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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.
- development of peripheral nerve compression symptoms following trauma or acute event
Please contact the on-call registrar to discuss your concerns prior to 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
- Modbury Hospital (08) 8161 2000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
- Noarlunga Hospital (08) 8384 9222
Regional Health Networks
Barossa Hills Fleurieu Local Health Network
- Mt Barker District Soldiers' Memorial Hospital (08) 8393 1777
Eyre and Far North Local Health Network
- Port Lincoln Health Service (08) 7669 1200
Flinders and Upper North Local Health Network
- Port Augusta Hospital (08) 8668 7500
Limestone Coast Local Health Network
- Mt Gambier and Districts Health Service (08) 8721 1200
Riverland Mallee Coorong Local Health Network
- Murray Bridge Soldiers' Memorial Hospital
- Monday to Friday (08) 8535 6777
- after hours or weekend (08) 8535 6777
Yorke and Northern Local Health Network
- Port Pirie Regional Health Service (08) 8638 4500
Category 1 (appointment clinically indicated within 30 days)
- acute sudden onset severe carpal tunnel symptoms suggestive of acute nerve compression
Category 2 (appointment clinically indicated within 90 days)
- progressive neurological changes with muscle wastage
- symptom recurrence post-surgical decompression
- moderate-severe carpal tunnel with nerve conduction study, if nerve conduction study not available, consider ultrasound (US) or magnetic resonance imaging (MRI)
- symptomatic carpal tunnel with impact on acts of daily living /employment
Category 3 (appointment clinically indicated within 365 days)
- intermittent symptoms without weakness or wasting after 6 months maximum medical management
- median/ulnar entrapment neuropathy without weakness or wasting when no response to equal to or greater than 6 months of maximal management
- mild carpal tunnel with nerve conduction study, if nerve conduction study not available, consider US or MRI
- symptomatic nerve entrapment without muscle wastage and weakness with failed maximal medical management equal to or greater than 6 months duration
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.
- cultural considerations
- age
- past medical/surgical history
- medications and dosages
- allergies and sensitivities
- height, weight and body mass index (BMI)
- smoking, alcohol and other drug use
- onset, duration, and progression of symptoms
- nerve conduction study,if nerve conduction study not available, consider ultrasound (US) or magnetic resonance imaging (MRI)
- management history including:
- injury/trauma if relevant
- onset and duration
- severity
- pain
- associated features, for example functional impairment
- use of immobiliser/splint/cast
- treatments trialled/implemented prior to referral
- sensory or motor deficit distribution, for example median, ulnar or radial nerves
Additional information to assist triage categorisation
- previous related allied health reports and summaries
Clinical management advice
Please note that hand and wrist referrals can be managed by the following specialist services:
Clinical resources
- Central Adelaide Local Health Network - PreHab
- Royal Australian College for General Practitioners - Hands, Fingers, Thumbs Assessment and Management of Common Hand Injuries in General Practice
- Therapeutic Guidelines - Limb Conditions
Consumer resources
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.