Dr. Gabrielle Freire


Affiliations: Department of Paediatrics, University of Toronto

Paediatric Emergency Physician, The Hospital for Sick Children, Paediatric Emergency Physician, The Hospital for Sick Children

Research Interests:

As a paediatric emergency doctor, my research interests include trauma/resuscitation, respiratory emergencies, and the use of point-of-care ultrasound. As a MHScTR candidate, I would like to develop an environment where paediatric trauma can be more easily studied, as most of our current practice relies on studies done in the adult population which may not translate directly to children. Multiple barriers exist to the development of such a research environment which I would like to explore and (hopefully!) overcome one day. Moreover, I would like to ensure that our paediatric trauma care reflects the latest published evidence and is standardized across the province/country, as I have observed a lot of practice variation in the field. This process will involve both exploration of the reasons behind practice variation, as well as efforts towards provider education and guideline implementation. Lastly, I am also interested in the root causes of paediatric injuries and applying that knowledge to injury prevention.

Brief Bio:

Gabrielle’s translational work focuses on the standardization of care for children presenting to emergency departments across the province regardless of geographic location. Gabrielle is a paediatric emergency physician working at The Hospital for Sick Children. Her pre-existing research expertise includes respiratory emergencies and paediatric trauma. To expand this work through translation, she is exploring strategies such as the creation of a paediatric emergency virtual care network and a prospective paediatric trauma registry. She is also interested in exploring the root causes of paediatric injuries to better educate injury prevention strategies. Gabrielle obtained her medical degree from McGill University, and completed her paediatric training at the CHU Sainte-Justine, in Montreal.

Capstone Project:

Injuries are the leading cause of death and disability in children worldwide. In Canada, 45% of children live more than an hour away from paediatric trauma centers and are more likely to present to general emergency departments without paediatric expertise when injured. Recent studies have shown that children living far from paediatric trauma centers often have worse outcomes compared to children that present directly to these centers. These studies have also demonstrated practice variation at general EDs when managing pediatric trauma.

Our Capstone project focused on addressing practice variation in the management of paediatric trauma patients at Ontario general EDs, to ensure that optimal care is received regardless of geographical location. In our journey, we have identified that a lack of human and physical resources, communication issues, complicated transfer processes and knowledge gaps contribute to practice variation for pediatric trauma management in Ontario. We developed a rigorous research protocol to assess the needs, pertaining to each of these categories, for providers treating paediatric trauma patients at general EDs in Ontario. In addition, the needs assessment will give insight into the knowledge transfer needs and preferences of these health care providers. This will help confirm the pertinence of implementing the PedsPac, a co-created knowledge transfer tool we identified, at Ontario general EDs.

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