Not yet in use
Specialty: Children's medicine
Age group: Children
Direct to an emergency department
- Inadequate fluid intake due to breathlessness (especially in children younger than 2 years)
- Life threatening asthma, including thunderstorm asthma (after initial emergency management)
- Severe asthma, including asthma with intercurrent disease (e.g. pneumonia) and thunderstorm asthma, if symptoms have not resolved after initial emergency management
- Suspected anaphylaxis (after initial emergency management).
Criteria for referral to public hospital service
- Previously diagnosed asthma that requires further advice on, or review of, the current management plan or management of treatment-related adverse effects because of
- three or more presentations to an emergency department in the last 12 months
- recent hospital admission with treatment in an intensive care unit
- uncontrolled symptoms despite Step 4 in maintenance treatment (i.e. moderate dose inhaled corticosteroid plus montelukast oral tablet, or inhaled corticosteroid/long-acting beta-agonist plus montelukast oral tablet)
- frequent use of oral corticosteroids
- prolonged use of high-dose inhaled corticosteroids
- frequent chest infections
- Asthma with clinical or spirometry features suggestive of an alternative or additional diagnosis
- Asthma with faltering growth, severe allergic reactions or additional lung disease.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Description of onset, nature, progression, recurrence and duration of symptoms (e.g. breathlessness, chest tightness, wheezing, cough). Include details of previous emergency treatment or hospitalisations for asthma and oral prednisolone or high-dose inhaled corticosteroids used
- Details of previous management including the course of treatment(s), assessment of adherence to current management plan and outcome of treatment(s)
- Current and complete medication history (including non-prescription medicines, herbs and supplements)
- Any known or suspected allergies or triggers or allergic diseases
- Smoking history or smoking exposure (cigarettes and all forms of tobacco, nicotine, vaping and cannabis)
- History of any other inhalant use, including if the patient is still using
- Past medical history and comorbidities including if the child was born prematurely (before 37 weeks gestation).
Provide if available
- Current asthma management plan
- Spirometry
- Other lung function tests
- Details of any previous respiratory assessments or opinions
- If the child identifies as an Aboriginal and/or Torres Strait Islander
- If the child is neurodiverse
- If the child is gender diverse
- If the child has a disability
- If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
- If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
- If the child is a refugee, seeking asylum or has a bridging visa while waiting for an immigration outcome
- If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.
Additional comments
The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.
The referral should include if this is a request for a second opinion.
Spirometry can be performed in primary care if reliable equipment and appropriately trained staff are available. Where it is not available, patients can be referred to an appropriate provider such as an accredited respiratory function laboratory.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Stable asthma that is controlled with the current management plan.
Updated