Irritable infant < 1 year
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.
- Fluctuating or altered conscious level – weak cry, not waking appropriately for feeds, lethargy, maternal concern of failure of normal interaction
- Suspicion of harm or any unexplained bruising, especially in infant <3 months
- Significant escalation in frequency or volume of vomiting
- New onset of blood mixed in stool
- Fever
- Increased respiratory effort
- Weak or absent femoral pulses in infant <3 months
- Presence of newly noted heart murmur in infant <3 months
- Inguinal hernia
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
- Maternal depression
- Significant vomiting
- Poor weight gain/ weight loss
- High level of maternal or infant distress.
- Infant < 6 months
- 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
Category 2
Appointment within 90 days is desirable
- Thriving child > 6 months
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 for assessment and management information if available.
- Refer the mother to Community Child Health nurse if not already in contact.
- Skilled breastfeeding support is an integral part of the management of breastfeeding difficulties.
- 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.
- 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.
Referral requirements
A referral may be rejected without the following information.
- General referral information
- Age of onset of irritability
- Report presence or absence of concerning features
-
- Frequent daily vomiting
- Blood in stools
- Irritability has no day/night variation with persistent screaming overnight and in the mornings as well as afternoon/evenings
- Weight loss or failure to gain weight
- Diagnosed or suspected maternal depression
- Inappropriate interaction or attribution to the baby by the mother – anger or resentment towards the infant.
- Developmental delay
- Confirmation of OOHC (where appropriate)
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category
- Description of pattern of irritability including relation to feeding. Does the infant sleep at night?
- Is there difficulty feeding? (Breast or bottle feeding or both)
- Height/weight/head circumference and growth charts with prior measurements if available, comment on whether the child is gaining weight appropriately or not
- Has the mother been to see a child health nurse or had other parenting assistance?
Pregnancy and birth history, including if premature birth - Medical history
- Developmental history
- Family history (especially infantile irritability, previous children with food intolerance)
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
Desirable information — will assist at consultation
- Other past medical history
- Immunisation history
- Medication history
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports
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