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.

  • tonsillitis with concerning features:
    • acute vocal hoarseness/sudden voice change
    • excessive drooling
    • haemodynamic instability
    • neck stiffness/swelling
    • poor fluid intake/dehydration
    • respiratory distress/obstruction/stridor
    • severe pain
    • torticollis
    • trismus

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)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • unilateral tonsillar enlargement

Category 3 (appointment clinically indicated within 365 days)

  • recurrent tonsillitis with:
    • 4 or more episodes within the last 12 months
    • 4 episodes per year within 2 consecutive years
    • 3 episodes per year within 3 consecutive years
    • minimum 2 weeks missed school or attendance at work due to illness
    • quinsy

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/family history specifically of bleeding disorder
  • current medications
  • allergies and sensitivities
  • onset, duration, and progression of symptoms
  • unilateral/bilateral features
    • frequency/number and timeframe of previous illness
    • the degree of systemic upset
    • recent hospitalisation from tonsillitis for the last 12 months
  • management history including treatments trialled/implemented including:
    • duration and outcome of the treatment prescribed
  • naso-oropharyngeal examination including:
    • hypertrophic tonsils (grading scale)
  • relevant diagnostic/imaging reports including location of company and accession number
  • if suspected bleeding disorder:
    • complete blood examination (CBE)
    • prothrombin time (PT)
    • activated partial thromboplastin time (APTT)
    • Von Willebrand screening (vWF)

Additional information to assist triage categorisation

  • pathology:
    • complete blood examination (CBE)
    • Epstein-Barr virus (EBV)
    • throat swab micro, culture and sensitivity (MC&S)

Clinical management advice

Refer to Royal Children’s Hospital Melbourne Clinical Guidelines for assessment and management of sore throat.

Obstructive sleep apnoea resulting from hypertrophic tonsils - refer to Obstructive Sleep Apnoea/Disordered Breathing CPC.

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

Clinical resources

Consumer resources