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.

  • haemoptysis >50mL in one episode
  • ongoing, uncontrolled, worsening haemoptysis of any amount
  • any haemoptysis with acute dyspnoea, measured hypoxia, altered consciousness, hypotension, tachycardia, chest pain other haemodynamic instability/compromise, or respiratory distress

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

  • Flinders Medical Centre, request Respiratory Consults Registrar (08) 8204 5511

Category 1 (appointment clinically indicated within 30 days)

  • recurrent, intermittent, ongoing haemoptysis not meeting criteria for emergency referral above

Category 2 (appointment clinically indicated within 90 days)

  • resolved haemoptysis associated with known haemoptysis-causing respiratory condition and no red flags

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.

  • duration and volume of haemoptysis
  • systemic and other symptoms associated with haemoptysis e.g. breathlessness, pleuritic chest pain, cough, leg swelling, weight loss
  • past medical history and co-morbidities, particularly recent clinical events such as viral symptoms, infective bronchitis
  • current medications, detail antiplatelet and anticoagulant therapy
  • recent travel
  • history of venous thromboembolism (VTE) risk factors:
    • immobility/malignancy/oral contraceptive pill (OCP)
    • known or family history of thrombotic abnormality
  • smoking history
  • imaging
    • chest x-ray and computed tomography (CT) – CT pulmonary angiography (CTPA) if pulmonary embolism (PE) is a consideration and renal function acceptable, no contrast allergy
  • blood results
    • full blood count (FBC)
    • coagulation studies
    • urea
    • electrolytes
    • liver function tests (LFTs)

Additional information to assist triage categorisation

  • relevant allied health/diagnostic/imaging reports, including location of company and accession number
  • CT scan thorax +/- sinuses
  • international normalized ratio (INR) results if on warfarin
  • previous lung function test results

Clinical management advice

  • for massive haemoptysis or suspected tuberculosis, please phone the relevant LHN thoracic registrar.
  • if haemoptysis associated with intercurrent bronchitis, treat infection
  • if current smoker, advise cessation
  • differential diagnosis for haemoptysis includes lung malignancy, infection including tuberculosis, pulmonary embolus/infarct, bronchiectasis, vasculitis or vascular pathology, coagulopathy

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.