Emergency department referrals
All urgent cases must be discussed with the on-call Registrar to obtain appropriate prioritisation and treatment. Contact through:
- Caboolture Hospital (07) 5433 8888
- Redcliffe Hospital (07) 3883 7777
- Royal Brisbane and Women's Hospital (07) 3646 8111
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.
- Headaches that wake the patient at night or headaches immediately on wakening
- New and severe headaches
- Headaches associated with significant persisting change of personality or cognitive ability or deterioration in school performance or delay in development
- Recent head injury or head trauma
- Any abnormalities on neurological examination, such as: focal weakness, gait disturbance, papilledema, diplopia, visual disturbance.
- Sudden onset headache reaching maximum intensity within 5 minutes (= explosive onset)
- Presence of an intracranial Cerebral Spinal Fluid (CSF) shunt
- Hypertension above 95th centile by age for systolic or diastolic
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Appointment within 30 days is desirable
- History of malignancy, recent head trauma
- Age < 6 years
- A child currently in out of home care (OOHC), or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service.
Appointment within 90 days is desirable
- Headaches with initial onset within 3 months of referral
- Missing significant amounts of school due to headaches
Appointment within 365 days is desirable
- Chronic headaches that have previously been assessed by a specialist
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
- Neuroimaging is not usually recommended when the neurological examination is normal. MRI is a more appropriate investigation than CT if imaging is required
- Clinical urgency is the dominant consideration in the prioritisation of a referral for a child currently in out of home care (OOHC), or at risk of entering or leaving OOHC.
- In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: Department of Children, Youth Justice and Multicultural Affairs
A referral may be rejected without the following information.
History and Examination
- Detailed history of headaches
- how long has the patient been getting headaches?
- what is their frequency and duration?
- BP (right arm, with appropriately sized cuff)
- Report presence or absence of concerning features
- Change in mood, mental status, or school performance since the onset of the headaches
- Headaches usually present on waking or wake the child in the early morning
- Confirmation of OOHC (where appropriate)
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category
- Exacerbating and relieving factors
- Reason for presentation at this time
- Details of previous specialist assessment
- Burden of disease:
- are there associated symptoms (vomiting, behaviour change)?
- is the child missing school? How many days missed in the last month?
- is the headache affecting sleep?
- other information to assess the burden of the symptom
Desirable Information- will assist at consultation.
- Other past medical history
- Immunisation history
- Developmental history
- Medication history
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Children, Youth Justice and Multicultural Affairs involvement)
- Height/weight/head circumference and growth charts with prior measurements if available.
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports, urinalysis result
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
- 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.)
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
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