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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.
- severe/uncontrolled abdominal and/or rectal pain unresponsive to first-line management
- significant or uncontrolled per rectum (PR) bleeding
- suspected bowel obstruction, potential symptoms include:
- inability to pass any bowel motions or gas
- significant change in bowel habits
- distended abdomen, abdominal pain and cramping
- nausea/vomiting
- inability to pass any bowel motions or gas
Please contact the the colorectal or general surgery on-call registrar to discuss your concerns prior to at the time referral.
For clinical advice, please telephone 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
Category 1 (appointment clinically indicated within 30 days)
- complicated diverticular disease, including:
- fistula
- stricture
- obstructive gastrointestinal symptoms
- unexplained weight loss of at least 5% of body weight in previous 6 months
Category 2 (appointment clinically indicated within 90 days)
- uncomplicated recurrent diverticulitis
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
- family history - specific to bowel cancer, irritable bowel disease, and polyposis
- medications and allergies
- smoking/alcohol and other drug status
- age
- presenting symptoms:
- concerning features
- previous management trialled and efficacy - including courses of antibiotics and previous admission/s to hospital
- height/weight
- body mass index
- examination findings:
- abdominal
- digital rectal examination, note sphincter tone
- reports of prior colonoscopies and pathology of specimens removed
- relevant diagnostic/imaging reports, including location of company and accession number
Additional information to assist triage categorisation
- abdominal computed tomography (CT)
- pathology:
- complete blood examination (CBE)
- electrolytes urea and creatinine (EUC)
- c-reactive protein (CRP)
- iron studies
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.