If you believe your patient requires immediate attention, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice.
Wounds of traumatic aetiology
Systemic Inflammatory Response Symptoms (SIRS) or clinically unwell (see Sepsis Clinical Tools )
Wounds with complex foreign body involvement and significant damage to associated surrounding structures including blood vessels, nerves, muscles, joints and tendons.
Wounds with associated compound fractures
Persistent significant bleeding not controlled with usual measures
Worsening pain and/or pain not in keeping with mechanism of injury
Lacerations and wounds not suitable for primary health management e.g. lip lacerations, large facial lacerations, lacerations with altered sensation, large skin defects
Arterial/ischaemic ulcer
Systemic Inflammatory Response Symptoms (SIRS) or clinically unwell (see Sepsis Clinical Tools
Worsening pain and/or pain not in keeping with progression of the wound/ulcer
Sepsis or acutely unwell due to infection3
Acute or critical limb ischaemia with necrosis
Rapidly deteriorating ulceration or necrosis.3
Ulcers or wounds in a limb with markedly compromised circulation
Wounds on the High-Risk Foot
Systemic inflammatory response symptoms (SIRS) or clinically unwell
Worsening pain and/or pain not in keeping with progression of the wound/ulcer
Progressive cellulitis despite initial treatment
Acute or critical limb ischaemia with necrosis
Acute Charcot arthropathy if access to podiatry is not accessible within 48 hours
Worsening pain and all pain not in keeping with current state of the wound
Progressive cellulitis despite initial treatment
Suspected incarcerated hernia or underlying abscess
Suspected bowel obstruction resulting in non-functioning stoma
Persistent significant bleeding, including peristomal varices, not controlled with usual measures
Stomal change in colour from red / pink to blue or black
Stomal prolapse causing circulatory compromise
Ongoing high output stoma and signs of dehydration
NB: If the problem is with the stomal appliance the patient can self-refer to stomal therapy nurse. Patients not in contact with regular stomal therapy nurse/service can be referred by GP.
Patients from Residential Aged Care Facilities can access wound advice from RADAR services (Residential Aged Care District Assessment and Referral Service) where they are established
Post-operative wound/dehiscence
Systemic Inflammatory Response Symptoms (SIRS) or clinically unwell (see Sepsis Clinical Tools )
Worsening pain and/or pain not in keeping with progression of the wound/ulcer
Prosthesis / metal work / mesh is on view/ vascular bypass procedure
Tendon blood vessel or other structure on view
Purulent discharge with associated fevers
Immunocompromised patients
Deep sinus or fistula present
Referral to Surgeon who performed operation/Surgical Clinic
Patients should have clearance from their surgeon for wound management alone if:
Acute wound dehiscence in the post operative period (< 6 weeks)
Venous leg ulcer
Systemic Inflammatory Response Symptoms (SIRS) or clinically unwell (see Sepsis Clinical Tools )
Worsening pain and/or pain not in keeping with progression of the wound/ulcer
Progressive cellulitis despite treatment – rapidly spreading cellulitis with peri-wound redness or erythema (colour change, warmth, tight oedema, or pain in pigmented skin tones) for > 2cm
Uncontrollable bleeding from ulcer
Useful Management Information
No useful management information
Minimum Referral Criteria
Does your patient meet the minimum referral criteria?
Category 1 (appointment within 30 calendar days)
Acute wound or ulcer of uncertain aetiology that is progressing in size despite maximal medical management1,2
Acute onset ulcer in patients receiving high dose steroids or immunosuppressive agents
Category 2 (appointment within 90 calendar days)
Subacute or chronic wound/ulcer of uncertain aetiology that is not responding to maximal medical management
Category 3 (appointment within 365 calendar days)
No category 3 criteria
If your patient does not meet the minimum referral criteria
Assessment and management information may be found on a range of conditions at HealthPathways
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
Please note that your referral may not be accepted or may be redirected to another service
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.)
Essential Referral Information
Co-morbidities and past medical history
Wound history e.g. duration, description and size, wound initiating event
Details of all treatments offered, and efficacy to date e.g. type of dressings used, date of commencement of any antibiotics with dose prescribed.
Additional Referral Information
History of allergies and list of current medications
Relevant pathology including biopsy (as clinically indicated)
Relevant medical imaging results if available –i.e. x-ray, ultrasound
Clinical photograph – with patient’s consent, where secure image transfer, identification and storage is possible
If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.
