Short Stature
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.
- Possible CNS signs (visual disturbance, morning headaches)
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
- Suspected chronic disease leading to growth arrest
- 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
- Children with undiagnosed short stature
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
- Short Stature defined as having a height below the 3rd percentile for age and gender
- Correct for prematurity (<37 weeks) until 24 months of age
- There are growth charts available for specific conditions including down syndrome, turner syndrome and williams syndrome and these should be used
- The frequency of follow up depends on the child’s weight, age and psychosocial circumstances. Younger infants need more frequent follow up.
- 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, including head circumference for children less than 2 years
- Report presence or absence of concerning features
- Presence of chronic respiratory or bowel symptoms
- Recurrent infectious illness
- Juvenile arthritis (as this may be a marker of inflammatory disease e.g. inflammatory bowel disease).
- Unexplained sudden growth arrest in a previously well-growing child
- Visual field defects, eye movement disorders, morning headaches or other neurological signs
- Confirmation of OOHC (where appropriate)
Additional referral information, Useful for processing the referral
Highly desirable Information – may change triage category
- Height/weight/head circumference/percentile charts (measured serially and plotted to note trend, if available). It is recommended that WHO growth standards be used for children under 2 years of age and CDC growth charts for children over 2 years of age
- Delayed pubertal development (no signs by 12 years in girls or 13 years in boys)
- Early signs of pubertal development (signs prior to 8 years in girls and 9 years in boys)
- Accurate parental heights obtained
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)
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
Investigations to consider if clinically indicated
- FBC ESR/CRP, Iron, B12 results
- Urea electrolytes and LFT results
- Bone chemistry results (calcium, phosphate and alkaline phosphatase)
- Coeliac serology (TTG & IgA) results
- TSH & FT4 results–to exclude hypothyroidism (peripheral or central)
- IGF1 results – to exclude GH deficiency
- Karyotype results in girls – to exclude Turner syndrome. May also request CGH microarray however a karyotype should be requested if mosaic Turner Syndrome is suspected.
- Urinalysis– to exclude renal disease
- Bone age XR of wrist
- FSH/LH results – if concerns about puberty
- Faecal calprotectin
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