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.
- cardiac arrhythmia
- concurrent hypokalaemia
- corrected serum calcium less than 1.8 mmol/l
- ionised calcium less than 0.9 mmol/l
Consult the on-call endocrine registrar for guidance in presentations with concerning features.
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
- Lyell McEwin Hospital
(08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Category 1 - appointment clinically indicated within 30 days
- symptomatic hypocalcaemia
- tetany, cramps, paraesthesia
- symptomatic hypoparathyroidism
Category 2 — appointment clinically indicated within 90 days
- asymptomatic hypocalcaemia in known hypoparathyroidism
Category 3 — appointment clinically indicated within 365 days
For information on referral forms and how to import them, please view general referral information.
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
- identify within your referral if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- past medical/surgical history, including previous neck surgery
- current medications and dosages including:
- previous drug therapy e.g. bisphosphonates, denosumab, phenytoin
- use/frequency of alcohol, tobacco, and other drugs
- allergies and sensitivities
- onset, duration, and progression of symptoms
- management history including treatments trialled/implemented prior to referral
- physical examination
- body mass index (BMI)
- electrocardiogram (ECG)
- relevant diagnostic/imaging reports, including location of company and accession number
- urea, electrolyte, and creatinine (UEC)
- estimated glomerular filtration rate (eGFR)
- plasma calcium (total and ionised)
- phosphate (PO4)
- vitamin D 25-OH
- magnesium (Mg)
- alkaline phosphatase (ALP)
- serum parathyroid hormone (PTH)
Clinical management advice
Confirm the presence of hypocalcaemia through the use of corrected or ionized serum calcium. Frequent reasons for authentic hypocalcaemia encompass hypoparathyroidism, certain medications (including those recently taken, such as denosumab), severe malnourishment, and alcohol consumption. Evaluate serum parathyroid hormone (PTH) levels.
Consider addressing deficiencies in 25-hydroxy vitamin D (25-OH) and/or magnesium through replacement therapies. Initiate treatment involving calcium and calcitriol if symptomatic, and consult the on-call registrar for guidance.
Please ensure that recent pathology results are available. Consider providing the patient with a repeat pathology form at the time of referral.
Patients who have previously received care from a specialist should be encouraged to return to their care for additional assessment if needed.
Referrals are subject to the evaluation of the triaging clinician. If you believe your patient necessitates specialist assessment but may not meet the provided criteria, feel free to connect with the specialist team to discuss your concerns.