Paediatric surgery registrars at Queensland Children's Hospital/ GCUH can offer telephone advice to rural HHS. In some areas it would be more appropriate to seek initial advice from local paediatric medical service or general surgery services:

• Queensland Children's Hospital: (07) 3068 1111
• GCUH: 1300 744 284

Burns

All major burns require emergency management and referral.

The Paediatric Burns Centre (PBC), Qld Children’s Hospital offers a 24/7 referral service. For a referral coming from regional QLD, an email referral service is available. Criteria for referring to our service is based on the Australian New Zealand Burns Association transfer guidelines for Burns Service referral.

• For those burns located in the Gold Coast region and below to Grafton NSW, please refer to Gold Coast University Hospital first. Paediatric surgical registrar or on call surgical cover 1300 744 284
  • If GCUH is unable to care for the patient, then please follow the information below to refer to Paediatric Burns Centre (PBC)
    
• To refer a patient to the Paediatric Burns Centre (PBC) at Queensland Children’s Hospital
  • Contact the Burns Register on call via switch (07) 3068 1111
  • Complete Category 1 Referral to Burns Outpatients (QH staff only)
  • Submit referral form by clicking ‘submit at the end of the form or by emailing through to burns-opd@health.qld.gov.au
    • Attach any photos to this email if possible
    • If advised that the patient can be treated locally, continue to contact the burns Registrar at each dressing change to update progress and send through photos to above email address
    • Paediatric patients may not physically be required to attend the Queensland Children’s hospital after referral. If treatment can be managed in the local area, then this is the preferred treatment

Antenatal & neonatal surgical conditions

• Patients with congenital malformations causing bowel obstruction or respiratory compromise are emergency referrals not outpatients. Resuscitation and safe transfer to tertiary paediatric unit is a priority. Notify neonatal unit or appropriate neonatal/paediatric medical specialist of neonatal/fetal diagnosis as per local protocol.
• Acute neonatal bowel obstruction

Enlarged lymph bodes/midline neck swelling

• Acute infective node with no improvement within 48 hours
• Nodes rapidly increasing in size, overlying skin erythema or very tender
• Acute infection not responding to treatment/antibiotics present to emergency

Umbilical and peri umbilical pathology

• Any painful, red, or irreducible hernia – discuss with on-call paediatric surgical registrar
• Suspected vitello-intestinal remnant or patent urachus

Abdominal pain - chronic

• Acute abdominal pain (suspected serious pathology) especially severe pain or peritonitis
• Intussusception
• Hypertrophic pyloric stenosis
• Suspected bowel obstruction with bile stained vomiting
• Suspected malignancy – discuss with on-call paediatric surgical registrar if serious pathology is suspected

Perineal conditions

• Severe pain or peritonitis

Perianal conditions

• Acute abscess

Constipation and encopresis

• Acute neonatal bowel obstruction

Vomiting

• Bile stained vomiting is a surgical emergency – phone the on-call paediatric surgical registrar,
• Suspected pyloric stenosis – phone the on-call paediatric surgical registrar

Stomas and abdominal devices

• Accidental removal of gastrostomy button or ACE tubing – phone on-call paediatric surgical registrar
• Any stomal or abdominal device issues refer to treating hospital

Hernia, hydrocele and testicular conditions

• Irreducible, incarcerated or strangulated inguinal hernia
• Suspected testicular torsion
• Inguinal hernia: If under <52 weeks post conceptual age, call nearest paediatric surgical unit for urgent review
• Acute scrotal pain with or without swelling
• Ambiguous genitalia and neonatal bilateral undescended testes are urgent referrals to service

Renal and bladder congenital lesions

• Acute retention
• Poor urinary stream in neonate / suspected valves

Urinary tract infections (UTI)

• Acute infant urinary tract infection presenting septicaemia or acutely unwell
• Hypertension > 97 percentile for age and/or height
• Presumed UTI in infant <3 months

Penile conditions

• Paraphimosis (when unable to replace foreskin)
• Disorder of sexual development (DSD) – refer to paediatric surgeon or paediatric medicine immediately

Skin and soft tissue masses

• Acute breast infection requiring admission or drainage
• Acute infection - if unresponsive to treatment or acutely unwell from infection
• Suspected solid paediatric tumours should be urgently referred through local paediatric medical service and/or paediatric oncology services

Vascular anomalies/haemangioma

• Obstruction of vision, airway compromise, uncontrolled bleeding, ulceration, suspected kapsiform haemangioendothelioma (KHE) or cardiac output compromise - contact paediatric surgical registrar on call

Reason for request

• To establish a diagnosis
• For treatment or intervention
• For advice and management
• For specialist to take over management
• Reassurance for GP/second opinion
• For a specified test/investigation the GP can't order, or the patient can't afford or access
• Reassurance for the patient/family
• For other reason (e.g. rapidly accelerating disease progression)
• Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

• Presenting symptoms (evolution and duration)
• Physical findings
• Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
• All conservative options that have been pursued unsuccessfully prior to referral
• Body mass index (BMI)
• Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
• Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
• Current medications and dosages
• Drug allergies
• Alcohol, tobacco and other drugs use

Patient's Demographic Details

• Full name (including aliases)
• Date and country of birth
• Residential and postal address including whether patient resides at an aged care facility
• Telephone contact number/s – home, mobile and alternative
• Medicare number (where eligible)
• Name of the parent or caregiver (if appropriate)
• Name of delegate and contact details (Department of Corrective Services)
• Preferred language and interpreter requirements
• Identifies as Aboriginal and/or Torres Strait Islander
• Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

• Full name
• Full address
• Contact details – telephone, fax, email
• Provider number
• Date of referral
• Signature
• Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

• Willingness to have surgery (where surgery is a likely intervention)
• Choice to be treated as a public or private patient
• Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)