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Stroke/Transient Ischaemic Attack (TIA)

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.

  • Patient with acute neurological symptoms of a stroke; multiple/crescendo TIA
  • New acute symptoms

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

  • Stroke/TIA known or suspected with last change in symptoms less than 2 weeks prior to referral

Category 2

Appointment within 90 days is desirable

  • Stroke/TIA known or suspected with last change in symptoms more than 2 weeks prior to referral

Category 3

Appointment within 365 days is desirable

  • Chronic ischaemic lesion identified on imaging not previously addressed
  • Covert brain infarction – and other neurovascular “what is this lesion” questions i.e., ICAD, DVAs, suspected amyloid angiopathy changes
  • Second specialist opinion for secondary prevention

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
  • Consider allied health (physiotherapy, occupational therapy, speech therapy) management
    • to assess functional capacity if disability increasing
    • speech pathology for assessment of swallowing and/or communication difficulties
    • occupational therapist and physiotherapist for patients with mobility/ADL changes
  • If the question relates to resumption of pre-stroke activities e.g. driving or working, please also refer to and include the Rehabilitation discharge summary.
  • Consider driving advice Austroads: Assessing Fitness to Drive 2016 http://www.austroads.com.au/driversvehicles/assessing-fitness-to-drive

Referral requirements

A referral may be rejected without the following information.

Essential referral information

    • Neuroimaging results
    • Medication list
    • Relevant previous medical history

    Additional referral information (useful for processing the referral)

    • ELFT, FBC, fasting lipids and glucose results
    • ABCD2 stroke risk score
    • ECG results
    • Doppler ultrasound carotid vessels
    • Echocardiogram
    • Holter monitor results
    • Discharge summary (if the patient is being referred for second opinion)

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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