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.

  • acute and/or complicated mastoiditis
  • acute facial nerve palsy
  • acute sensorineural hearing loss
  • auricular haematoma
  • cellulitis unresponsive to oral antibiotics
  • meningitis
  • otitis externa with concerning features
  • penetrating foreign body
  • profound vertigo
  • sudden deterioration in sensorineural hearing
  • trauma

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

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

If clinical advice is required urgently or out of hours, please contact Flinders Medical Centre or the Women’s and Children’s Hospital.

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network

Category 1 (appointment clinically indicated within 30 days)

  • acute progression of unilateral/bilateral hearing loss (reported on 2 audiograms) and:
    • sensorineural hearing loss and/or
    • vertigo

Category 2 (appointment clinically indicated within 90 days)

  • middle ear effusion with hearing loss for greater than:
    • 3 months (bilateral)
    • 6 months (unilateral)
  • hearing loss with delayed speech/learning impairment
  • hearing aid authorisation
  • new diagnosis of:
    • unilateral/bilateral sensorineural hearing loss or
    • congenital hearing loss

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.

  • age
  • past medical/surgical history including autoimmune disease, craniofacial or cleft palate
  • allergies and sensitivities
  • onset, duration, and progression of symptoms
  • management history including treatments trialled/implemented prior to referral, including:
    • systemic and topical medications prescribed
    • length of medication treatment
    • outcome of the treatment
  • naso-oropharyngeal examination
  • relevant diagnostic/imaging reports including location of company and accession number

Ear examination

  • signs of acute inflammation of the tympanic membrane (TM) such as:
    • bulging, red, opaque on visualisation
    • most common cause of red TM alone, is a viral upper respiratory tract infection rather than otitis media
  • hearing loss, unilateral/bilateral
  • speech delay

Additional information to assist triage categorisation

  • audiology report is highly desirable

Clinical management advice

Glue ear, also known as otitis media with effusion (OME), is a common childhood condition where fluid accumulates behind the eardrum, causing temporary hearing difficulties and often follows an ear infection. Most cases improve without intervention, but if it persists, or affects your child's hearing, it is important to be seen by a doctor.

Antibiotics, antihistamines, and decongestants are not effective in managing glue ear. If needed, a hearing test and referral to a specialist might be recommended to ensure your child's hearing and speech development are not delayed.

Refer to clinical resources for assessment and management advice for glue ear/hearing loss first-line management options prior to referring. General practitioners can directly refer patients to audiologists who can offer diagnostic hearing assessments and recommendations for hearing aids and/or an ear, nose and throat (ENT) opinion.

Conventional or standard hearing aids are not distributed by public hospitals. If your child has mild, moderate, or severe bilateral hearing loss, it's advisable to seek referral to a nearby hearing aid provider. Hearing aids are available for children, veterans, and pensioners through the Office of Hearing Services, a branch of the National Department of Health. These aids are supplied by local audiologists, and it's advisable to consider a direct referral to Hearing Australia.

Developmental speech and language screening in children should be referred to speech pathology for assessment and diagnosis.

Please utilise the relevant Aboriginal Liaison Units (ALU) to provide support to Aboriginal families.

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.