Project Overview

The Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU) is based in the School of Nursing, Curtin University, Perth, Western Australia. PRECRU is a collaborative research endeavour with St John (Ambulance) Western Australia and consists of a multi-disciplinary team of researchers who conduct clinical and health services research aimed at improving patient outcomes. As a research student with PRECRU you will join a successful and supportive research unit, with the opportunity to build collaborative networks with other prehospital resuscitation researchers nationally (through links with the Australian & New Zealand Resuscitation Outcomes Consortium, Aus-ROC), and internationally (through links with the International Liaison Committee on Resuscitation, ILCOR).  

Cardiac arrest occurring outside of hospital (i.e. at home or in the community), known as out-of-hospital cardiac arrest (OHCA), is a significant public health issue, affecting 30,000 Australians each year, including children and young adults. OHCA has a high case fatality, typically with only 10% of victims surviving to hospital discharge. However, the early actions of bystanders are known to have a large impact on patient outcomes - namely through cardiopulmonary resuscitation (CPR) and the use of defibrillators. Bystander application of an automated external defibrillator (AED) reduces the time to defibrillation in OHCA, rather than having to wait 8-12 minutes for the paramedics to arrive; and significantly improves survival. In Western Australia in 2018-2022, rates of 30-day survival for OHCA patients were significantly higher (3-fold) if a public AED was used, compared to patients who first received defibrillation by paramedics. 

Strategic placement of AEDs in the community is essential to ensure their accessibility. Initial work undertaken by PRECRU developed an empiric model for the strategic placement of publicly accessible AEDs in metropolitan Perth. Using data on the location and timing of OHCAs, and the locations and hours of access of existing public-access AEDs, candidate locations were compared for future deployment of AEDs. However, to-date this analysis has focussed on arrests in public locations in metropolitan Perth. 

Building on this initial research by PRECRU, this doctoral program will examine strategies for improving AED access in rural and remote WA, and for the majority (70%) of OHCAs that occur in private residences. In addition, this PhD will compare the feasibility and effectiveness of alternative strategies for enabling rapid access to AEDs – including the use of app-based alerts of registered community first responders, and emerging technologies such as personal AEDs. These comparisons are expected to require a combination of biostatistical analysis, spatial analysis (e.g. using Geographic Information Systems, GIS), and computer simulation methods.

Aims

The aim of this project is to estimate and compare the effectiveness of different strategies for enabling the fast delivery of defibrillators to the scene of out-of-hospital cardiac arrests, in order to improve patient survival.

Objectives

The specific objectives of this project include: 
1. Undertaking a scoping review of the alternative methods for the pre-ambulance deployment of AEDs to the scene of cardiac arrests in the community 
2. Analysing trends in the levels of AED coverage in Western Australian in different location types (public locations versus private residences; metro versus rural; areas of varying socioeconomic status), and estimating the potential number of lives that could be saved in those location types with future growth of the AED network. 
3. Estimating the impact of alternative methods of AED delivery through the use of spatial simulation methods.  Examples of novel methods of AED delivery include: 
- Improvements in app-based deployment of bystanders – e.g. optimal use of information on the proximity of bystanders to public-access AEDs; 
- Provision of personal/handheld AEDs to registered community responders; 
- Use of drones for aerial deployment of AEDs to cardiac arrests; 
4. Comparing the effectiveness of different methods of AED provision

Significance 

The significance of this PhD is that it provides the opportunity to develop and apply analytical skills in relation to an important real-world problem – of helping to inform future gains in survival from out-of-hospital cardiac arrest. While recent years have seen a promising increase locally and internationally in the numbers of lives saved through bystander use of AEDs (with 30% of all OHCA survivors in WA in 2018-2022 received an AED shock by bystanders), the overall use of AEDs remains low (only 15% of OHCA cases in WA in 2018-2022 had an AED applied by bystanders). For future gains, especially in more challenging locations such as rural/remote regions and private homes, there is a need for robust analytical methods to compare different strategies. This PhD will help fill that knowledge gap.

PRECRU is a successful research group in the Curtin School of Nursing; with a long-standing collaborative research partnership with St John (Ambulance) WA (SJ-WA).  As part of PRECRU, the PhD student will join a productive and supportive research unit, with opportunities to build collaborative research networks nationally and internationally.  They will be provided a PRECRU desk (secure office), a computer, statistical software, and research methods training if required. PRECRU also aims to fund doctoral candidates to present their work at a national/international conference.  

The project feasibility is ensured by the availability of the project data, and content knowledge and methodologic expertise of the proposed supervisors. Dr Stephen Ball (PRECRU Deputy Director) manages the St John WA/PRECRU Out-Of-Hospital Cardiac Arrest Registry, and is an emerging national leader in resuscitation research; with expertise in spatial analysis and epidemiological modelling. JCD Prof Judith Finn (PRECRU Director) is a NHMRC Leadership Fellow with an international profile in resuscitation (cardiac arrest) research. This PhD will further build on the successful relationship between PRECRU/Curtin University and SJ-WA. In particular, the project will build new research capacity through the development of advanced spatio-temporal methodology, as applied to an important real-world problem of decreasing the time to defibrillation.

An internship may be available for this project. This project has an internship opportunity to work as part of various teams at St John (Ambulance) Western Australia (SJ-WA) that are responsible for coordinating the use of AEDs (defibrillators) in the community. This includes SJ-WA’s Community First Responder team who maintain the Western Australian state register of public-access defibrillators, and who facilitate the use of the AED network by members of the public who are registered on the St John First Responder App.

• Future Students

• Faculty of Health Sciences

• Higher Degree by Research

• Australian Citizen
• Australian Permanent Resident
• New Zealand Citizen
• Permanent Humanitarian Visa
• International Student

• Merit Based

The annual scholarship package, covering both stipend and tuition fees, amounts to approximately $70,000 per year.

In 2024, the RTP stipend scholarship offers $35,000 per annum for a duration of up to three years. Exceptional progress and adherence to timelines may qualify students for a six-month completion scholarship.

Selection for these scholarships involves a competitive process, with shortlisted applicants notified of outcomes by November 2024.

1

All applicable HDR courses.

The applicant will need to demonstrate an interest in quantitative research methods: epidemiology, biostatistics or spatial analysis methods. Experience using statistical software, spatial analysis software (e.g. Geographic Information Systems), or computer programming would be an advantage; however, training will be provided if required. Whilst clinicians (including paramedics) are welcome to apply, a clinical background is not essential. PRECRU PhD students are expected to publish academic papers during their candidature and will be supported to achieve this. Fluency in English is essential and the successful applicant will be required to work both independently and as part of a team.

 

Please send your CV, academic transcripts and brief rationale why you want to join this research project via the HDR Expression of Interest form to the project lead researcher, listed below. 

You must be enrolled in a Higher Degree by Research Course at Curtin University by March 2025.

Project Lead: Dr Stephen Ball