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Ulcers

Emergency referrals

Advise patient to present to the RBWH Department of Emergency Medicine.

For emergency referrals the on-call Oral and Maxillofacial Registrar must be contacted through RBWH 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

  • Malignant ulcers
  • Traumatic ulcers
  • Autoimmune ulcers
  • Infectious/ viral ulcers
  • Dermatological conditions (Lichen planus)

Priority

Category 1

Examples

  • Malignant ulcers

Evaluation

Consider:

  • Biopsy if confident

Referral to include:

  • History including: Alcohol abuse, smoking, sharp teeth, dentures and non- healing tooth extraction socket

Priority

Category 2

Examples

  • Traumatic Ulcers

Evaluation

Refer to the dentist in the first instance for assessment for local causes and treatment

Consider:

  • Topical anaesthetic paste
  • 0.2% Chlorhexidine mouthwash
  • Leave out dentures (if applicable)
  • If not healed after 10 days – biopsy

Refer if no improvement to conservative measures after 2 weeks.

Referral to include:

  • Details of conservative measures trialled
  • Biopsy result

Priority

Examples

  • Autoimmune Ulcers

Evaluation

Consider:

  • Corticosteroid or paste
  • May take two weeks to heal

Refer if no improvement to conservative measures after two weeks.

Referral to include:

  • Details of conservative measures trialled

Priority

Examples

Dermatological conditions

  • Lichen planus

Evaluation

Consider:

  • Treat painful ulcerations with Kenalog in Orobase
  • Persistent ulceration is suspicious as malignant

Referral to include:

  • Details of conservative measures trialled
  • History including: Alcohol abuse, smoking, sharp teeth or dentures

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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