Allergic conditions

Red flags

Consider urgent referral for patients with the following

  • Anaphylaxis

Information That May Lead to More Urgent Categorisation

  • Most cases where an anaphylactic reaction has occurred previously will be Category 1

Referral for allergic conditions is usually for diagnosis and management. The GP will often be required to take an active part in the management if desensitisation therapy is used.

Main conditions in this category are:

  • Allergic rhinitis/rhinosinusitis
  • Angio-oedema
  • Conjunctivitis
  • Drug Allergy
  • Food allergy
  • Respiratory allergy (generally refer to Thoracic Medicine)
  • Urticaria

Other important information for referring practitioners

Lifestyle changes

  • Allergen avoidance
    • Dust reduction
    • Air filters in air conditioning units and vacuum cleaners
    • Reduced carpets and soft furnishings that may trap dust
  • Advise on Medic Alert (bracelet, pendant)

Medical management

  • Ensure the availability of an epipen if anaphylaxis has occurred
    • Provide information on anaphylaxis action plan (see link below)
  • Careful history taking will often narrow down the possible allergens
  • Advise patients with intermittent rash to take photos which may help in diagnosis
  • Use diet and symptom diary to help identify food allergies
  • RAST testing is expensive and if performed should be targeted specifically at the most likely allergens. Do not perform blanket testing.

Referral requirements

A referral may be rejected without the following information.

  • Reason for referral
  • List of symptoms and timeline
    • Include frequency and severity of symptoms as these are important for accurate triage
  • Suspected or proven allergens
  • List significant medical conditions
  • Medication trialled and reasons for failure
  • Current medications and known allergies

Additional referral information (useful for processing the referral)

  • Eosinophil count
  • Total IgE
  • Specific RAST testing (include results of all such testing even if negative)
    • (do not perform extensive RAST panels for screening as these are expensive and often unhelpful)
  • Skin prick testing if available
  • Skin biopsy results if performed
  • Imaging if previously performed including CXR

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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