding call were encouraged from clinicians working in clinical areas at UCLH that have significant opportunities for growth, where patients are currently under-served in research. The call was open to staff with prior research experience, but with fewer than 1 current PA (or 0.1 whole time equivalent) of time per week for research.
