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.
- AF with red flags:
-
haemodynamic instability
- shortness of breath
- chest pain
- syncope/pre syncope/dizziness
- known Wolff-Parkinson-White syndrome
- neurological deficit indicative of transient ischaemic attack/stroke
For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Northern Adelaide Local Health Network
- Lyell McEwin Hospital (08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
- Noarlunga Hospital (08) 8384 9222
Exclusions
Asymptomatic well controlled chronic AF
Triage categories
Category 1 - appointment clinically indicated within 30 days
- new AF without red flags
- recurrent paroxysmal AF
- AF with signs of heart failure (HF) or reduced left ventricle (LV) function not requiring presentation to emergency department
Category 2 — appointment clinically indicated within 90 days
- chronic unstable/uncontrolled AF requiring management review e.g. rate control, anticoagulation, further intervention
- recent onset AF without haemodynamic compromise
Category 3 — appointment clinically indicated within 365 days
- nil
For information on referral forms and how to import them, 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.
- identifies as Aboriginal and/or Torres Strait Islander
- identify within your referral if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- description of symptoms, frequency, duration and risk factors
- presence of red flag symptoms
- alleviating interventions and management
- complete medical history
- details of previous treatments and outcomes
- current medication and previous therapies including risk factor management
- known allergies and sensitivities
- complete blood examination (CBE)
- urea, electrolytes and creatinine (UEC)
- liver function tests (LFTs)
- blood sugar levels
- estimated glomerular filtration rate (eGFR)
- thyroid stimulating hormone (TSH)
- electrocardiogram (ECG), specifically during episode/s of arrythmia, and any other concerning tracings
Additional information to assist triage categorisation
- relevant reports and investigations e.g. echocardiogram (Echo), chest x-ray, holter monitor, and sleep study
- use/frequency of alcohol, tobacco and other drugs
Clinical management advice
Patients who have been seen by a specialist cardiologist previously, are encouraged to be referred back to their care for further review.
To minimise the burden of atrial arrhythmia (new onset < 48hrs) with early cardioversion, contact cardiology on call in your Local Health Network to escalate and discuss clinical concerns.