Emergency department referrals

All urgent cases must be discussed with the on call Neurology Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000
  • Redcliffe Hospital (07) 3883 7777

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.

  • Headache with concerning features:
    • sudden onset/thunderclap headache
    • severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness)
    • first severe headache age > 50 years
    • severe headache associated with recent head trauma
    • headaches with papilloedema
    • > 50 years with raised CRP/ESR or if giant cell arteritis or vasculitis suspected

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

  • Abnormal neurological exam with concerning features on neuroimaging (new onset headache)
  • Severe/acute trigeminal Neuralgia with inability to eat

Concerning features:

  • sudden onset/thunderclap headache
  • severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness)
  • first severe headache age > 50 years
  • severe headache associated with recent head trauma
  • recent onset headaches in young obese females
  • headaches with papilloedema
  • >50 years with raised CRP/ESR or if giant cell arteritis or vasculitis suspected

Category 2

Appointment within 90 days is desirable

  • Severe frequent headaches and trial of at least 3 migraine preventive medications without improvement (list 3 treatments trialled)

Category 3

Appointment within 365 days is desirable

  • Chronic/complicated headache/migraine unresponsive to medical management

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

Medical management

  • Manage migraine – acute pain treatment, dietary advice, hormone management and or preventive medications trial for at least 2-3 months
  • Tension/cervicogenic headaches – simple analgesia, massage, physiotherapy review
  • Consider ELFT FBC ESR CRP in patients at risk for a systemic cause for headaches
  • Consider neuroimaging to exclude intracranial pathology
  • Consider medication overuse headache if patient using large amounts of over-the-counter analgesics such as aspirin, opioids, paracetamol and/or caffeine
  • Social modifiers – impact to ADLs
  • Adequate chronic disease/lifestyle () management is a requirement for most patients

Referral requirements

A referral may be rejected without the following information.

  • Medication history, including non-prescription medications, herbs and supplements
  • List all treatments trialed (at least three migraine prophylactic – i.e. Not triptans or acute analgesics) and reasons for failure

Additional referral information (useful for processing the referral)

  • ELFT, FBC, ESR, CRP results
  • ECG tracing
  • Neuroimaging results (MRI preferable)

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.)
Back to top