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.

  • suspected hyperglycaemia
  • suspected hypoglycaemia
  • ketones present on urinalysis

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)

  • homozygous familial hypercholesterolemia
  • hypertension greater than 95th percentile for age/gender
  • suspected obstructive sleep apnoea
  • metabolic syndrome
  • associated type 2 diabetes mellitus
  • abnormal lipid results, contact the paediatric medicine on-call registrar to discuss your concerns prior to referral/commencement of medication

Category 2 (appointment clinically indicated within 90 days)

  • children less than 6 years of age with a body mass index (BMI) greater than 95th percentile for age/gender
  • concerns about height and growth velocity
  • other symptomatic obesity including:
    • obstructive sleep apnoea
    • hip or knee pain
    • high levels of psychological distress about weight
    • signs of insulin resistance
  • suspected underlying medical or endocrine cause

Category 3 (appointment clinically indicated within 365 days)

  • children greater than 6 years of age with a body mass index (BMI) > 95th percentile for age/gender

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, provide any relevant features as relating triage categories
  • developmental history, particularly concerns of developmental delay, features of autism spectrum disorder, intellectual problems, or learning difficulties
  • medications and allergies
  • presenting symptoms including:
    • avoidant/restricted food intake or disordered eating patterns
    • previous strategies trialled and outcomes
    • behavioural concerns/stressors
    • obesity related co-morbidities including obstructive sleep apnoea (OSA), non-alcoholic fatty liver disease (NAFLD)
  • presence of concerning features including:
    • polyuria
    • polydipsia
    • nocturia
    • acanthosis nigricans
    • hepatomegaly
  • dietitian summary/report
  • 3-day food chart
  • weight/height trends
  • body mass index (BMI) if child is aged ≥ 16 years
  • growth chart trends
  • blood pressure trends
  • abdominal examination findings
  • pathology:
    • complete blood examination (CBE)
    • urea, electrolytes, creatinine (UEC)
    • liver function tests (LFTs)
    • c-reactive protein (CRP)
    • erythrocyte sedimentation rate (ESR)
    • iron (Fe) studies
    • coeliac serology
    • urinalysis
  • if suspected OSA
    • sleep study
  • if suspected type 2 diabetes mellitus
    • glycated haemoglobin test (HbA1c)
    • random blood glucose level
  • allied health and other medical specialist involvement if previous medical consultation completed reports/summaries

Additional information to assist triage categorisation

  • relevant diagnostic/imaging reports including location of company and accession number

Clinical management advice

Timely identification, using a multidisciplinary team approach optimises the management of childhood obesity by providing a comprehensive, personalised, and well-coordinated strategy. By collaborating with multiple specialties at the same time, we are able to address the complexities of the condition, leading to more successful and sustainable outcomes.

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.