Interstitial lung disease (ILD)

Emergency department referrals

If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary).

Acute exacerbations of known ILD with any of the following concerning features:
- severely breathless/Class 4 dyspnoea (ADL’s affected by dyspnoea)
- demonstrated worsening hypoxaemia
- new arrhythmia/chest pain
Newly diagnosed or suspected ILD with radiographic evidence with Class 4 dyspnoea (ADLs affected by dyspnoea)

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

Newly diagnosed or suspected ILD with Class 2/3 dyspnoea
Known ILD with worsening hypoxemia or right heart failure

Category 2

Appointment within 90 days is desirable

Chronic ILD with Class 1 dyspnoea
Newly diagnosed or suspected ILD without symptoms

Category 3

Appointment within 365 days is desirable

Known ILD with stable symptoms requiring specialist opinion

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

Referral requirements

A referral may be rejected without the following information.

Essential referral information

History and Examination

Duration and severity of ILD or symptoms
Management to date
Other relevant medical conditions (particularly connective tissue disorders)
Medications
Occupational history

Imaging and Reports

CXR
High resolution CT (HRCT) chest

Additional referral information (useful for processing the referral)

Previous lung function tests
FBC
Auto-antibody screen results (ANF (plus ENF if positive) plus rheumatoid factor)

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.

Clinical Modifiers (where relevant)

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

Reason for Referral (essential)

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

Clinical Information (essential)

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