Not yet in use
Specialty: Children's medicine
Age group: Children
Direct to an emergency department
- Acute weight loss with haemodynamic instability
- Altered conscious state
- Cachexia, hypoglycaemia or hyperglycaemia
- Significant dehydration
- Significant malnutrition or illness.
Criteria for referral to public hospital service
- Accelerated growth in height or tall stature with either
- suspected precocious puberty or
- a bone age x-ray assessment that indicates the child’s bone age is 2 or more years older than the child’s chronological age
- Slowing growth or short stature with either
- height less than third height-for-age percentile curves
- height difference more than 8.5 centimetres of the child’s calculated mid-parental height
- sustained drop in height centiles or
- features suggesting an underlying cause related to endocrinopathy or skeletal dysplasia
- Precocious pubertal development in females younger than 8 years or males younger than 9 years.
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
- Findings on physical examination including head circumference
- Growth charts, including current height
- Calculated mid-parental height
- Pubertal staging (i.e. Tanner staging)
- Developmental history and relevant medical history
- Any relevant growth family history
- Previous assessments or opinions.
Provide if available
- If available
- bone age x-ray assessment
- coeliac serology
- full blood examination
- free thyroxine (T4) and thyroid stimulating hormone level (TSH)
- liver function tests
- urea and electrolytes results
- 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.
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
- When a child’s height is tracking within normal centile ranges and calculated mid-parental height
- Slowing growth or short stature when the child has reached their final height (i.e. with bone age older than 14 in females and older than 16 in males).
Updated