Heart failure
Emergency department referrals
Phone on call Cardiology Registrar via:
- Royal Brisbane & Women’s Hospital switch - (07) 3646 8111
- The Prince Charles Hospital switch - (07) 3139 4000
- Redcliffe Hospital switch – (07) 3883 7777
- Caboolture Hospital switch – (07) 5433 8888
and send patient to the Department of Emergency Medicine (DEM) at their nearest hospital.
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.
- Acute or chronic heart failure with any of the following concerning features:
- NYHA Class IV heart failure
- Ongoing chest pain
- Significant orthopnoea/PND
- Oxygen saturation < 90%
- Clinical and/or radiographic signs of acute pulmonary oedema
- Haemodynamic instability:
- pre-syncope / syncope / severe dizziness
- altered level of consciousness
- heart rate > 120 beats per minute
- systolic BP < 90mmHg with symptoms of hypoperfusion
- systolic BP < 80mmHg irrespective of symptoms
- Significant pulmonary or pedal oedema
- Recent myocardial infarction
- Pregnant patient
- Signs of myocarditis
- Signs of acute decompensated heart failure
NB: Early discussion with the patient’s usual heart failure team would be advised for local care protocols
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
- Newly diagnosed heart failure with worsening symptoms but without any of the following concerning features
- NYHA Class IV heart failure
- Ongoing chest pain
- Significant orthopnoea/PND
- Oxygen saturation < 90%
- Clinical and/or radiographic signs of acute pulmonary oedema
- Haemodynamic instability:
- pre-syncope / syncope / severe dizziness
- altered level of consciousness
- heart rate > 120 beats per minute
- systolic BP < 90mmHg
- Significant pulmonary or pedal oedema
- Recent myocardial infarction
- Pregnant patient
- Signs of myocarditis
- Signs of acute decompensated heart failure
- Established heart failure on medical therapy with clinical signs of decompensation, but without concerning features
Category 2
Appointment within 90 days is desirable
- Established heart failure on medical therapy with worsening symptoms but without clinical signs of decompensation or concerning features
- Suspected or newly diagnosed left ventricular dysfunction with minimal/no symptoms or clinical evidence of decompensation
Category 3
Appointment within 365 days is desirable
- Patients with established heart failure on optimal medical therapy requiring routine review i.e., take-over of care
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
- Heart Failure may impact on a patient’s medical fitness to drive. The Queensland Government’s Transport and Motoring website and Austroads – Assessing Fitness to Drive website has advice about managing driving
Referral requirements
A referral may be rejected without the following information.
- BP
- Weight, height & BMI
- Recent fluctuations in weight indicative of cardiac dysfunction (if known)
- New York Heart Association (NYHA) class
- FBC, ELFTs, fasting lipids, HbA1c (if diabetic), TSH results
Additional Referral Information (Useful for processing the referral)
- Details of relevant signs and symptoms
- Details of all treatments offered and efficacy and if referral is for a routine review/takeover of care
- Relevant previous medical history and co-morbidities
- Sleep study report if OSA suspected
- Stress test report (if performed)
- ECG (if available)
- CXR report (if available)
- Investigations relevant to co-morbidities
- Respiratory function tests if patient a smoker, has COPD or asthma
- Echocardiogram report
- BNP or NT-pro-BNP results
- History of smoking, alcohol intake and drug use (including recreational drugs)
- Aboriginal or Torres Strait Islander or Māori/Pacific Islander / Refugee status (increased risk of acute rheumatic fever and rheumatic heart disease)
- Iron studies
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