Soft tissue conditions of the face and oral cavity

Emergency referrals

Advise patient to present to the Royal Brisbane and Women's Hospital Department of Emergency Medicine.

For emergency referrals the on-call Oral and Maxillofacial Registrar must be contacted through Royal Brisbane and Women's Hospital switch (07) 3646 8111 to obtain appropriate prioritisation and treatment advice. Urgent  cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Oral and Maxillofacial Clinic Fax:  (07) 3646 3545

  • Lumps and suspected neoplasms
  • Salivary gland lumps
  • Salivary gland infection (Sialoadenitis/ Sialolithiasis)

Triage and management guideline

Priority

Category 1

Examples

  • Lump and suspected neoplasms

Evaluation

Refer all suspected malignancies

Referral to include:

  • CT scan head and neck
  • FNA of lymph nodes
  • Biopsy result (if available)

Priority

Category 2

Examples

  • Salivary gland lumps

Salivary gland infection

  • Sialoadenitis/ Sialolithiasis

Evaluation

Referral to include:

  • CT scan head and neck
  • FNA of lump
  • Facial nerve evaluation

Consider:

  • Culture of purulent discharge (mouth)
  • Hydration
  • Anti staphylococcal antibiotics: Augmentin
  • Occlusal view of floor of mouth for calculi

Refer immediately in the presence of:

  • Limited eye opening
  • Facial swelling
  • Increasing pain
  • Tinnitus
  • Dysphagia

Referral indicated if:

  • Calculi suspected on exam – depending on circumstances
  • Poor antibiotic response within one week of diagnosis – depending on severity
  • Abscess formation
  • Hard mass present – consider neoplasm

Referral to include:

  • Occlusal view x-ray of floor of mouth for calculi
  • USS or sialogram (sialogram in the absence of infection or when cleared up with antibiotics)

Referral requirements

A referral may be rejected without the following information.

  • 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.)

Send referral

Hotline: 1300 364 938

Fax: 1300 364 952

Electronic: eReferral system

Mail: Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road
ASPLEY QLD 4034

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:
healthpathways@brisbanenorthphn.org.au

Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org

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