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 bacterial rhinosinusitis with visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
  • orbital complications from sinusitis

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

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • chronic sinusitis with red flags
  • complicated sinus disease e.g. extra sinus passage

Category 2 — appointment clinically indicated within 90 days

  • complicated sinus disease suggestive of fungal disease

Category 3 — appointment clinically indicated within 365 days

  • chronic and recurrent: persistent symptoms > 8 weeks, and/or > 3 episodes per year
  • failed/not responding to maximal medical management
  • chronic sinusitis
  • increased congestion with positive skin prick testing (immunology assessment)

For more on outpatient referrals, see the general referral information page.

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.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • clinical history including:
    • onset and duration of rhinosinusitis
    • frequency of episodes
    • treatments and interventions
    • associated functional impairment/s e.g. headaches and neuralgia
  • associated features presence of red flags
  • details of previous medical management including:
    • systemic and topical medications prescribed
    • duration and outcome of the treatment
  • computerised tomography (CT) paranasal sinuses after completing medical management
  • CT in presence of red flags or after 3-month course of medical therapy, including company and accession number
  • complete blood examination (CBE)

Clinical management advice

Red flags:

  • unilateral nasal discharge mixed with blood persistently for more than a month
  • orbital symptoms (swelling, redness, loss of vision or eye pain) with sinusitis
  • persistent unilateral clear nasal discharge and beta-2 transferring positive on testing (cerebrospinal fluid analysis)
  • abnormal imaging with suspected malignancy

Clinical resources

Consumer resources