Asthma
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
- The Prince Charles Hospital (07) 3139 4000
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.
- Acute exacerbation of asthma not responding to therapy
- Asthma with any of the following features:
-
- coexistent pneumothorax
- pneumonia
- silent chest
- cardiovascular compromise
- drowsiness
- poor respiratory effort
- SpO2 ≤92%
- failure to respond to acute management
- respiratory distress
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
- History of life-threatening asthma in the past 12 months requiring ventilation or ICU admission
- Unstable asthma with consistent FEV1 < 60% predicted or z-score < -2.5
- Asthma caused or exacerbated by workplace exposure where ability to work is affected
Category 2
Appointment within 90 days is desirable
- Uncontrolled asthma despite optimal asthma treatment
- Frequent asthma-related healthcare utilisation
- Asthma related hospital admission/s in the last 6 months
- More than 4 primary care presentations with uncontrolled asthma in the past 12 months
- After-hours attendance (ED or after-hours GP) despite optimal treatment
- Need for oral corticosteroids on more than 2 occasions in the last year
- Asthma caused or exacerbated by workplace exposure where patient is still able to work as a result
- Symptomatic asthma during pregnancy
Category 3
Appointment within 365 days is desirable
- Uncertainty about diagnosis
- Persistent reduced spirometry after at least 3 months of optimal treatment not explained by other pathology
- Asthma education where this cannot be provided in the community
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 or local guidelines
- The aim of asthma management is to control the disease. Complete control is defined as:
- Absence of nocturnal symptoms
- No symptoms on wakening
- No need for reliever medications
- No restriction in day-to-day activities
- No days off school or work
- No asthma flares (NAC)
- Inhaler techniques and therapy usage should be assessed at each visit
- A written, personalised self-management (action) plan should be provided to all patients
Referral requirements
A referral may be rejected without the following information.
- Details of previous treatments and reasons for discontinuation
- Smoking history
Additional referral information (useful for processing the referral)
- Allergy testing results
- Vaccination status
- FBC results
- Spirometry and FeNO result (exhaled nitric oxide), if available
- CXR
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