Otitis externa - Paediatric
+ Emergency
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.
Adult
EAR
- ENT conditions with associated neurological signs
- Sudden onset hearing loss in absence of clear aetiology and/or associated with vertigo and tinnitus
- Sudden onset debilitating constant vertigo where the patient is very imbalanced (vestibular neuritis/stroke)
- Sudden onset facial weakness
- Barotrauma with sudden onset vertigo
- Foreign body
- Complicated mastoiditis/cholesteatoma or sinusitis (periorbital cellulitis, frontal sinusitis with persistent frontal headache)
- Ear canal oedema/unable to clear discharge
- Trauma
NOSE
- Acute bacterial rhinosinusitis - visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
- Acute nasal fracture with septal haematoma
- Severe or persistent epistaxis
THROAT
- Airway compromise- stridor/drooling breathing difficulty/acute or sudden voice change/severe odynophagia
- Ludwig’s angina
- Acute tonsillitis with airway obstruction and/or unable to tolerate oral intake and/or uncontrolled fever
- Tonsillar haemorrhage
- Acute hoarseness associated with neck trauma or surgery
- Laryngeal obstruction and/or fracture
- Pharyngeal/laryngeal foreign body
- Accidental dislodgement or obstruction of permanent tracheostomy
- New onset of bleeding or shrinkage of laryngectomy stoma
- Abscess or haematoma, (e.g. peritonsillar abscess/quinsy, salivary abscess, septal or auricular haematoma, paranasal sinus pyocele) with or without associated cellulitis
Paediatric
EAR
- Foreign body
- Trauma
- ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
- Acute and/or complicated mastoiditis
- Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
- Auricular haematoma
NOSE
- Foreign body (button batteries)
- Trauma
- Periorbital cellulitis with or without swelling with or without sinusitis
- Severe or persistent epistaxis
- Septal haematoma
THROAT
- Foreign body (button batteries – inhaled or ingested)
- Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/ severe odynophagia
- Trauma
- Abscess or haematoma (e.g. peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
- Post-tonsillectomy haemorrhage
- Hoarseness associated with neck trauma or surgery
+ Other management information
- An ear wick should be inserted when the ear canal is very oedematous (to maintain patency of the ear canal and allow topical drops to enter the ear canal) and moistened frequently with topical drops
- If child wears a hearing aid, consider impact of the condition on the ability to wear the device
- Avoid syringing
- If ear discharge is present, swab for M/C/S
- Topical antibiotics if associated infection
- sofradex for bacterial infection
- locacorten vioform drops for fungal infection
+ Minimum referral criteria - Does your patient meet the minimum referral criteria?
Does your patient meet the minimum referral criteria?
|
Category 1 If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral |
|
| Category 2 (appointment within 90 calendar days) |
|
| Category 3 (appointment within 365 calendar days) |
|
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 To be included in all referrals
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
- A comprehensive capture of information in relation to MSH Referral Criteria
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 informationWithout this information the referral will be rejected
|
+ Additional referral information for referrals
- Ear swab M/C/S results
Out of Catchment
West Moreton Health is responsible for providing public health service to people who reside within its boundaries. Due to high demand it is not possible to accept referrals from outside this catchment area. If your patient lives outside the West Moreton Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
Last updated: Sunday, August 12, 2018
