Irritable infant < 1 year
PAEDIATRIC
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Fluctuating or altered conscious level – weak cry, not waking appropriately for feeds, lethargy, maternal concern of failure of normal interaction
- Suspicion of harm or any unexplained bruising, especially in infant <3 months
- Significant escalation in frequency or volume of vomiting
- New onset of blood mixed in stool
- Fever
- Increased respiratory effort
- Weak or absent femoral pulses in infant <3 months
- Presence of newly noted heart murmur in infant <3 months
- Inguinal hernia
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| Category 1 (appointment within 30 calendar days) |
where they have previously been on a waiting list for this problem and were removed without receiving a service |
| Category 2 (appointment within 90 calendar days) |
|
| Category 3 (appointment within 365 calendar days) |
|
Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- 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
2. Essential referral information Referral will be returned without this
- Age of onset of irritability
- Report presence or absence of concerning features
- Frequent daily vomiting
- Blood in stools
- Irritability has no day/night variation with persistent screaming overnight and in the mornings as well as afternoon/evenings
- Weight loss or failure to gain weight
- Diagnosed or suspected maternal depression
- Inappropriate interaction or attribution to the baby by the mother – anger or resentment towards the infant.
- Developmental delay
- Confirmation of OOHC (where appropriate)
3. Additional referral information Useful for processing the referral
Highly desirable information – may change triage category
- Description of pattern of irritability including relation to feeding. Does the infant sleep at night?
- Is there difficulty feeding? Breast or bottle feeding or both.
- Height/weight/head circumference and growth charts with prior measurements if available. Comment on whether the child is gaining weight appropriately or not.
- Has the mother been to see a child health nurse or had other parenting assistance?
- Pregnancy and birth history, including if premature birth.
- Medical history.
- Developmental history
- Family history (especially infantile irritability, previous children with food intolerance)
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Child Safety, Seniors and Disability Services involvement)
Desirable Information- will assist at consultation
- Other past medical history
- Immunisation history
- Medication history
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology.
- Any relevant laboratory results or medical imaging reports
4. Request
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Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
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
- 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
- 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
- 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.)
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 4 December 2024
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