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.

  • clinical suspicion of the following:
    • amaurosis fugax

Patients with suspected acute stroke or transient ischaemic attack (TIA) should be referred to the nearest hospital and the referrer should dial 000 to activate the Code Stroke process which will facilitate timely care:

  • carotid artery dissection
  • vertebral artery dissection

It is strongly advised that after hours presentations attend the Royal Adelaide Hospital or Flinders Medical Centre emergency departments.

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

Category 1 — appointment clinically indicated within 30 days

  • carotid body tumour confirmed ≥ 2 cm

Category 2 — appointment clinically indicated within 90 days

  • carotid body tumour confirmed ≤ 2 cm
  • asymptomatic internal carotid stenosis < 75 years ≥ 70%
  • symptomatic subclavian steal syndrome
  • pulsatile tinnitus (confirmed CAD ≥ 50% on imaging)

Category 3 — appointment clinically indicated within 365 days

  • asymptomatic occluded internal carotid artery
  • asymptomatic internal carotid artery stenosis 50 - 69% on imaging < 75 years
  • asymptomatic internal carotid artery stenosis ≥ 70% on imaging > 75 years

For more on outpatient referrals, see the general referral information page.

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
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • complete past medical history
  • current medication list
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation
  • body mass index (BMI)
  • carotid imaging (confirming pathology) and include location and accession number

Additional information to assist triage categorisation

  • complete blood examination (CBE)
  • urea, electrolytes and creatinine (UEC)
  • liver function tests (LFT)
  • estimated glomerular filtration rate (eGFR)