Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • collapse/altered level of consciousness/new neurological deficit/seizures
  • bulging fontanelle +/- prominent veins on head
  • sunsetting eyes

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Women's and Children's Health Network

Exclusions

  • asymptomatic children > 2 years of age with a head circumference greater than the 98th centile with no history of crossing > 2 centile lines or disproportionate to other growth parameters
  • children > 2 years of age with a head circumference greater than the 98th centile and developmental delay or neurological deficits without radiological intracranial abnormality should be referred to paediatric neurology services at Southern Adelaide Local Health Network or Women’s and Children’s Health Network

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • children < 2 years of age without concerning features and head circumference that crosses 2 or more centile lines

Category 2 (appointment clinically indicated within 90 days)

  • asymptomatic children > 2 years of age with a head circumference greater than the 98th centile with history of crossing > 2 centile lines or disproportionate to other growth parameters

Category 3 (appointment clinically indicated within 365 days)

  • nil

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • child/parent’s demographic information including best contact details
  • past medical/surgical history
  • current medications, allergies

history of presenting complaint including:

  • onset
  • duration
  • concerning features
    • developmental delay
    • regression in developmental milestones
    • papilledema
    • irritability / behavioural changes
  • treatments trialled/implemented prior to referral
  • head circumference measurements at birth and at time of assessment
  • growth chart trends including head circumference
  • neurological examination findings
  • in children greater than 2 years of age or with closed anterior fontanelle brain computed tomography (CT)
  • in children less than 2 years of age and/or with open anterior fontanelle ultrasound (US) head
  • confirmation of diagnosis on imaging and associated reports including location, company, and accession number