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.

  • anaphylaxis*. Symptoms include:
    • difficult/noisy breathing
    • swelling of tongue
    • swelling/tightness in throat
    • difficulty talking and/or hoarse voice, wheeze, or persistent cough
    • persistent dizziness or collapse
    • pale and floppy in young children
    • persistent abdominal pain, vomiting are signs of severe allergic reaction to drugs/insects
  • symptoms have required the administration of adrenaline

*Refer to the Australasian Society of Clinical Immunology and Allergy (ASCIA) Guidelines – Acute Management of Anaphylaxis for the definition of and recommended treatment for anaphylaxis.

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant specialty service.

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

  • Flinders Medical Centre (08) 8204 5511, after hours on-call service for patients of all ages until 11:00 pm

Women’s and Children’s Hospital Network


Category 1 (appointment clinically indicated within 30 days)

  • idiopathic anaphylaxis
  • anaphylaxis related to
    • insect venom e.g. bee, wasp, jumper ant
    • food (both staple and non-staple)
    • latex
    • drug

Category 2 (appointment clinically indicated within 90 days)

  • ongoing review of patient with anaphylaxis or allergy previously assessed by an Allergist with a management plan

Category 3 (appointment clinically indicated within 365 days)

  • nil

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.

  • symptoms including severity, and interval between exposure and reaction
  • identification of likely trigger if possible
  • co-morbidities and current medications
  • treatment required to manage reaction:
    • adrenaline
    • antihistamines
    • salbutamol
    • fluid resuscitation
    • corticosteroids
  • history suggestive of atopy e.g. presence of eczema/asthma
  • confirm if patient given ASCIA Action Plan for Anaphylaxis
  • confirm if adrenaline device and training able to be provided

Additional information to assist triage categorisation

  • mast cell tryptase if diagnosis in doubt and within three hours of the onset of symptoms (if possible)
  • any blood tests which have already been done

Allergy & Anaphylaxis Australia have trained health professionals (doctors, registered nurses and dietitians) responding to clinician and consumer enquiries through the national allergy support phone line and website.

Clinical management advice

If acute anaphylaxis is present or suspected, see referral to emergency. Otherwise:

  • prescribe adrenaline device and educate on correct use
    • Pharmaceutical Benefits Scheme (PBS) guidelines state that General Practitioners can organise an adrenaline device prescription (initial and continuing) in consultation with an allergist, paediatrician or respiratory physician if the patient has presented to an emergency department and required adrenaline
  • educate on recognition and management of anaphylaxis including positioning and use of adrenaline
  • provide ASCIA Action Plan for Anaphylaxis and provide education on how it should be used to identify symptoms and manage allergic reaction
  • educate on strict avoidance of allergen if trigger identified to prevent further allergic reactions
  • consider medical identification jewellery for venom or drug allergy
  • ensure alert is in place within relevant patient records
  • ensure any asthma is well controlled

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.

Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.

The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.