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
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
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
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 neurologic changes with muscle wastage
- symptom recurrence post-surgical decompression
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
- symptomatic nerve entrapment without muscle wastage and weakness with the following failed maximal medical management equal to or greater than 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
- past medical/surgical history
- current medications and dosages
- allergies and sensitivities
- presenting symptoms
- nerve conduction study
- 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
- sensory or motor deficit distribution, e.g. median, ulnar, or radial nerves
Additional information to assist triage categorisation
- ultrasound median or ulnar nerve
- 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:
- general surgery
- plastics and reconstructive surgery
For mild to moderate carpal tunnel syndrome, consider allied health referral for hand therapy prior to specialist outpatient referral.
It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Refer to Clinical management advice and resources for further information.
If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.
- Therapeutic Guidelines - Limb Conditions
- Royal Australian College for General Practitioners - Hands, Fingers, Thumbs Assessment and Management of Common Hand Injuries in General Practice
- Central Adelaide Local Health Network – PreHab: Getting Ready for Surgery