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.
- acute development of peripheral nerve compression symptoms following trauma
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.
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Exclusions
- common peroneal nerve injury - refer to orthopaedics or plastics and reconstructive surgery
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- acute neurologic deficit from trauma
- pressure from external lesion
- symptomatic disease with muscle wasting and weakness
Category 2 (appointment clinically indicated within 90 days)
- symptom recurrence previous history of surgical decompression
Category 3 (appointment clinically indicated within 365 days)
- symptomatic nerve entrapment without muscle wasting or weakness
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.
- relevant past medical/surgical history
- current medications, allergies
- history of presenting complaint including:
- onset
- duration
- concerning features
- neurological examination findings
- confirmation of diagnosis on imaging and associated reports including location, company, and accession number
- to assist in triage categorisation, a nerve conduction study would expedite the patient's management
Clinical management advice
Carpal tunnel syndrome (CTS) can be referred to neurosurgery as well as the following specialties but will be triaged in a unified manner by all specialties concerned:
Clinical resources
- HealthPathways SA – Carpal Tunnel Syndrome (CTS)
- Royal Australian College of General Practitioners – Nerve conduction studies
Consumer resources
Reason for request
- to establish a diagnosis
- for treatment or intervention
- for advice and management
- for specialist to take over management
- for a specified test/investigation the General Practitioner cannot order
- for other reason (e.g. rapidly accelerating disease progression)
- transfer of care from another tertiary service
- clinical judgement indicates a referral for specialist review is necessary.
Patient demographic details
- 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
Clinical modifiers
- 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
Other relevant information
- 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.
- Relevant social history, including identifying 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.
- Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
- Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
- A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
- All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.