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 or persistent epistaxis

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

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • epistaxis with suspicion of a tumour on imaging, specify on referral

Category 2 — appointment clinically indicated within 90 days

  • unilateral epistaxis in adolescent male aged 16 to 18 suspicion of juvenile nasopharyngeal angiofibroma (JNA)

Category 3 — appointment clinically indicated within 365 days

  • epistaxis not responding to maximal medical management for > 6 to 8 weeks e.g. topical creams, no nose picking, manage allergic rhinitis
  • epistaxis - please describe frequency and duration
  • minor recurrent epistaxis

For more on outpatient referrals, see the general referral information page.

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
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • presenting complaint history and symptoms including:
    • vision disturbance
    • dental malignancy
    • cerebrospinal fluid (CSF) leak
  • details of previous medical management including:
    • systemic and topical medications prescribed
    • duration and outcome of the treatment
  • current medication list including any:
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • aspirin or warfarin and
    • anti-hypertensives
  • complete blood exam (CBE)
  • coagulation profile
  • relevant reports and results

Additional information to assist triage categorisation

High resolution computerised tomography (CT) if concerns of juvenile nasopharyngeal angiofibroma (JNA), including company and accession number.

Clinical management advice

Medical management (refer to The Royal Australian College of General Practitioners (RACGP) Epistaxis Guidelines) and consider investigation for:

  • clotting disorders
  • hypertension/management of hypertension

Clinical resources