Paediatric Obesity
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.
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
- Hypertensive > 95% for age with appropriate size cuff (BP centile by age and height)
- Type 2 diabetes
- Severe obstruction in sleep with repeated arousals and distress
- 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
- An underlying medical or endocrine cause is suspected, or there are concerns about height and growth velocity.
- Obese children < 6 years
- Other symptomatic obesity including obstructive sleep apnoea, hip or knee pain, high levels of psychological distress about weight
- Signs of insulin resistance
Category 3
Appointment within 365 days is desirable
- Obese children > 6 years
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
- Use BMI charts to monitor growth. Interpretation of BMI values in children and adolescents aged 2–18 years is based on sex-specific BMI percentile charts. Ensure that the same chart is used over time to allow for consistent monitoring of growth.
- Growth of children less than 2 years of age is monitored using World Health Organization (WHO) growth charts. (Australian practice)
- While waist circumference may not have a place in screening for overweight and obesity in children and adolescents, a waist circumference that is greater than half the height suggests a need for more thorough weight assessment.
- Consider involvement of other professionals (e.g. aboriginal health worker, multicultural health worker, interpreter) to facilitate communication
- 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
- 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.
History and Examination
- Current height and weight, and include date of measurement
- Report presence or absence of concerning features
- Significant obstruction in sleep with repeated arousals and distress
- Type 2 diabetes (random glucose > 11 or fasting >7.0) use diabetes CPC referral guide
- Recent rapid change in weight (gain or loss)
- Hypertension >95 centile for age with appropriate size cuff
- Fatty liver
- Confirmation of OOHC (where appropriate)
Pathology and Test Results
- Fasting glucose insulin U&E LFT FBC iron studies CRP TFT results
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category
- History of obesity-related burden of disease – sleep disturbance, exercise limitation, orthopaedic pain, psychological disturbance
- Height/weight/head circumference and growth charts with prior measurements if available
- Diet history including if:
- the child has a very restricted diet, or specific dietary restrictions (refer to a dietitian)
- extreme weight loss behaviours, signs of eating disorders, high level of negative body image and/or negative social experiences are evident (refer to psychological services)
Desirable information — will assist at consultation
- Assessment of parental obesity and other family history
- Other past medical history
- Pregnancy and birth history
- Immunisation history
- Developmental history
- Medication history
- Allergies
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Children, Youth Justice and Multicultural Affairs involvement)
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any other 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