Not yet in use
Specialty: Children's medicine
Age group: Children
Direct to an emergency department
- Sudden onset or thunderclap headache
- Headache concurrent with change in personality or cognitive function
- Headache consistently waking child from sleep or waking them early
- Headache with vomiting, double vision, unequal pupil size or abnormal pupil reaction to light
- Headache with neurological signs or deficit
- Optic nerve head swelling (papilloedema)
- Severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness, dehydration)
- Severe disabling headache
- Severe headache associated with recent head trauma
Criteria for referral to public hospital service
- Chronic or atypical headache unresponsive to medical management (e.g. cluster headache, trigeminal neuralgia, medication overuse headache)
- Severe frequent migraine impacting on daily activities (e.g. work, study, school) despite prophylactic treatment
- Head circumference is greater than the 98th percentile for age or disproportionately large when compared to the child’s other growth parameters.
Information to be included in the referral
Information that must be provided
- Onset, characteristics and frequency of headache
- Findings on physical examination including neurological examination and blood pressure
- Current and recent previous growth measurements, height, weight and head circumference
- Details of any previous neurology assessments or opinions
- Developmental history and relevant medical history
- Relevant family history
- Any medicines previously tried, duration of trial and effect
- Current and complete medication history (including non-prescription medicines, herbs and supplements).
Provide if available
- Neuroimaging results (including date and details of the diagnostic imaging practice)
- Comprehensive eye and vision assessment including cycloplegic refraction and dilated retinal examination (usually performed by an optometrist or ophthalmologist) with best corrected visual acuity (i.e. measured with spectacles or contact lenses) for both eyes or visual behaviour assessment if the child is pre-literate or non-verbal
- 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
- Headaches without red flag symptoms such as those listed above that are relieved by analgesia.
Updated