Persistent and chronic cough
Emergency department referrals
All urgent cases must be discussed with the on-call Registrar to obtain appropriate prioritisation and treatment.
Contact through:
- Caboolture Hospital (07) 5433 8888
- Redcliffe Hospital (07) 3883 7777
- Royal Brisbane and Women's Hospital (07) 3646 8111
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- Infants who have apnoea or cyanosis during paroxysms of coughing
- Children with recurrent or persistent respiratory symptoms who have had an episode of choking suggestive of a possible inhaled foreign body
- Cough causing inability to feed or sleep in an infant
- Prominent dyspnoea, especially at rest or at night
- A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Systemic symptoms: fever, weight loss, failure to thrive
- Feeding difficulties (including choking or vomiting)
- Stridor and other respiratory noises
- Abnormal clinical respiratory examination including clubbing
- Abnormal CXR
- History of haemoptysis
- Severe paroxysms with vomiting or colour change
- A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service
Category 2
Appointment within 90 days is desirable
- Recurrent episodes of chronic, wet or productive cough
- Recurrent pneumonia
- Most other referrals for persistent or chronic cough
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- Refer to HealthPathways for assessment and management information if available
- Acute persistent cough is from 2-4 weeks
- Chronic cough is >4 weeks
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: Department of Children, Youth Justice and Multicultural Affairs
- Australian cough guidelines, summary statement for adults and children. MJA March 2010: 192(5) 265-271
- Clinical urgency is the dominant consideration in the prioritisation of a referral for a child currently in out of home care (OOHC), or at risk of entering or leaving OOHC.
Referral requirements
A referral may be rejected without the following information.
History and Examination
- History of the cough:
- duration
- paroxysm-related symptoms such as vomiting or colour change
- Report presence or absence of other respiratory illness
- asthma
- chronic lung disease
- cystic fibrosis
- Report presence or absence of concerning features
- Persistent fevers
- Night sweats
- Weight loss (if so, estimate how much)
- Haemoptysis
- Significant contacts with TB or pertussis
- Confirmation of OOHC (where appropriate)
Imaging and reports
- CXR
Additional referral information
Useful for processing the referral
Desirable information – will assist at consultation
- Other past medical history
- Immunisation history
- Developmental history
- Medication history
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Children, Youth Justice and Multicultural Affairs involvement)
- Height/weight/head circumference and growth charts with prior measurements if available.
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports, urinalysis result
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- 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
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- 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
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- 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.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org