The Heart Foundation of Heartweek is on the 6th to 12th May.
The 2012 Influenza Vaccination Program will commence nationally on Thursday 15th March 2012
Children presenting to the emergency department with moderate or severe asthma attacks are less likely to be admitted to hospital if they are treated with systemic corticosteroids within the first 75 minutes after triage, according to a new study.
Central Queensland University conductes the largest Australian sleep census to explore the sleep habits of the nation. 
New research shows increased information and education regarding the neurocognitive, cardiovascular and metabolic consequences of untreated OSA, as well as the importance of persisting with the treatment has positive consequences on patients CPAP compliance.
New research results reinforce the value of follow-up tools following right heart catheterisation and provide further support for some of the treatment goals currently suggested by international guidelines.• Establish good rapport with your patient and his or her family. A confrontational approach or immediately raising the possibility of revoking the driver's licence will lose you the patient. The emphasis should be on maintaining doctor–patient confidentiality, appealing to the patient's social responsibility, and the fact that, with appropriate diagnosis and treatment, most patients with sleep disorders can drive unrestricted.
• Make an assessment about the level of sleepiness and its possible impact on driving risk in your patient. It would be unreasonable and totally impractical to send all patients with obstructive sleep apnoea for daytime sleep latency tests to determine level of sleepiness.
Assessing the effect of a patient's sleepiness on their driving
- Ask about instances of falling asleep while driving (eg, wheels on the verge or hitting the "cats eyes", lane drifting, previous fall-asleep crash)
- Seek corroborative history from the spouse or partner
- Ask patient to fill out the Epworth Sleepiness Scale questionnaire,10 which takes about five minutes. It requires patients to rate their chance of dozing in eight specific situations. The normal value is < 10 out of a maximum possible score of 24. A score > 15 indicates severe sleepiness and has been associated with substantially increased risk of fall-asleep MVAs.
- Consider additional causes of daytime sleepiness. Sleep restriction is very common and sleeping for less than five or six hours for even one night significantly increases the risk of a fall-asleep MVA.
• Consider your patient to be in a "high-risk" category if there is a history of (1) a recent fall-asleep accident, (2) repeated "near-miss" fall asleep episodes while driving, (3) repeatedly falling asleep in other active situations (eg, during conversation, at meal table), or if your patient has a very high score on the Epworth Sleepiness Scale. Australian guidelines for healthcare professionals indicate that such "high-risk" patients should be instructed to stop driving immediately while referral to a sleep specialist and further investigation and treatment is arranged. If you consider that your patient is sleepy but does not fit the above "high-risk" categories, it may nevertheless be wise to advise him or her to reduce the risk of an MVA by avoiding night or country driving and by abstaining from all alcohol before driving.
• Keep careful notes. Ideally, all patients with obstructive sleep apnoea should be informed verbally, and in writing (eg, a pamphlet) if possible, about the increased risk of fall-asleep MVAs and the need to exercise care while driving.
• Special provisions apply if your patient wishes to apply for or renew a commercial or heavy vehicle driver's licence. Current Australian guidelines for healthcare professionals recommend that the licence be withheld if obstructive sleep apnoea (of any severity) is diagnosed, unless and until it is successfully treated. A conditional licence should be recommended (ie, restrictions imposed) if the driver has sleep apnoea symptoms of any severity until these symptoms are investigated. Thus, the burden of proof of driver safety has been deliberately increased for commercial drivers who have or are suspected of having obstructive sleep apnoea.
• Current uniform national driver licensing laws in Australia place the legal responsibility on drivers to notify their State/Territory licensing authority that they have a medical condition likely to affect their driving. If effective treatment for obstructive sleep apnoea (or any other sleep disorder) cannot be instituted within a reasonable time frame, and if your patient refuses to restrict driving as advised, you should remind him or her of this obligation.
• Finally, what is your ethical and legal responsibility if you have reason to believe that, against your advice, your patient is continuing to drive while seriously impaired?
- at this point public safety takes precedence over patient confidentiality.
- you could be found liable in the case of serious injury or death in the event of a fall-asleep accident should you fail to take reasonable steps to prevent your patient driving in a dangerous manner.
- you should advise the patient that, in the interests of public safety, you must inform the licensing authority. This action can and will annoy some patients, but legislation in all Australian States and Territories provides medical practitioners with legal indemnity under these circumstances.
- The National Road Transport Commission (NTC) released proposed changes to the medical standards for private and commercial drivers for public consultation in May 2010 to read more click here.