Monday, 24 August 2015

Reducing unwarranted radiation exposure to children and young people from CT scans

In Australia, many computed tomography (CT) scans are performed on children and young people each year. CT is a valuable diagnostic tool, especially in emergency situations. However, CTs use higher doses of radiation than other types of medical imaging tests, and their use in childhood or adolescence has been linked to a slight increase in developing cancer later in life.1

Children and young people may also undergo a cone beam computed tomography (CBCT) scan as part of their oral health care. CBCT scans can provide dentists, orthodontists and surgeons with important information to help them with decisions regarding oral health care. While typical radiation doses in cone beam CT are much lower than those used in medical CT, use of radiation in oral health care should also be kept as low as possible.

Information for parents
If your child has had a CT or a CBCT scan, or may need one in the future, do not be alarmed. Talk to your child’s doctor or dentist about the benefits and risks of the test. You may want to ask:
  • how the test will improve your child’s health care
  • whether there are alternative imaging options, and
  • if a CT scan is necessary, how the radiation dose will be kept as low as possible for your child.
Always let the doctor or dentist know about any other scans your child has had and take any previous scans with you to appointments.
If your child is referred for a CT or CBCT scan, it is important for you to remember that a scan which is warranted, will almost always result in more benefit than harm to most patients.

The Australian Commission on Safety and Quality in Health Care (the Commission) has partnered with the Association for the Wellbeing of Children in Healthcare and NPS MedicineWise to develop a brochure that answers questions that you may have if your child needs a CT scan.  A companion poster has also been developed by these organisations for display in doctors’ practices, medical imaging services and early child health services.

In partnership with the Australian Dental Association and other dental organisations, a brochure for parents and carers and a companion poster on CBCT have also been produced.

Support for health professionals
To support doctors requesting CT scans, the Commission has also partnered with the Australian Radiation Protection and Nuclear Safety Agency to update a fact sheet providing information on CT scans for children, including the typical radiation doses for various scans.  

To support all people involved in the CT patient journey, the Commission has partnered with Healthdirect Australia to establish a web page dedicated to hosting these and other resources on CT scanning for children and young people. Visit for access to the fact sheet, brochures, posters and videos and interactive tablet games to assist parents and carers to prepare a young child for a CT.

For more information about CT scans for children and young people, visit


 1 Mathews JD et al. Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence:  data linkage study of 11 million Australians. BMJ.2013;346:2360

Dimity Herden
Senior Project Officer
Australian Commission on Safety and Quality in Health Care

Monday, 3 August 2015

The three little “P’s” - Playgroup and Peppa Pig

Children were excited when Peppa Pig Goes to Hospital was the story of the day at one Sydney play group. There were about 15 children, mainly two year olds and pre-schoolers, who sat on the story time mat. During playtime they couldn't wait to put bandages on their dolls or teddies and one boy carefully bandaged his dinosaur’s tail. Craft was a lot of fun with Humpty Dumpty, both before and after the accident, some children preferred the ambulance craft. It was a bustling morning but there was time for children to select a book from our display and have a quiet read. A few did this.  There were over twenty books to browse or borrow and several parents commented about the range of books available.

Before the story, children were told, ‘When we go to see a doctor or nurse we can take a special toy or book and we will have our mum or dad or person who cares with us’. Peppa pig’s hospital room had a bright rainbow and after the story I commented, ‘We can always play and draw pictures when visiting the doctors or in hospital’.

The playgroup was well equipped with hospital play kits including stethoscopes, bandages and toy thermometers. If any toy was short of a bandage, a box of bandaids was within reach. One little girl showed me green dots all over her baby’s head. She and her mother had carefully placed bandaids over the middle of the baby’s head covering the ‘dots’. This was clearly a topic the kids related to.
I was the first of several visitors for term three with the theme, 'people who care for us'. The playgroup leader introduced the topic talking about doctors and nurses and the children sang several action songs about being sick, including ‘humpty dumpty’.

When the doll, teddy and dinosaur play began a brochure was handed out, ‘Hospital preparation for pre-schoolers – time well spent’. In amongst the fun I was hoping to convey to the children that when we are sick or hurt, it is not because of something we have done. Also if we are sick, doctors and nurses are there to help us get better and Mums, dads or the person caring for us will be there to give us a hug.

Whilst the children played, parents were reminded that fear of the unknown is an issue for young children and that pre-schoolers need reassurance. When we think of going to hospital, we think about the role of health professionals and may not stop to think about the role of parents. My take home message for parents was that their role is really important too. Parents and carers help their children cope with fear by being calm. Playgroup parents laughed at this point, recognising this is something easier said than done. I showed them two books Help! My child is in hospital and Everybody stay calm.

Before my voice faded into the general hubbub, my final point was that it is important to be informed and not to be afraid to ask if something is not clear. Parents can ask the hospital what resources are available to help prepare. The AWCH website and Dr Angela MacKenzie have many helpful links for parents and carers who want to prepare their children in different medical situations. A special mention was given of the wonderful free app designed for and with young children, “Okee in medical imaging”.

A chat with staff at a local pre-school followed. It was not long after I had arrived when a teacher pointed out the hospital corner, put together because of a child's recent hospital stay. The staff borrowed books to read to their classes and enquired about books for children with special health needs or those who have sick parents.
 One of the most poignant reasons for preparing children for hospital came from a playgroup mum. She shared an experience as a three year old child. She recalled how her parents said she was going on holidays. It was devastating to find this was misheard and that instead, her parents had said she was going to hospital. This became a traumatic experience and hard to get over. I finished the morning with a greater certainty that preparation is time well spent*.

Perhaps the three little ‘ps’ stand for – preparation, playgroup and Peppa pig.

Jillian Rattray
AWCH librarian
July 2015

*Dr Angela MacKenzie encourages parents to do their “homework” and be prepared.

Monday, 20 July 2015

An EA/TEF Story Inside and Out

I will never forget the moment my world turned upside down: on Friday the 13 March 2009.

I was thirty weeks pregnant, my husband was out of town and I was alone in a city I had just moved to.  I was folding laundry when suddenly, I felt something was happening, my water broke. “Please, not now baby!” I pleaded while holding my deflating belly.

Twelve hours later, Castalia’s heart was dangerously slow and I was rushed to the Operating Room for an emergency C-section. Even as a first time mother, I knew very well what a quiet birth meant. I felt numb.

I vividly remember the painfully heavy silence growing in the room, even when I finally found the strength to ask where my baby was. I was laying alone on the operating table, feeling the rhythmic pull of the stitches applied to my vacant womb, preparing myself to be told that my baby was dead.

The next thing I remember is slowly waking up and seeing a figure, a doctor stood by the door. It took a lot of effort to focus on the words he was saying, I was feeling very groggy still. In a detached voice, he announced:  “We suspect that your infant has Esophageal Atresia. She will be transferred to the Children’s Hospital to get evaluated and possibly undergo surgery today. We need you to sign some papers.”

"-Esopha…what? Can you explain what this means in terms that I can understand?”

Just like most people, I had never heard of this GI (gastro-intestinal) birth defect that affects one out of 3500 births. In a nutshell, it means that her esophagus, her food pipe, was not attached to her stomach. In her case, her upper esophagus ended in a pouch while her lower esophagus connected her stomach to her trachea.

I had no idea what that meant for her future or for ours.

EA/TEF (Esophageal Atresia and Tracheoesophageal Fistula) kids seem to have widely different journeys that do not simply stop at “getting repaired.” Even if their primary closure is successful, in most cases the esophageal muscles and nerves don’t work properly. It can make eating and drinking difficult or impossible, resulting in random choking episodes, strictures or Gtube feedings.

Furthermore, about half of them, like my daughter, have other birth defects.  Most also have GERD and will need to be on antacid medicine their whole life.  EA/TEF kids tend to get sick more often and stronger than other children but there hasn’t been much research to truly explain why.

They often have tracheomalacia - floppy airways. It can make it hard for them to breathe, especially when they are sick and it gives them a deep barky chronic cough that earns them lots of stares in public.
My resolution for 2015 was: to find a way to raise awareness and money for the condition. To accomplish both, I decided to write a children’s picture book called “An EA/TEF Story Inside and Out” to empower EA/TEF children, educate the public about the condition and offer ways for others to help.

It is available on: 
Or visit for more information. It is available worldwide in English (American and British Spelling) and in French. Coming soon in Spanish, Italian and Croatian.

Thank you for your support and please help spread the word about the condition.

Vanessa Munsch

Wednesday, 8 July 2015

Adventures of the little black trackas

Written by Merle Hall
Graphic design and illustrations by Gary Saunders
Neenann: Mill Park, VIC.

To celebrate NAIDOC week 2015, AWCH purchased Adventures of the little black trackas, we are celebrating by looking at a children’s resource which “studies Aboriginal and Torres Strait Islander arts and crafts”. The resource is a collection of four books, “welcome in Bangerang” country poster and CD, created for children aged 1 to 8. The children’s books and CD teach Bangerang language words. Through these vibrant books children discover Bangerang culture and learn about habitat and environment.

The books can be read to individual children or within a class. With 15 suggested activities written on the back cover, children can be inspired to write or create their own artworks. Local Aboriginal words can be substituted for Bangerang language words for people from a different Nation/Clan area.

The four books are:
  • Adventures of the little black trackas: Yedabila (animals)
  • Adventures of the little black trackas: Wala yedabila (water animals)
  • Adventures of the little black trackas: Djunda (bird)
  • Adventures of the little black trackas: Bamanebala (insects)

Each book features a different child who takes readers on a tracking journey. The readers are asked questions, learning Bangerang words as they look closely at the animals, birds, insects and habitat. Each journey starts with an introduction by the narrator who is the little black tracka. Readers accompany the little black tracka and learn about habitat and Aboriginal culture. At the end of each story the focus is returned to the smiling face of the little black tracka and the shared experience.

Graphic design and illustrations are in bright and earthy tones, they are both expressive and wonderfully detailed. The glossy A4 pages and bold pictures make these books useful for classroom reading. The books meet “Victorian essential learning standards VELS level 1 and 2 (pre, grade 1 and 2)”.

Adventures of the little black trackas is available for loan from the AWCH library or can be purchased through the Secretariat of National Aboriginal and Islander Child Care, SNAIC distributes this resource on behalf of the Neenann family, publishers. SNAICC writes how the resource supports “the Early Years Learning Framework for Australia of Belonging, Being and Becoming”. Visit their website to find out about the cultural significance of Adventures of the little black trackas.

Jillian Rattray
AWCH librarian

NAIDOC week 2015