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Chronic anaemia

Emergency referrals

All urgent cases must be discussed with the on call Haematology registrar or after hours the on call consultant. Contact through Royal Brisbane and Women's Hospital switch (07) 3646 8111 or The Prince Charles Hospital switch on (07) 3139 4000 to obtain appropriate prioritisation and treatment.

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

Red flags

Consider urgent referral for patients with the following

  • Haemolytic anaemia
  • Any evidence of pancytopenia (Hb <100g/L, Neut <1.0, PLT <50)
  • Abnormal blood film (circulating blasts, leucoerythroblastic or dysplastic changes)
  • New unexplained back pain
  • Hypercalcaemia
  • Weight loss
  • Splenomegaly
  • Lymphadenopathy
  • Fevers/night sweats
  • Presence of a paraprotein or abnormal serum free light chain ratio

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Hb level of < 80gm/l or
  • Hb level of 80-100gm/l with severe symptoms
  • Anaemia of any degree with diagnosis of haemolytic anaemia

Category 2

Appointment within 90 days is desirable

  • Hb level of 80-100gm/l without treatable cause

Category 3

Appointment within 365 days is desirable

  • Isolated low Hb >100 without treatable cause (see above caveats)

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

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Presence of any red flags
  • General referral information
  • Serial FBC, reticulocyte count
  • Iron studies
  • B12, folate
  • TFT’s
  • E/LFT including LDH
  • Evidence that a non-haematological cause has been excluded (FOB X 3, coeliac screen, gynae history, MSU micro C&S etc)

Additional useful information (useful for processing the referral)

  • Haemolysis screen (only if there is a high reticulocyte count)
  • serum protein electrophoresis and serum free light chain assay
  • Haemoglobin electrophoresis if MCV <80 and normal iron studies
  • CRP
  • Coagulation profile
  • Transfusion requirements
  • Co-morbid chronic disease
  • Prior B12, oral iron therapy

Out of catchment!

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North 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.

  • 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

  • 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

  • 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

  • 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

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • 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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