Friday, 24 June 2016

SPHPM Profile: Tony Trapani

If you haven’t bumped into Tony Trapani on Level 6, or perhaps down the road at CafĂ© 12 grabbing a quick coffee, now is your chance to catch up as he features as our latest staff member profile this week.

Tony joined SPHPM in 2010 and his varied career in healthcare is the stuff of legend, being inspired as a young orderly at the Queen Victoria Hospital, and then pursuing intensive care nursing and paramedicine. He now oversees two studies at the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC).

Q: What is your role at SPHPM?

I’m at ANZIC-RC. Currently I am managing two studies the first is Prophylactic Hypothermia Trial to Lessen Traumatic Brain Injury (POLAR) which is an randomised control trial (RCT) examining the affect of early and prolonged cooling of patients with severe Traumatic Brain Injury (TBI). The study has Australian sites as well as international sites. The other study is called OzENTER, an observational study of TBI patients which links into Centre TBI (a European consortium).

Q: Where did you work prior to starting at the University?

A: Most of my working career has been spent in Intensive Care. I have held various roles – a number of years as a Clinical Educator at The Alfred and also five years as Intensive Care Unit (ICU) Manager at Western Health. I have also spent a few years “on the road” as an Ambulance Victoria paramedic.

Q: Tell us more about your background - how did you get here?

A: The POLAR study appeared to fit me pretty well and covered all the areas I am interested in: pre-hospital care, intensive care, trauma and trauma outcomes. When it was advertised it was too good an opportunity to miss – I have continued to learn every day.

Q: What do you like best about your role?

A: On a day to day basis I really enjoy the problem solving the role requires of me. Working with a number of sites and many of these overseas offers challenges each day. The research is pragmatic in its design so I get to consider real life clinical scenarios frequently.

On a longer term basis, I have seen the affect trauma, especially brain trauma has on families. The effect of this pathology can put an enormous strain on families and also has great social and economic affects. I hope this study can help, even a little, in improving our care of this patient group.

Q: Why did you choose your current career path?

A: I started my university life doing electrical engineering but it soon became evident that I needed a more social profession. My mother was chief interpreter at Queen Victoria Hospital and she secured me a job as a porter/orderly. It did not take me long to realise how much I enjoyed being involved in health. I completed my nursing and quickly mixed to the ICU at The Alfred. I have also been heavily involved in Australian College of Critical Care Nursing.

What project are you currently working on and what does it involve?

A: TBI is a leading cause of death and long term disability, particularly in young adults. Studies from Australia have shown that approximately half of those with severe TBI will be severely disabled or dead six months post injury. Given the young age of many patients with severe TBI and the long term prevalence of major disability, the economic and more importantly the social cost to the community is very high.

Pre-hospital and hospital management of patients with severe brain injury focuses on prevention of additional injury due primarily to lack of oxygen and insufficient blood pressure. This includes optimising sedation and ventilation, maintaining the fluid balance and draining cerebrospinal fluid (CSF) and performing surgery where appropriate. In recent years there has been a research focus on specific pharmacologic interventions, however, to date there has been no treatment that has been associated with improvement of neurological outcomes.

One treatment that shows promise is the application of hypothermia (cooling). This treatment is commonly used in Australia to decrease brain injury in patients with brain injury following out-of-hospital cardiac arrest. Cooling is thought to protect the brain using a number of mechanisms.

POLAR-RCT: Prophylactic Hypothermia Trial to Lessen Traumatic Brain Injury – Randomised Controlled Trial is a prospective, randomised controlled multi-centre international trial of early and sustained prophylactic hypothermia in patients with severe traumatic brain injuries.

In your opinion, what are some of the greatest challenges facing public health?

A: Our population continues to grow older. The impact of the aging population on the health system is large. Older patients are finding their way to acute care facilities and these patients have their own particular needs. I am not sure if we accommodate this patient group well in an acute setting or if the impact of this older group has been considered in apportioning resources.

I think a great deal more needs to be done to consider and address the needs of our aging population.

Anything else of interest you wish to discuss?

I cannot emphasis enough the importance of the team at ANZIC-RC and at SPHPM. My role would be so much more difficult if I did not have a fabulous group of colleagues to help, support and advise me. These studies require a huge undertaking from a number of people that often remain nameless – thanks.

Q: Choose a few words that best describe SPHPM.

Future, planning and proofing – I really believe SPHPM does not sit on its posterior waiting. It is a school that is constantly trying to look to the future.

Tell us something about yourself that your colleagues wouldn’t know.

I am a trifle noisy! Only a trifle...

What/where is your favourite place to go (for a coffee or for exercise) when you step away from desk?

Boxing through the Staff Wellbeing and Activity Program (SWAP) has been absolutely great fun and a bargain. I have had an opportunity to get to meet some lovely people while attempting to get some fitness. Everyone should think about being involved! The bike active centre has also been fabulous. Both things have got me doing exercise more consistently.

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