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.

  • suspected sepsis or septic arthritis
  • complications of disease or therapy requiring emergent review – systemically unwell

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

For clinical advice, please telephone 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)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • suspected autoinflammatory disease
  • known autoinflammatory disease on treatment (including biological disease-modifying antirheumatic drugs (DMARD) therapy)

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.

  • if the patient is pregnant or planning a pregnancy
  • complete medical history
  • family history of autoinflammatory conditions
  • description of symptoms and timeframe, for example, fever, rash, serositis, polyarthritis
  • clinical examination
  • blood results including location of company and accession number if available:
    • full blood count (FBC)
    • liver function tests (LFTs)
    • electrolytes, urea, creatinine (EUC)
    • estimated glomerular filtration rate (eGFR)
    • C-reactive protein (CRP)
    • erythrocyte sedimentation rate (ESR)
    • ferritin
  • details of previous medical management including the course of treatment and outcome
  • current and previous medication history including non-prescription medicines, herbs and supplements

Additional information to assist triage categorisation

  • relevant diagnostic/imaging reports including location of company and accession number
  • results of previous genetic screening
  • interference with activities of daily living and working ability, for example, has the patient had to stop or change work practices, are they requiring assistance with self care.
  • previous assessments or opinions from a rheumatologist or other relevant specialist or allied health clinician

Clinical management advice

Please phone the rheumatology registrar or on call consultant or allergy and immunology service if an autoinflammatory condition is suspected.

Autoinflammatory diseases are a group of rare diseases characterised by unprovoked episodes of fever and inflammation. These are not antibody-mediated but occur when there are problems with the innate immune system whereby immune cells target the body’s own healthy tissues in error. This can result in episodes of inflammation that result in symptoms such as fever, rash or joint swelling.

Some examples of autoinflammatory diseases include:

  • Familial Mediterranean Fever (FMF)
  • periodic fevers
  • cryopyrin-associated periodic syndromes (CAPS)
  • Muckle-Wells Syndrome
  • tumor necrosis factor receptor-associated periodic syndrome (TRAPS)
  • mevalonate kinase deficiency (MKD)

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.