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Otitis media/Otological Concerns

Emergency department referrals

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.

  • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc

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

  • No category 1 criteria

Category 2

Appointment within 90 days is desirable

  • Suspicion of complicated otitis media e.g. cholesteatoma
  • Painful discharging ears despite topical antibiotic (first line) and/or PO antibiotic therapy (second line) for 5 days
  • Middle ear conditions without previous audiology
  • ASOM with ear drum perforation

Category 3

Appointment within 365 days is desirable

  • Chronic middle ear conditions that have previous audiology

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 Adult ENT CPC, Health pathways or local guidelines
  • Exclude SSNHL, see Hearing loss CPC
  • If adult wears a hearing aid, consider impact of the condition on the ability to wear the device
  • Management of environmental factors
  • Consider referral to ENT service
  • Refer to HealthPathways for assessment and management information if available

Queensland public hospitals do not dispense conventional or standard hearing aids. Aids for children, veterans, pensioners, ADF or NDIS participants with hearing needs are fitted by local audiologists via application to the Australian Government Hearing Services Program (Hearing service program). For non-eligible patients with a symmetrical mild, moderate or severe hearing loss, refer to a local private hearing aid provider.

Queensland Health Audiologists provide diagnostic hearing assessments which may result in a recommendation for hearing aids and/or an ENT opinion, but not the fitting of hearing aids.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • History including relevant symptoms, comorbidities, cognitive ability, physical mobility and dexterity (NICE Guidelines, 2018)
    • Description of:
      • Onset, duration, frequency, severity
      • Previous ENT history
      • Social modifiers ie. effect on work

Additional Referral Information (Useful for processing the referral)

  • Family history of hearing loss in patient’s parents or siblings
  • Other medical conditions or syndromes known to be related to hearing loss including Down syndrome
  • Results of Health Assessment for Aboriginal and/or Torres Strait Islander People

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.)
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