​​​​​​​​​​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 severe colitis (> 6 bloody bowel motions per 24 hours)
  • dehydration unable to be managed at home
  • suspected bowel obstruction – bilious vomiting, significant distention, lack of passage of flatus, obstipation.

When public outpatient services are not routinely provided

  • Allergic colitis.
  • Non-tertiary referrals for chronic constipation and encopresis.
  • Positive stool multiplex PCR for infection.
  • Self-limiting diarrhoea < 6 weeks.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Persistent diarrhoea (bloody or non-bloody) > 4 weeks with any of the following features:
    • negative stool multiplex PCR for infection
    • faltering growth (weight loss of > 2 weight centiles)
    • elevated inflammatory markers (raised platelet count, C-reactive protein, erythrocyte sedimentation rate and/or reduced albumin)
    • tissue transglutaminase IgA (TTG IgA) > 10 x upper limit normal (ULN)
    • elevated faecal calprotectin (> 100 mcg/g).

Note: faecal calprotectin levels can be elevated in healthy, pre-school aged children and should be interpreted with caution.

Category 2
Recommended to be seen within 90 calendar days.		Persistent diarrhoea > 4 weeks without any of the above features.
Category 3
Recommended to be seen within 365 calendar days.		Tertiary referral (i.e. paediatrician or paediatric surgeon) for treatment resistant constipation or encopresis.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition including duration of symptoms and medical management to date.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • ‘Blue Book’, growth charts or any recent growth measurements
    • current weight and length or height
    • weight loss (amount and timeframe)
    • c-reactive protein (CRP)
    • erythrocyte sedimentation rate (ESR)
    • faecal multiplex PCR result
    • faecal calprotectin result (in children aged > 4 years with diarrhoea > 4 weeks)
    • full blood count (FBC)
    • iron studies
    • liver function test results
    • coeliac serology: tissue transglutaminase IgA (TTG IgA), total IgA (where possible) with or without anti-endomysial antibody (EMA).

If available

  • Previous investigations and reports (for example, endoscopy, radiological reports).
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ and/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: Thursday 14 November 2024
Contact page owner: System Purchasing