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.

  • abscess/hematoma in the neck for example, peritonsillar, parapharyngeal, salivary, retropharyngeal
  • acute vocal hoarseness/sudden voice change
  • acutely enlarging neck mass
  • airway compromise/stridor
  • cellulitis
  • difficulty breathing
  • severe odynophagia/drooling
  • trauma
  • uncontrolled pain

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

If clinical advice is required urgently or out of hours, please contact Flinders Medical Centre or the Women’s and Children’s Hospital.

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network

Category 1 (appointment clinically indicated within 30 days)

  • suspected/confirmed malignancy
  • neck mass with concerning features:
    • increasing in size and/or
    • not responding to antibiotics and/or
    • present for greater than 6 weeks
  • neck mass in child presenting from region with endemic tuberculosis

Category 2 (appointment clinically indicated within 90 days)

  • suspected thyroid mass
  • neck mass without concerning features

Category 3 (appointment clinically indicated within 365 days)

  • nil

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  
  • identify within your referral 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
  • interpreter required
  • age
  • past medical/surgical/psychosocial/birth/developmental/immunisation history
  • known allergies and sensitivities
  • onset, duration, and progression of symptoms
  • management history including treatments trialled/implemented prior to referral
  • naso-oropharyngeal examination
  • physical examination, including:
    • fluctuations
    • erythema
    • obstructed airway
    • skin changes/sinuses
    • pain/tenderness
  • neck ultrasound (US) with notation of thyroid
  • relevant diagnostic/imaging reports including location of company and accession number
  • if suspected thyroid mass:
    • thyroid stimulating hormone (TSH)
    • free thyroxine (FT4)
    • thyroid peroxidase (TPO) antibodies

Additional information to assist triage categorisation

  • copies of any relevant reports and results, such as:
  • complete blood examination (CBE)
  • electrolytes urea and creatinine (EUC)
  • liver function tests (LFTs)
  • c-reactive protein (CRP)
  • thyroid stimulating hormone (TSH)

Clinical management advice

Cervical lymphadenitis can be addressed at the community level using oral antibiotics effective against staph bacteria. If the situation is reviewed and resolution is confirmed, referral might not be required.

Cervical lymphadenitis and midline neck swelling referrals can be completed by the following specialist services:

  • ear, nose and throat (ENT)
  • paediatric surgery

Please utilise the relevant Aboriginal Liaison Units (ALU) to provide support to Aboriginal families.

Clinical resources

Consumer resources