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Hearing Loss – Sudden/Rapid Onset

Emergency department referrals

If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary):

  • Hearing loss with associated neurological signs
  • Sudden / Rapid onset unilateral or bilateral hearing loss (>30dBHL at 3 or more frequencies that developed over less than a 72-hour period)

(direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate)

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

  • Rapid progressive severe unilateral or bilateral sensorineural hearing loss and/or vertigo

Category 2

Appointment within 90 days is desirable

  • Hearing loss and/or tinnitus following recent barotrauma

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 or local guidelines
  • Refer RBWH Hyperbaric Medicine Service – Clinician Information
  • Urgent steroid or hyperbaric treatment may be required
    • Treatment is most effective when it occurs within the following timeframes:
      • Oral steroid therapy should be started in the first 72 hours
      • Consider referral for hyperbaric oxygen treatment as soon as sudden sensorineural hearing loss is confirmed (within 4 weeks of onset)
    • Sudden idiopathic sensorineural hearing loss within 4 weeks may meet criteria for direct referral to Hyperbaric Medicine (RBWH and Townsville Hospital)

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Audiology assessment (Highly desirable where available and not cause significant delay)
  • Oral steroid treatment commenced

Additional Referral Information (Useful for processing the referral)

  • Any previous audiology assessment

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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