Michael Austin

Major research initiatives have been in the field of Out-of-Hospital Care. These completed and ongoing projects designed have led to a research program focus on advancing the practice of paramedicine and optimizing best patient care. 

1) Oxygen is a Drug 
Dr. Austin's work regarding oxygen therapy has informed guidelines internationally and changed the way all health care practitioners approach the use of ‘the drug’ oxygen not only for chronic obstructive pulmonary disease patients but, for all comers (Austin M A, Wills K E, Blizzard L, Walters E H, Wood-Baker R. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial BMJ 2010; 341 :c5462 doi:10.1136/bmj.c5462).

2) Participation as Co-Investigator in the Resuscitation Outcomes Consortium (ROC)
The ROC is the largest clinical trial network in the world focusing on research in the area of pre-hospital cardiopulmonary arrest and severe traumatic injury. Members of this network include a number of internationally recognized scientific experts from eleven participating centres across North America and include Dr. Austin who plays a major role in the network. He co-authored on many ROC proposals. Many of these have been published in very high impact journals such as NEJM, JAMA, Circulation, and CMAJ.

3) Paramedics Providing Palliative Care in the Home 
With the exciting changes in the practice of paramedicine in Ontario, the Paramedics Providing Palliative Care in the Home is the first of the New Patient Care Models that is leading these changes. Dr. Austin and Dr. Charbonneau have developed and introduced a new model of care. This quality improvement project prepares emergency paramedics to assess and treat patients so that patient symptom management can begin at home. In addition to symptom management, the patient and substitute decision makers (SDMs) can make an informed decision to remain in their home and avoid transport to a hospital emergency department.

4) Pain 
Pain is responsible for approximately 40% of ambulance calls. Effective and safe relief of acute pain is not only an important medical problem but, since 2004, it is has been considered a fundamental human right. Yet, it is often undertreated in prehospital settings. Dr. Austin is working on ensuring paramedics have the right tools in their pain tool box to ensure patients with pain can be managed in a timely fashion. 
 
5) Diabetic Emergencies 
The increasing scope of practice of paramedics over the past several decades has led to the provision of definitive treatment for emergencies at the scene, often raising questions from patients, paramedics and physicians about the necessity of transport to a hospital. Releasing patients after effective treatment likely has resource utilization and cost benefits to the hospital and prehospital care service, and patient satisfaction with this practice is well-documented. Hypoglycemia is a common complication in patients with diabetes treated with insulin and/or oral hypoglycemic agents and occurs in over ten percent of these patients each year resulting in paramedic response. The safety of prehospital treat-and-release of hypoglycemic patients is unclear. Dr. Austin and the team are working to develop a clinical decision tool for paramedics to identify patients who require transport. As well, Dr. Austin is working to utilize the available health resources to ensure those who remain at home have follow up for their acute presentation ensuring the patient's diabetes is well managed and reducing any long-term complications.