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.

  • nil

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

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • history of trauma
  • sudden change in range of motion (ROM) or increased pain ≤ 72 hrs onset

Category 2 — appointment clinically indicated within 90 days

  • sudden onset pain in wrist ≤ 3 months
  • postpartum women ≤ 6 months or in third trimester pregnancy with failed maximal medical management

Category 3 — appointment clinically indicated within 365 days

  • chronic wrist pain with duration ≥ 3 months

For more on outpatient referrals, see the 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
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • complete past medical history including relevant surgical history
  • current medication list
  • private health cover/compensable status e.g. WorkCover claims
  • management history including:
    • injury/trauma (if relevant)
    • onset and duration
    • pain
    • associated features, e.g. functional impairment
    • immobiliser/splint/cast
    • allied health management reports
    • previous management trialled
  • functional range of motion (ROM)
  • plain X-ray – anterior posterior/lateral views include radiological details/accession number

Additional information to assist triage categorisation

  • complete blood examination (CBE)
  • electrolytes, urea, creatinine (EUC)
  • liver function tests (LFTs)
  • estimated glomerular filtration rate (eGFR)
  • erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • uric acid

Clinical management advice

Consideration of risks versus benefits of surgical intervention may include:

  • age
  • frailty
  • additional comorbidities
  • patient expectations of outcome
  • patient suitable for surgery, engagement in self-management
  • body mass index (BMI) and weight loss
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation

Optimisation of chronic medical conditions should occur as part of initial assessment and conservative management as this may impact on suitability for surgical intervention.

Clinical resources