Give yourself time to deal with  feelings of shock , denial confusion disappointment  anger, guilt sadness and frustration that may manifest as exhaustion , disturbed sleep , changed eating patterns.

Help the  parents by visiting , phone calls , sms , cards consider memorial mementoes. Be an active listener to reduce pent up stress and grief , be an active support to everyday living and routine chores where possible. After respectfully seeking the parents  permission – do not  usurp parent’s roles they sometime need to busy themselves. Allow parents to plan the grieving and funeral processes.

Found  in  6-17% of the  adult population and associated with symptoms of fatigue and sleep that is not refreshing, poor  concentration  low  or depressive mood. Other  presentations may be altered driving  behaviour , cognitive  deterioration ,  and  non breathing periods  during sleep.

Often associated factor  are airway obstruction , obesity  difficult  to  control hypertension, fatigue,   poor  motivation or depression.

Investigation includes clinical history , screening  questionnaire, appropriate  physical  examination,   and sleep studies by polysomnogram which may  be done  in certain case  by home  telemetry or formal laboratory  hospital based sleeps studies.

Treatment is by correction of underlying   physical  factors  and    the  use of  C-pap  positive  pressure devices  occasionally dental splinting   and  corrective  ENT  surgery may be  appropriate.

The patient  health summary is the  most  useful information you can present to a doctor you are seeing  for the first time or when attending Accident  & Emergency or being admitted to   hospital.  Patient  health  summaries are  readily printed by your GP and  ususally  are  1-2 A 4 pages that are easily carried and read by a health professional. They also faciltate any practitioner  contacting your regular doctor and assist  in providing  the  address for communicating results , correspondence  and discharge summaries to.

We encourage you to ask  your doctor to print you a copy to carry

Approximately 1000 children  die from inhaled foreign bodies  per year  and around the age of   3 yo. Mostly between  1 –2  yo. The  most  common  inhaled  objects are  food and nuts but  potentially any  small item.

A history of choking /coughing with associated respiratory distress like  wheeze noisy whistling  breathing ,  “ turning blue “ with coughing or wheeze., a subsequent  quiescent  asymptomatic phase may prevail  then be  followed  by  respiratory complications  like bronchitis  or pneumonia  with symptoms  of  cough , fever  and being generally unwell.

Metal and glass objects  may show  on  xray but plastic and food  or other organic objects will not . A swallowed  battery is a an urgent  medical emergency because of its  corrosive nature. Especially  beware  hearing aid , watch and  other  button batteries.

It is recommended that  hard lollies  , popcorn  , raw carrot , raw apple be avoided under  15 months and nuts  not be  offered until after 4 yo

Chest thrusts  or  back slaps  are  appropriate during  choking episodes.

If suspicious  of  foreign  body ingestion or aspiration   a  GP  or  A&E review  is appropriate   Specialist   paediatrician ENT review  may be  required.

Community  immunity  protects   those  members of the community  who cannot or  have  not  already been vaccinated  – like the  immunocompromised  with serious other illness like cancer  or dialysis, old age debility , those undergoing  chemotherapy and  new borns  not  yet vaccinated. To achieve community immunity  at least   92% of the community need to be vaccinated.

Potentially  life threatening diseases that  are  vaccinated against in Australia are: Diptheria , Whooping  cough , Tetanus , Poliomyelitis, Measles, gastroeneteritis from Rotavirus.and chickenpox

Additionally  significant  diseases  like  cancer of the cervix, meningococcal infection, hepatitis B  pnemococcal disease are  also  vaccinated through  school  and  retired  age group programs .