The Centre for Clinical Research in Emergency Medicine (CCREM) is a new Centre within the Western Australian Institute for Medical Research (WAIMR) focused on research activities within the spectrum of Emergency Medicine.

Our research involves collaboration between clinical academics working in the Emergency Department (ED), research nurses collecting samples from patients presenting to the ED with acute illnesses and basic scientists analysing samples in the laboratory using immunological and molecular biological techniques. Current projects include:-

· Venom Allergy Studies – identification of specific allergens within Australian ant species that trigger severe, life-threatening allergy (anaphylaxis), a randomised controlled trial of different methods of Venom Immunotherapy (VIT) to prevent anaphylaxis, and a variety of laboratory studies to assess changes in venom-specific immunoglobulin and cytokine responses during the time course of immunotherapy and how these correlate with clinical endpoints.

· Emergency Department Anaphylaxis (EDA), Australian Snakebite Project (ASP) and the Redback Antivenom Evaluation (RAVE) Studies, as a member of the Snakebite, Toxicology, Anaphylaxis, Redback (STAR) collaboration (www.star.ferntree.com):

• The EDA study aims to define the clinical spectrum of anaphylaxis, biochemical mediators and responses to treatment. This involves analysing samples collected from patients presenting to the ED with acute anaphylaxis for potential markers of mast cell degranulation and immune system activation (cytokines, leukotrienes etc). This work is now being expanded to include identification of potential genetic risk factors for severe anaphylaxis.
• The ASP and RAVE studies investigate the clinical nature of envenomings and responses to the specific antivenoms used to treat them. Within the STAR collaboration, CCREM has a particular interest in the nature of anaphylaxis and other immunological reactions to antivenoms and venoms.

· Chest Pain Studies - development of a new method to assess chest pain presenting to the ED using a multi-marker approach to exclude cardiac conditions.

· Illnesses affecting the Elderly - including long term follow up of elderly patients with diastolic heart failure and developing methods to improve the clinical differentiation between acute systolic and diastolic heart failure in elderly patients.

· Sepsis/Shock Studies - examine the early human immune responses to sepsis and shock in adults and elderly patients presenting to the ED.