Paediatric Medicine

Guidelines for specialist referrals:

Behavioural

• Behavioural

Cardiac  

• Murmurs / Symptoms of Syncope / Arrhythmias
   
• Rheumatic Fever

Child Protection  

• Child Protection: General
   
• Child Abuse (General)
   
• Physical Abuse
   
• Emotional Abuse
   
• Sexual Abuse
   
• Neglect

Dermatological

• Dermatological
     

Developmental Delay

• Developmental Delay: General
   
• Speech / Language Delay
   
• Multi-handicap

Gastroenterology 

• Gastrointestinal tract haemorrhage
   
• Gastrointestinal tract / Failure to thrive - gastrointestinal causes
   
• Gastro-oesphageal reflux
   
• Pyloric Stenosis
   
• Vomiting & Nausea ( >2 weeks duration)
   
• Abdominal Pain - Acute
   
• Recurring Abdominal Pain
   
• Jaundice
   
• Abnormal Liver Function Tests
   
• Cows' Milk Intolerance
   
• Malabsorption
   
• Diarrhoea - Acute
   
• Diarrhoea - Chronic
   
• Constipation
   
• Rectal Bleeding

Genetic Disease

• Newborn Screening Positive
   
• Request for Genetic Counselling

Endocrine  

• Precocious Puberty
   
• Delayed Puberty
   
• Amenorrhoea
   
• Diabetes 

Growth  

• Height / Weight discrepancy
   
• Overgrowth - Tall Stature
   
• Overgrowth - Obesity
   
• Thyroid Disease
   
• Adrenal
   

Immunology

• Recurrent Infections
   
• Allergic Disorders / Allergic Rhinitis
   
• Venom Allergy
   
• Food Allergy (+/- eczema)
   
• Antibiotic Allergy
   
• Chronic Urticaria

Infectious Disease  

• Recurrent / Resistant / Persistent Infections
   
• Hepatitis (exclusive of chronic hepatitis)
   
• Tropical Infections
   
• HIV - confirmed/suspected/perinatal
   
• Vaccine Problems
   
• Meningitis
   
• Tuberculosis
   
• Rheumatic Fever

Metabolic Disease  

• Newborn Screening Positive
   
• Metabolic Disease - General

Neonatal  

• Jaundice
   
• Prolonged Jaundice ( > 2 weeks)
   
• Feeding Difficulty
   
• Maternal Hepatitis B / Antigen Positive
   
• Any other concern about infant less than 6 weeks of age

Neurological  

• Meningitis / Acute Encephalopathy / Encephalitis
   
• Headache - Acute
   
• Headache - Chronic
   
• Migraine
   
• Stroke / Cerebrovascular Accident
   
• Convulsions / Fits
   
• Acute Paralysis
   
• Muscle weakness or flaccidity / delayed motor functions
   
• Progressive Loss of Neurological Function
   
• Vertigo, unaccompanied by other neurological symptoms
   
• Visual Disturbance
   
• Suspected or Definite Papilloedema without other neurological symptoms/signs
   
• Back and neck pain
   
• Spinal Syndromes
   
• Large Head / Hydrocephalus
   
• Tremor
   
• Cerebral Palsy & Movement Disorders including persistent toe walking

Oncological /Haematological  

• Leukaemia (abnormal white blood cells)
   
• Low Platelet Count < 100,000
   
• Large Head / Hydrocephalus
   
• Anaemia
   
• Abnormal Mass

Respiratory

• Respiratory - General
   
• Chronic / Recurrent Cough / Recurrent RTI's
   
• Whooping Cough Syndrome
   
• Cough Variant Asthma
   
• Psychogenic Cough
   
• Asthma
   
• Chronic Lung Disease
   
• Cystic Fibrosis
   
• Pneumonia / Bronchiolitis
   
• Acute Laryngo Tracheobronchitis (viral croup)
   
• Epiglottitis
   
• Sleep Disordered Breathing

Rheumatology

• Single Joint
   
• Irritable Hip
   
• Chronic (longer than 6 weeks)
   
• Multiple Joints
   
• Multisystem Disease
   
• Recurrent Limb Pains

Socio-Economic Issues

• Socio-Economic Issues - General

Urology / Renal

• Urinary Tract Infection
   
• Antenatally Diagnosed Hydronephrosis
   
• Enuresis
   
• Haematuria
   
• Proteinuria