Paediatric obesity (General Paediatrics)
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.
- No emergency indicators identified; routine prioritisation applies
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- Refer to local HealthPathways or local guidelines
- Use BMI charts to monitor growth. Interpretation of BMI values in children and adolescents aged 2–18 years is based on sex-specific BMI percentile charts. Ensure that the same chart is used over time to allow for consistent monitoring of growth (see RCH Growth Charts)
- Growth of children less than 2 years of age is monitored using World Health Organization (WHO) growth charts. (Australian practice)
- While waist circumference may not have a place in screening for overweight and obesity in children and adolescents, a waist circumference that is greater than half the height suggests a need for more thorough weight assessment.
- Consider involvement of other professionals (e.g. Aboriginal health worker, multicultural health worker, interpreter) to facilitate communication
- In the majority of cases, it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
- Next of kin or person(s) who is legally responsible for patient consent, with the exception of children under guardianship orders with the Department of Child Safety, Seniors and Disability Services, should be present at the first outpatient appointment.
- 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
- Statement of intent – the prioritisation of health services for children and young people in the child protection system
| 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) |
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| Category 3 (appointment within 365 calendar days) |
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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
- Current height and weight, and include date of measurement
- Fasting glucose insulin, U&E, LFT, FBC, iron studies, CRP, TFT results
- Report presence or absence of concerning features
- Significant obstruction in sleep with repeated arousals and distress
- Type 2 diabetes (random glucose > 11 or fasting >7.0) use diabetes CPC referral guide
- Recent rapid change in weight (gain or loss)
- Hypertension >95 centile for age with appropriate size cuff
- Fatty liver
- Confirmation of OOHC (where appropriate)
3. Additional referral information Useful for processing the referral
Highly desirable information – may change triage category
- History of obesity-related burden of disease – sleep disturbance, exercise limitation, orthopaedic pain, psychological disturbance
- Height/weight/head circumference and growth charts with prior measurements if available
- Diet history including if:
- the child has a very restricted diet, or specific dietary restrictions (refer to a dietitian)
- extreme weight loss behaviours, signs of eating disorders, high level of negative body image and/or negative social experiences are evident (refer to psychological services)
Desirable Information- will assist at consultation
- Assessment of parental obesity and other family history
- Other past medical history
- Pregnancy and birth history
- Immunisation history
- Developmental history
- Medication history
- Allergies
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Child Safety, Seniors and Disability Services involvement)
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any other 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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