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

Exclusions

  • cosmetic concerns
  • benign lesions:
    • lipomas
    • naevi (melanocytic/pigmented)
    • sebaceous cysts of the torso and lower extremities
    • seborrheic keratoses
    • skin tags
    • warts
    • xanthelasma

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • suspected malignancy
  • suspected soft tissue tumour
  • rapidly enlarging growths

Category 2 — appointment clinically indicated within 90 days

  • infected cyst of head, neck, or hand
  • vascular malformation or other tumour causing significant functional impairment

Category 3 — appointment clinically indicated within 365 days

  • ganglion of the hand or wrist with maximal medical management that is:
    • enlarging
    • symptomatic
    • causing functional impairment

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.

  • past medical/surgical history
  • medications and dosages
  • onset, duration, and progression of symptoms
  • current medications and dosages
  • allergies and sensitivities
  • presenting symptoms
  • management history including:
    • injury/trauma if relevant
    • onset and duration
    • severity
    • pain
    • associated features, e.g. functional impairment, range of motion (ROM)
    • treatments trialled/implemented prior to referral
  • ultrasound (US) – ganglion

Additional information to assist triage categorisation

  • photograph including disposable measurement tool – with patient’s consent, where secure image transfer, identification and storage is possible

Clinical management advice

Please note that hand and wrist referrals can be managed by the following specialist services: 

SA Health plastic and reconstructive surgery services do not provide treatment for the following conditions:

  • lipomas
  • naevi (melanocytic/pigmented)
  • sebaceous cysts of the torso and lower extremities
  • seborrheic keratoses
  • skin tags
  • warts
  • xanthelasma.

Most people with ganglion cysts do not require treatment. If your ganglion is impacting hand function, it may be appropriate for this to be reviewed in a hand clinic.

Consider referring hand ganglion/s to allied health before plastic surgery to exhaust conservative management options.

It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Please refer to useful resources section for further information.

If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.

All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.

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.