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 aortic dissection
  • ruptured AAA
  • symptomatic AAA — abdominal, back pain, tenderness, compressive symptoms, distal embolisation
  • thoracic aneurysm with chest/back pain
  • AAA ≥ 7 cm — please contact on call registrar to discuss clinical concerns

If your patient is in a life-threatening situation and requires immediate emergency care, call triple zero (000) or visit the nearest emergency department.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the Vascular Registrar on call 24 hours a day, 7 days a week.

For patients who are unstable and require immediate assessment, please refer to the ‘Referral to emergency’ section.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • AAA ≥ 5cm in diameter
  • thoracic aneurysm ≥ 5cm in diameter
  • rapidly expanding AAA (same modality of examination) ≥ 1 cm per year

Category 2 — appointment clinically indicated within 90 days

  • AAA 3cm to 5cm in diameter
  • thoracic aneurysm ≤ 5cm in diameter

Category 3 — appointment clinically indicated within 365 days

  • nil

Vascular outpatient services accept statewide e-Referrals. For information on e-Referral forms and how to import them, or to download referral forms, 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.

  • aneurysm location and diameter
  • current and previous imaging results
  • past medical history including previous abdominal surgery
  • recent renal function — please attach most recent creatinine result and estimated glomerular filtration rate within 6 weeks of referral
  • complete past medical history
  • current medication list
  • smoking status - if active smoker, strongly consider referral for smoking cessation
  • body mass index

Additional information to assist triage categorisation

  • complete blood examination (CBE)
  • urea, electrolytes and creatinine (UEC)
  • liver function tests (LFT)
  • estimated glomerular filtration rate (eGFR)
  • glycated haemoglobin test (HbA1c)

Clinical management advice

Private driving MUST cease if abdominal aortic aneurysm (AAA) is greater than or equal to ≥ 5.5 cm, commercial driving MUST cease if AAA is greater than or equal to ≥ 5.0 cm – refer to Austroads - Assessing fitness to drive

  • Aneurysm size is assessed by anteroposterior (AP) diameter
  • Please note length of aneurysm is not clinically relevant
  • Optimize atherosclerosis risk factor management including:
    • active blood pressure management and antihypertensives
    • diabetes management
    • dyslipidaemia management aiming for LDL-C less than <1.8mol/L
  • Lifestyle modification including:
    • increasing activity levels
    • dietary management
    • weight management
    • smoking cessation, including cigarettes & non-tobacco nicotine products such as e-cigarettes
    • reducing alcohol intake
  • It is strongly recommended people who smoke stop before surgery as there are significant benefits in perioperative outcomes. Please consider directing your patient to a smoking cessation program, refer to ‘Clinical and Consumer resources’ sections.

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.