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.

  • uncontrolled sepsis including hand infections
  • complex facial trauma - any fractures of the craniofacial skeleton - please use the facial fractures clinical prioritisation criteria
  • traumatic or partial amputation (limb, ear, nose, lip, scalp)
  • crush injury
  • compartment syndrome
  • foreign body e.g. glass/nail
  • nerve injury including rapid onset compression
  • lacerations of face, hand, head, and neck, or with large skin deficit
  • hand presentations including:
    • acute fingertip injuries
    • complex tendon injuries
    • nerve and vascular injuries
    • unreducible dislocations
    • compound fractures
    • suspected septic joint
    • flexor tenosynovitis
    • fingertip infections
    • hand abscess

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

Exclusions

  • removal of sutures following trauma
  • simple post trauma wound management

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • chronic hand soft tissue infection or osteomyelitis
  • closed hand fractures or reduced dislocation
  • delayed presentation nerve injury
  • delayed presentation tendon or ligamentous injury of the hand
  • subcutaneous foreign body

Category 2 — appointment clinically indicated within 90 days

  • delayed presentation hand trauma greater than 2 months
  • foreign body present for greater than 2 months

Category 3 — appointment clinically indicated within 365 days

  • nil

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
  • tetanus vaccine last administered
  • allergies and sensitivities
  • presenting symptoms
  • management history including:
    • injury/trauma/surgery if relevant
    • onset and duration
    • severity
    • pain
    • associated features, e.g. functional impairment, range of motion (ROM)
    • treatments trialled/implemented prior to referral
  • sensory or motor deficit distribution, e.g. median, ulnar, or radial sensory or motor signs
  • relevant investigations and reports, include provider details and accession number

Clinical management advice

All acute fractures, tendon injuries or soft tissue injuries that do not require emergency department presentation are triaged as a category 1 and require assessment within 7 days – please contact your Local Health Network Plastic and Reconstructive surgery service to ensure any referrals can be actively followed up.

Facial fractures can be referred utilising the facial fractures clinical prioritisation criteria.

Dental trauma requires referral to oromaxillofacial for assessment, management, and treatment.

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.

Clinical resources