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.

  • sickle cell crisis
    • symptoms including stroke symptoms or chest pain in someone with known sickle cell disease

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

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Inclusions

  • thalassaemia with clinically significant anaemia
  • sickle cell disease
  • assessment of reproductive risk in carrier couples planning pregnancy is discussed in an SA Pathology multidisciplinary team (MDT). Referrals to this MDT can be sent to Haematology. No clinic appointments will be made.

Exclusions

  • asymptomatic carriers of sickle cell disease or thalassaemia
  • pregnant couples with screening bloods indicating a risk of thalassaemia/haemoglobinopathy in the foetus
  • family planning issues – please refer to Paediatric Reproductive Genetics Unit (PRGU) for genetic counselling - Reproductive Genetics CPC

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • sickle cell disease
  • thalassaemia with clinically significant anaemia

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.

  • history
    • symptoms
  • current medication list
  • past medical history
  • family history of a haemoglobinopathy or red cell disorders
  • blood results:
    • complete blood examination (CBE)
    • blood film examination
    • liver function tests (LFTs)
    • electrolytes, urea, creatinine (EUC)
    • estimated glomerular filtration rate (eGFR)
    • iron studies
    • haemoglobin variant analysis
    • alpha thalassaemia genetic tests (where relevant)
    • Eosin-5-maleimide binding studies (where relevant for hereditary spherocytosis)
  • if the patient is pregnant or planning pregnancy please supply the above information, as well as laboratory results for both partners if there are concerns regarding pregnancy or family planning.

Clinical management advice

Assessment of reproductive risk in carrier couples planning pregnancy is discussed in an SA Pathology multidisciplinary team (MDT). Referrals to this MDT can be sent to Haematology. No clinic appointments will be made.

Clinical 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.