Dubbo Kids' Health

Welcome to Dubbo Kids Health which is a  child health community website for health professionals and the families that they serve.

The purpose of this website is to provide child health information from reputable sources in a single location; we  also aim to make it easier for families to find reliable and relevant information. We note that some hospitals provide information on site on their own intranet via Sharepoint. Some hospitals provide internet resources for ease of access to all.

Please note this is not an official Dubbo Base Hospital, Western NSW Local Health District or NSW Health resource. For staff working in these facilities seek specific information for these sites, please refer to their local internet sites and discuss with staff currently working.

The site is divided into a few sections :

• Emergency: this has information mostly relevant for staff working within the emergency department

• Babies: information who are less than 28 days of age, also known as "neonates"

• Kids :  this has information on medical problems in older children , from 1 month to 16 years of age 

• Remote Kids: this considers how medical staff and families meet the medical needs of children in remote locations in NSW

• Dubbo Paediatric Outpatients: this looks at outpatient services in Dubbo and looks at information for clinicians and families in these cases

• Family information :  this has information designed for carers and families. In particular we seek to obtain medical information , with easy to read fact sheets on common medical problems. 

The Dubbo Kids' Health website is curated by Dr Dominic (Francis) FitzGerald who is a general paediatrician who has lived in Dubbo for 15 years.  Over this time he has hoped to improve the access to reliable child health information in this big, sparsely populated area of western NSW,  for rural health professionals and the families they serve.

To be clear that this website is not a NSW Health Website, and even though Dr FitzGerald is employed by NSW Health, this is a separate and distinct entity to NSW Health and its own governance. Note that there are some links onto NSW Health website and Royal Children's Hospital Websites, the governance that is relevant when accessing these sites, is with regards to the original authorship.

He has compiled the website links with the assistance of nursing staff and medical colleagues. This is a not-for-profit website that is self-funded, and any mention of medications, local pathology or radiology services are done so for the benefit of patients. There are no private endorsements being paid to our staff. 

Credit for the formulation of the idea of a simple, easily accessible website is shared with Sr Tiana Richardson (nee Trappel) , who was crucial in the initial phases of development.

Dr. FitzGerald may be reached through his secretary  Ms Ayesha Anwar on 6809 7083 for discussion on issues arising , or by email dominic.fitzgerald1@health.nsw.gov.au

If the weblinks are not working, please email Dr. FitzGerald.

EDITORIAL TEAM

The maintenance of a website that is broad in scope, is an ambitious undertaking that risks inaccuracy and mediocrity unless supported by a team.

Dr FitzGerald has invited an editorial team to assist with the publishing and maintenance of information for our community.

It is proposed that regular meetings will be held to ascertain the accuracy and currency of the information on Dubbo Kids Health.

A) General Practice contributors: Dr Ai-Vee Chua, Dr Paul Lunney, and Dr Chantal McGrath

B) Intensive Care contributors: Dr Tim Stanley (ICU at Dubbo Hospital and in Sydney)

C) vCare consultant :  FACEM (Clinical Director – vCARE, Emergency Specialist

D) Paediatric contributors: Dr Jacky Askwith, Dr Gina Mariano

E) Medical students helped in outpatient...

This website is just a guide to discuss with your nurse/doctor 

Do not use it without consulting with local staff

If you are working in NSW Health , utilise an appopriate NSW Health guideline

Its main aim is to provide information rapidly for families and clinicians working with sick children

Before reading and implementing any clinical practice guidelines with your doctor and/or nurse practitioners, it is important for health professional to:

Step 1.  REVIEW the sources of information and to understand  in what setting the author intended it to be used.

Step 2.  DISCUSS with senior clinicians, prior to implementation,  and reach an agreement with the family/ carer of the child , on what is the best plan.

Step 3. IMPLEMENT  the agreed plan with senior clinician providing oversight where possible.

Step 4. REVIEW AGAIN to confirm patient is responding appropriately to the plan with no serious side effects or complications, and discuss  options again with the senior clinician,  if patient fails to respond to treatment  (or has complications) 

Please note that clinical practice guidelines  (CPGs or guidelines for short) outlined on this website are not a substitute for medical care. The guidelines are from a variety of sources, and are intended only as an adjunct to the medical care provided by your community doctors and nurses.  If your child has a significant medical problem, we encourage parents to find  an appropriate local resource in Dubbo and  its environs. The author plans to carefully document , within the Dubbo Kids' Health site, what options are available to our community  if, and when you have a sick child.

We note  that there may be some administrative and/or legal concerns that the public may use the guidelines incorrectly with the acknowledged risk of them suffering harm as a result. And  in  such individuals doing so there may be a fear of doors being opened to litigation of the author, or the websites  that the user is directed to by the Dubbo Kids'  Health website. The author believes that the majority of the public, by the time a medical consultation  (being driven no doubt by normal human curiosity and valid fears)  have attempted a  "Dr Google self-diagnosis"  Internet search. 

It is apparent that said individuals are at already at considerable  risk of accessing poorly regulated medical information; this website tries to direct these inevitable "Dr Google searches" to what we believe are well curated and reliable sources of information. It the author's view that the acknowledged  risk of individuals using a resource incorrectly does not mean that the resource may not potentially benefit many sensible people; nor does it mean that the website  is  seriously flawed in conception, and as such, would be better taken down.

Perhaps unfortunately, some links may only be accessed by NSW Health Staff, as the relevant website is not for public access.  The author's view is that medical information should be  shared as widely available as possible, and that health practitioners should help interpret the information available with patients and , where possible, reach the decision together as to the best possible care plan.  Importantly, we also note that GPs may not be able to access some hospital guidelines. It the author's view that this does not facilitate the integration of primary care with hospital care and, as such, is not in our patients' best interests.  As a result ,the author of the website has also attempted to include guidelines that will be available to all parties: hospital staff, the GP and their patients.

Sources of information  (CIAP Paediatric Guidelines) Western NSW Local Information Paediatric Star

 1) Paediatric Improvement Collaborative  For acute paediatric problems start here, this part of Royal Children's Hospital

2) The Sydney Children's Hospital Network  (SCHN) which as both the Children' s Hospital at Westmead and the Sydney Children's Hospital CPGs.

This may be obtained on the internet  ( for all users including  general public use or GPs in their private rooms)  or intranet ( NSW Health public employees only).

• Internet

• Intranet

3) NETS  - the NETs calculator for emergencies fluid  and drug doses and NETS Guidelines

3) SCHN has guideline groups for areas that preferentially utilise some guidelines: 

•  Emergency Department: 

•  Paediatric Intensive Care Guidelines

4) NSW Health policy directives:

Note that as Western LHD staff work in NSW we have preferentially  listed NSW guidelines above. Where there is no NSW guideline, we encourage staff and families to look interstate, as the Royal Children's Hospital - see below.

5) Paediatric Improvement Collaborative: please note that states are working together to developed shared CPGs at the Paediatric Improvement Collaborative

6) Royal Children’s Hospital Melbourne - Clinical Practice Guidelines: 

The RCH has a comprehensive, easy to use, A-Z listing of common, and less common paediatric presentations. 

7) Emergency Care Institute NSW:  

The ECI has been set up under the umbrella of the Agency for Clinical Innovation (ACI) with its primary role being to improve outcomes for patients presenting at hospital emergency departments (ED) across NSW through coordination, networking and research. It has excellent links to single page algorithms for busy staff.

8)   Clinical Excellence Commission: 

The CEC has produced some documents relevant for paediatrics , such as the sepsis pathways, which have been included in the Western LHD list of  CPGs

9) ASCIA – for allergy information and anaphylaxis plans for EpiPen: 

10) Paediatric Epilepsy Network (PENNSW) :  Excellent for outpatient management of seizures for clinicians and families

11)   Australian Society of Infectious Diseases (ASID):

 b)  ASID management of perinatal infections

12) CIAP: An overarching NSW Health  clinical resource with multiple link

13) Healthpathways for Western LHD (this is derived from outpatient paediatric conditions published in New Zealand)

13) Metabolic diseases: This is hard area of paediatric medicine - this website is recommended by the Metabolic Team at the Children's Hospital at Westmead

14) Dermatology DermNet NZ ( A free access website supported by NZ dermatologists) 

15) ACI Paediatric Portal 

16) NSW Health employees- other health services intranet

17) RPAH intranet policies and Liverpool NICU policies

18) The Paediatric Portal  

19) Aukland : Starship Child Health  

29) Radiopaedia ( a free radiology site, with advertisements present, with a wide range of paediatric radiology images)

18) Ortho Bullets  Orthopaedics (a concise site, covering common paediatric conditions)

19) Don't forget the bubbles

Direct link for CIAP subscribers

• NEJM Paediatric section

• Pediatrics 

• Journal of Paediatrics and Child Health 

• BMJ best practice- A to Z of common paediatric conditions-

• Paediatric Clinics of North America

Education 

• Medical education with information sheets,  images and videos online (a variety of photos and images to help family and clinicians with diagnosis)

• Kids Health Library of cases

Rural Generalist Nurse and GP team

Educational Video on NSW Health Sharepoint

DRUG INFORMATION -for safe prescribing 

•   Meds4Kids  : Children's Hospital at Westmead  drug resource on general information for  prescribing medication for kids

•   Injectable drugs  (also from Children’s Hospital at Westmead): aimed at nurses drawing up IV drugs

• Australian Medicines Handbook : ,Very useful from prescriptions  as it has generic and trade names for  drug dosing and concentrations of suspensions

• MIMs:  May use “Drug interactions” and “add drug” for checking for drug interactions and a fairly comprehensive side effects list

• eTG

• CIAP 

Aboriginal Health issues are one of the core concerns of the Dubbo Kids Health website.

As your child receives medical care it is important to let your health professional know if you identify as being of Aboriginal ethnicity. This may change the timing and type of treatments your child would be offered.

In view of the special considerations needed for our Aboriginal people  the Dubbo Kids Health editorial group has invited both Aboriginal clinicians (doctors and nurses) and community elders to advise us if we are are achieving our goals in providing culturally appropriate and relevant information for our local Aboriginal community.

Those local members of our Aboriginal Community who have invited  to be part of the editorial advisory board are:

Dr Khyarne Biles

Dubbo Aboriginal Medical Service (Local General practice service)

Local  NSW  Aboriginal Health Centres - Health Direct Search on Aboriginal health

Primary Health Aboriginal Health Services

Wiradjuri Mob Facebook page

We welcome feedback from the general community and emails to Dr FitzGerald and Dr Biles will help the editorial group meet the needs of the local Aboriginal Community.

Dubbo is located in Wirradjuri country. The Wirradjuri people have been custodians of this land since the dreaming.

Dubbo, the town we are proud to call our home, is a Wiradjuri word meaning "red earth".

In our region 

Aboriginal nations within our region include:

• Barindji

• Barkandji/Paakantji

• Barranbinya       

• Barundji

• Gunu

• Kamilaroi

• Muruwari

• Muthi Muthi

• Ngemba

• Nyampa

• Wailwan

• Wilyakali

• Wiradjuri

• Wongaibon

On this website the term ‘Aboriginal’ is used to describe the nations, clan and language groups across NSW including all Aboriginal and Torres Strait Islander people within this region. 

Aboriginal Clan Map

This website is not affiliated with NSW Health, though some resources referenced will originate from NSW Health.

The website is supported and endorsed by Dr Dominic FitzGerald in his role as a private citizen, not in his role as an employee of NSW Health.

The website is reviewed periodically and attempts to stay as current as possible by utilising live URLs to reputable sites. Periodically the links will not work.