If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

It is proposed that the following conditions should be sent directly to emergency. This is not a list of all conditions that should be sent to the emergency department, it is intended as guidance for presentations that may otherwise have been directed to general paediatric outpatients:

Brain & Nervous System

  • Seizures
    • all children with new onset of clinically obvious epileptic seizures should be referred to emergency for initial assessment, observation and consideration of emergency investigation or management.
    • any abnormalities on neurological examination, such as: focal weakness, gait disturbance, papilledema, diplopia
    • significant change in seizures for established epilepsy:
      • new onset of focal seizures or
      • a dramatic change in seizure frequency or duration


Useful Management Information
  • An EEG should be performed only to support a diagnosis of epilepsy in children and young people. If an EEG is considered necessary, it should be performed after the second epileptic seizure but may, in certain circumstances, as evaluated by the specialist, be considered after a first epileptic seizure. An EEG should not be performed in the case of probable syncope because of the possibility of a false-positive result. The EEG should not be used to exclude a diagnosis of epilepsy in a child, young person or adult in whom the clinical presentation supports a diagnosis of a non-epileptic event.
  • Encourage parents to keep diaries of events and video an event if possible
  • Epilepsy Queensland:
  • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services:
  • In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Minimum Referral Criteria

Category 1
(appointment within 30 calendar days)

  • All children with recent onset of clinically obvious seizures

Children who have been seen by a paediatric consultant in emergency with a first seizure may not require a category 1.Most children seen in emergency following a first seizure will be discharged when stable and specialist follow up should be arranged by their GP if required.

  • Unstable epilepsy requiring re-evaluation and management
Category 2
(appointment within 90 calendar days)
  • Known epilepsy with stable management who are transferring care and do not have a specialist available for advice or management
  • Children with episodes that may be suggestive but are not conclusively epilepsy
Category 3
(appointment within 365 calendar days)
  • Known epilepsy with stable management who are transferring care and have appropriate interim care arrangements in place

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If you still need to refer your patient:
    • 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
Standard Referral Information

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

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, BMI), 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

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

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

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

Without this information the referral will be returned

  • General referral information
  • Detailed seizure description, duration, frequency, date of onset
  • Associated problems such as cyanosis or injuries during events
  • Details of current medications used to control epilepsy, if any
  • Report presence or absence of Red flags

Presence of Red flags

  • Headaches
  • Focal seizures
  • Personality change
  • Polyuria or polydipsia
  • Recent change in sleep behaviour
  • Recent onset of clumsiness or poor coordination,
  • Unexplained vomiting
Additional Referral Information

Highly desirable Information – may change triage category.

  • Additional history of events including post event drowsiness, incontinence or injuries during events
  • Past treatments/medications offered and efficacy Including previous acute anticonvulsant management
  • Other neurological or development conditions present
  • Either:
    • current developmental status (age appropriate, some delay, significant delay) OR
    • brief comment on current school educational attainments (good, average, poor, very poor [>2 years behind])
  • Any previous EEG results (note advice on ordering EEGs in other useful information section. Generally it is not required to order an EEG for referral. If previous results are available please include with referral)

Desirable Information- will assist at consultation.

  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports, urinalysis result
Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email or phone 3413 7402.