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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 urolithiasis/nephrolithiasis with infection or severe pain
- suspected urinary retentio/obstruction — anuria, oliguria
Please contact the on-call registrar to discuss your concerns prior to referral.
For clinical advice, please telephone the relevant specialty service.
Central Adelaide Local Health Network
- Central Northern Adelaide Renal and Transplantation Service, (08) 7074 4790
- on-call Renal Registrar opinions and referrals out of hours (08) 7074 0000
- urgent enquiries about medications, contact the Renal Pharmacists via Royal Adelaide Hospital switchboard on (08) 7074 0000 and request speed dial 81006
- Kidney Care Team Nurses 0408 233 866 or 0409 151 417
Northern Adelaide Local Health Network
- Lyell McEwin Hospital (08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
- Noarlunga Hospital switchboard (08) 8384 9222
Category 1 (appointment clinically indicated within 30 days)
- nil
Category 2 (appointment clinically indicated within 90 days)
- nil
Category 3 (appointment clinically indicated within 365 days)
- recurrent nephrolithiasis with any of the following:
- urinary metabolic assessment is needed
- tubular dysfunction is evident
- systemic disease with associated stone formation is evident
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.
Clinical features
- reason for referral
- detailed history of nephrolithiasis
- past medical history: cardiovascular disease, diabetes mellitus, hypertension (include historical blood pressure readings), medical comorbidities, family history, previous medical reactions and allergies
Investigations
- electrolytes, urea and creatinine (EUC)
- complete blood examination (CBE)
- liver function tests (LFT)
- imaging - ultrasound of kidneys, ureters and bladder
- urine microscopy, culture and sensitivities (MCS)
Additional information to assist triage categorisation
- family history of chronic kidney disease and/or calculi
- blood pressure
- record of previous urinalysis if available
- record of and previous calculus biochemistry if available
- stone analysis
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.