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.

  • bilious (green) vomiting
  • raised intracranial pressure
  • injury — clavicle fracture, non-accidental injury
  • incarcerated inguinal hernia
  • urinary tract infection
  • hair tourniquet
  • corneal foreign body/abrasion
  • respiratory distress/stridor
  • severe diarrhoea/vomiting with symptoms of dehydration
  • suspected intussusception

Please contact the paediatric medicine on-call registrar or relevant surgical or medical subspecialty to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant specialty service.

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network

Regional Health Networks 

Eyre and Far North Local Health Network

Flinders and Upper North Local Health Network

Limestone Coast Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • full term delivery (37 to 40 weeks gestation) with concerns of:
    • blood or mucous in stools, exclude cow’s milk allergy
    • faltering growth
    • maternal mental health concerns
    • milestone development
    • severe diarrhoea/perineal excoriation without symptoms of dehydration
    • severe eczema
    • severe vomiting without symptoms of dehydration
    • irritability with sleep/settling unresponsive to first-line management strategies
  • premature delivery, earlier than 35 weeks gestation

Category 2 (appointment clinically indicated within 90 days)

  • nil

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.

  • past medical history including provide any relevant features as relating triage categories
  • medications and allergies
  • presenting symptoms including:
  • dates and frequency of symptoms
  • duration and severity of episodes
  • treatment trialled and response
  • current management regime including medications
  • presence of concerning features
  • postnatal depression screening assessment
  • abdominal examination findings
  • height/weight
  • growth chart trends
  • allied health reports/summaries
  • relevant diagnostic, imaging reports including location of company and accession number

Additional information to assist triage categorisation

  • psychosocial history including family support, siblings, stressors
  • postnatal depression screening assessment
  • allied health reports/summaries

Clinical management advice

Managing infants with suspected gastroesophageal reflux disease (GORD) can present a challenge in clinical practice and requires a collaborative, multidisciplinary approach. When assessing a fussy baby/infant with suspected gastroesophageal reflux key areas to address may include:

  • assess parent/s to ensure they are coping and provide access to support services (including postnatal depression screening).
  • consider the inclusion of thickeners for formula fed babies to assist in reducing symptoms
  • infants with ‘normal growth’ require limited intervention if they are growing in alignment with expected parameters, and meeting milestones. Providing support and reassurance to parents that reflux is a common occurrence in babies can often alleviate concerns.
  • referring parent/s to lactation consultants, child and youth health nurses, and/or facilities such as Torrens House can offer additional guidance and support, to support parents managing infants with feeding difficulties.

Clinical resources

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.

Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.

The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.