• Non-acute skull fracture/ non- acute traumatic brain injury
  • Acute trauma
  • Change in consciousness level or deteriorating neurological functions i.e., increasing headache or local pain at site of trauma, development of nausea, vomiting and or decrease in conscious level, seizure, development of focal neurological signs
  • Head trauma with seizures
    
• Brain tumours (intracerebral, meningioma, skull base, pituitary)
  • Symptoms of signs of raised intracranial pressure
  • Severe and increasing headache
  • Deteriorating neurological function i.e. increasing headache and/or nausea vomiting, decrease in conscious level, seizure, development of focal neurological signs
  • Seizures
  • Suspected glucocorticoid deficiency
    
• Neurovascular disorders (aneurysm, arteriovenous malformation, AVMs, other)
  • Symptoms of signs of raised intracranial pressure
  • Severe and increasing headache
  • Deteriorating neurological function i.e. increasing headache and/or nausea and vomiting, seizure, decreasing conscious level, the development of focal neurological signs
  • Seizures
  • Clinical suspicion or subarachnoid haemorrhage or intracerebral haemorrhage
    
• Hydrocephalus and ventriculoperitoneal VP shunt
  • Symptoms or signs of raised intracranial pressure
  • Increasing severity of headache
  • Deteriorating neurological function i.e. increasing headache and/or nausea and vomiting, seizure, decreasing level of consciousness, development of focal neurological signs, tenderness, redness and/or swelling along shunt tract
  • Seizures
  • Swelling pain or redness along shunt tract
  • Abdominal pain or swelling
  • Clinical suspicion of shunt infection
    
• Trigeminal neuralgia and other cranial nerve abnormalities
  • Severe intractable pain preventing adequate fluid intake
    
• Spine
  • Actual or threatened cauda equina syndrome
    • bilateral nerve pain (leg pain below knees)
    • unexplained or unexpected loss of bladder or bowel function
    • perineal anaesthesia
    • progressive weakness
  • Spinal tumour with significant pain and/or neurological deficit
  • Clinical signs spinal nerve root compression or spinal cord compression with rapidly progressive neurological signs/symptoms
  • Spinal trauma with significant pain and/or neurological deficit
  • Spinal fractures demonstrated on imaging
  • Clinical suspicion of spinal infections
  • High risk of irreversible deficit if not assessed urgently
• Peripheral nerve compression with acute neurological deficit including carpal tunnel syndrome, ulnar nerve entrapment neuropathy, common peroneal and lateral cutaneous nerve of thigh compression syndromes
  • Acute development of peripheral nerve compression symptoms following trauma
• Sciatica, brachialgia, cervical and lumbar canal stenosis, disc herniation
• Intradural spinal tumours
• Back and/or Neck Pain
  • Cauda equina syndrome
  • High energy spinal trauma
  • Suspected epidural abscess or discitis
• Other Neurological Conditions
  • Symptoms of signs of raised intracranial pressure
  • Severe and increasing headache
  • Deteriorating neurological function
  • Seizures
• Incidental finding on brain and spine imaging, e.g. intracranial arachnoid cyst, cavernous haemangioma of the vertebral body.

Other referrals to emergency not covered within conditions:

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.)