​​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • acute, sudden voice change
  • acutely enlarging neck mass with any of the following associated airway symptoms:
    • drooling
    • dysphagia
    • stridor
  • airway compromise with or without severe stridor, drooling or respiratory distress
  • severe odynophagia
  • witnessed cyanosis or severe apnoea.
CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.

Polysomnographic evidence of severe obstructive sleep apnoea with continuous positive airway pressure (CPAP) intolerance (despite effort) and significant, uncontrolled desaturations or cardiovascular compromise.

Category 2
Recommended to be seen within 90 calendar days.​​

  • Severe obstructive sleep apnoea confirmed on polysomnography (PSG).
  • Obstructive sleep apnoea with faltering growth (failure to thrive).
  • Prolonged history (> 3 months) of an obstructive breathing pattern persisting after trial of nasal steroids with all of the following present:.
    • parental report or video evidence of obstruction
    • significant daytime behavioural impacts
    • witnessed clinical apnoea or gasping episodes.

Category 3
Recommended to be seen within 365 calendar days.

  • Mild to moderate sleep disordered breathing or obstructive sleep apnoea.
  • Obstructive sleep disordered breathing following trial of nasal steroids for ≥ 4 weeks.
  • Sleep disordered breathing and underlying developmental or behavioural issues.
  • Snoring and/or significant sleep fragmentation and sleep related behavioural concerns.
  • Persistent bed wetting (enuresis).
  • Tooth grinding (bruxism) following dental review and exclusion of other causes.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • tonsillar hypertrophy grading scale (Brodsky scale)
    • presence of a co-existing craniofacial abnormality.

If available

  • Paediatric Epworth or pictorial Sleepiness Scale.
  • Recent paediatric polysomnography (PSG).
  • Video evidence of child with sleep disordered breathing.
  • Total OSA-5 score.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ or among a vulnerable, disadvantaged or priority population.
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Monday 17 June 2024
Contact page owner: System Purchasing