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.
- facial fractures, please contact Cleft & Craniofacial SA on (08) 8161 7000
- traumatic or partial amputation (limb, ear, nose, lip, scalp)
- crush injury
- compartment syndrome
- foreign body e.g. glass/nail
- nerve injury – including rapid onset compression
- lacerations of face, hand, head, and neck, or with large skin deficit
- hand presentations including:
- acute fingertip injuries
- complex tendon injuries
- nerve and vascular injuries
- irreducible dislocations
- compound fractures
- suspected septic joint
- flexor tenosynovitis
- fingertip infections
- hand abscess
For clinical advice, please telephone the relevant specialty service.
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Category 1 - appointment clinically indicated within 30 days
- acute soft tissue defects
- closed hand fractures or reduced dislocation
- delayed presentation nerve injury
- delayed presentation tendon or ligamentous injury of the hand
- foreign body subcutaneous
- chronic hand soft tissue or osteomyelitis
Category 2 — appointment clinically indicated within 90 days
- chronic wounds
- uninfected foreign bodies
- delayed presentation of hand trauma (greater than 2 months).
- foreign body present for greater than 2 months
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.
- past medical/surgical history
- last administered tetanus vaccine
- current medications and dosages
- allergies and sensitivities
- presenting symptoms
- management history including:
- injury/trauma/surgery, if relevant
- onset and duration
- severity
- pain
- associated features, e.g. functional impairment and range of motion
- treatments trialled/implemented prior to referral
- sensory or motor deficit distribution, e.g. median, ulnar, or radial sensory or motor signs
- relevant investigations and reports, include provider details and accession number
Clinical management advice
All acute fractures or tendon or soft tissue injuries that do not require emergency department presentation are triaged as a category 1 and require assessment within 7 days – please contact your local Plastic and Reconstructive surgery by phone to ensure any referrals can be actively followed up.
Fractures of craniofacial bones should be discussed with the Women’s and Children’s Hospital (WCH) Craniomaxillofacial SA service.
This is a guideline for outpatient referral only. If you have clinical concerns, please contact the WCH Plastic and Reconstructive surgery service via switchboard on (08) 8161 7000
Clinical 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.