Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Inclusions

  • persistent allergic rhinitis/rhinoconjunctivitis (hay fever) for more than two years, with inadequate response to standard management, see ‘clinical management advice and resources’, in patients who may be candidates for allergen immunotherapy and who are unable to access private immunologist/allergist

Exclusions

  • patients under 17 years old
  • patients being treated for same condition at other hospital
  • patients with adequate response to standard management, without severe symptoms or complex respiratory allergic disease

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • persistent allergic rhinitis/rhinoconjunctivitis (hay fever) for more than two years, with inadequate response to standard management, see ‘clinical management advice and resources’, in patients who may be candidates for allergen immunotherapy and who are unable to access private immunologist/allergist

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • duration, impact, and seasonality of symptoms
  • potential environmental triggers
  • response to trial of standard management, see ‘clinical management advice and resources’
  • medical history, including presence of asthma or sinusitis

Additional information to assist triage categorisation

Clinical management advice

  • standard management of allergic rhinitis/rhinoconjunctivitis (hay fever) includes
    • allergen avoidance
    • intranasal corticosteroid spray – use regularly once or twice daily throughout season or all year
    • non-sedating antihistamines – may use double dose if needed
    • saline nasal spray or irrigation
    • antihistamine nasal spray, eyedrops
  • standard management should be trialled for at least six weeks

Clinical resources

Consumer resources

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery, where surgery is a likely intervention.
  • Choice to be treated as a public or private patient.
  • Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.