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.
- acute peripheral nerve compression symptoms following trauma or acute event
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
- acute neurologic deficit from trauma
- pressure from external lesion
- symptomatic (severe) disease with muscle wastage and weakness and nerve conduction study confirmation of diagnosis (loss of touch sensation)
- common peroneal nerve injury (upper limb radiculopathy should be assessed utilising orthopaedic spinal referral criteria)
Category 2 — appointment clinically indicated within 90 days
- progressive neurologic changes with numbness and weakness
- symptom recurrence past surgical decompression
Category 3 — appointment clinically indicated within 365 days
- symptomatic nerve entrapment without muscle wastage and weakness with the following:
- rapid progression of deterioration
- failed maximal medical management ≥ 6 months duration
For information on referral forms and how to import them, please view general referral information.
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 and/or requires a third party to receive correspondence on their behalf
- interpreter requirements
- complete past medical history including relevant surgery
- current medication list
- management history including:
- injury/trauma if relevant
- onset and duration
- associated features, e.g. functional impairment
- use of immobiliser/splint/cast
- treatments trialled/implemented prior to referral
- functional range of motion (ROM)
- sensory or motor deficit distribution, e.g. median, ulnar, or radial sensory or motor signs
- plain X-ray include radiological details/accession number
Additional information to assist triage categorisation
Nerve conduction study
Clinical management advice
Please note that hand and wrist referrals can be managed by the following specialist services:
- general surgery
- plastics and reconstructive surgery
Consideration of risks versus benefits of surgical intervention may include:
- additional comorbidities
- patient expectations of outcome
- patient suitable for surgery, engagement in self-management
- body mass index (BMI) and weight loss
- smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation
Optimisation of chronic medical conditions should occur as part of initial assessment and conservative management as this may impact on suitability for surgical intervention.
Patients with BMI ≥ 35 should be referred for weight loss management with or without bariatric opinion. Patients with BMI ≤ 40 may be considered for review with documented evidence of participation in attempts to lose weight.
Carpal tunnel syndrome can be managed by a variety of specialties including:
- Plastic Surgery
- General Surgery
All referrals will be triaged in a unified manner by all specialities concerned.
- HealthPathways SA - Carpal Tunnel Syndrome (CTS) (log in required)
- HealthPathways SA - Frail But Stable Older Persons (log in required)