<html> <head> <meta charset="UTF-8"/> <meta name="tikaGenerated" content="true"/> <meta name="date" content="2016-12-28T00:36:14Z"/> <meta name="creator" content="Mary Dickson"/> <meta name="xmp:CreatorTool" content="Acrobat PDFMaker 10.1 for Word"/> <meta name="Company" content="SDGP"/> <meta name="meta:author" content="Mary Dickson"/> <meta name="meta:creation-date" content="2016-12-28T00:36:12Z"/> <meta name="created" content="Wed Dec 28 11:06:12 ACDT 2016"/> <meta name="dc:creator" content="Mary Dickson"/> <meta name="xmpTPg:NPages" content="1"/> <meta name="Creation-Date" content="2016-12-28T00:36:12Z"/> <meta name="dcterms:created" content="2016-12-28T00:36:12Z"/> <meta name="Last-Modified" content="2016-12-28T00:36:14Z"/> <meta name="dcterms:modified" content="2016-12-28T00:36:14Z"/> <meta name="Last-Save-Date" content="2016-12-28T00:36:14Z"/> <meta name="meta:save-date" content="2016-12-28T00:36:14Z"/> <meta name="SourceModified" content="D:20161222055554"/> <meta name="Author" content="Mary Dickson"/> <meta name="producer" content="Adobe PDF Library 10.0"/> <meta name="modified" content="2016-12-28T00:36:14Z"/> <meta name="Content-Type" content="application/pdf"/> </head> <body> <pre> Version Date from Date to Amendment 1.1 November 2016 November 2018 Review Nov 16 OUTPATIENT GP REFERRAL GUIDELINES EAR, NOSE & THROAT SERVICES (ENT) Southern Adelaide Local Health Network (SALHN) Otitis Media Indications for surgery are Recurrent Acute Ototis Media - > 4 episodes per year, or 3 episodes in 6 months Persistant Otitis Media with Effusion; Unilateral effusion present for more than 6 months, Bilateral effusion present for more than 3 months or unilateral effusion in the only hearing ear Severely retracted tympanic membrane Information Required Number of episodes of OM and/or duration of effusion If the child is of high risk : Aboriginal or Torres Strait Islander, Craniofacial syndrome, Immunodeficiency, Un-immunised Hearing loss and/or speech delay Helpful Investigations Audiogram (GP s can refer children directly to FMC Audiology for hearing test) Fax Referrals to ENT Clinic Fax: 8374 4928 Red Flags Acute mastoiditis red fluctuant swelling over mastoid process in a child with features of AOM. Contact the on- call ENT registrar to arrange urgent review in the Emergency Department the same day Suggested GP Management For recurrent AOM Analgesia (paracetamol 15mg/kg/dose or ibuprofen 10mg/kg/dose) and watchful waiting is appropriate for most children with AOM In children < 6 months, high risk children or those with sever bilateral disease commence oral amoxicillin 15mg/kg/dose, orally, TDS for 5 days For non-responders switch to amoxicillin + clavulanate 22.5+3.2mg/kg, orally, TDS for 5-7days For AOM in presence of grommet Clloxin 0.3% ear drops, 5 drops, twice a day for 9 days For OME There is no strong evidence for oral antibiotics, antihistamines, oral steroids or auto-inflation devices to improve resolution of OME Clinical Resources South Australian Paediatric Practice Guidelines Acute Otitis Media in Children Therapeutic Guidelines - Antibiotic Patient Information Parenting and Child Health. Women s and Children s Health Network. Available at URL: http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p =114&np=304&id=1855 General Information to assist with referrals and the and Referral templates for FMC and RGH are available to download from the SALHN Outpatient Services website www.sahealth.sa.gov.au/SALHNoutpatients Approved by Prof Eng Ooi Date: </pre> </body> </html>