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Upper limb nerve compression

Emergency referrals

All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000
  • Redcliffe Hospital (07) 3883 7777
  • Caboolture Hospital (07) 5433 8888

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.

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

  • Refer directly to emergency if:
    • upper limb radiculopathy in the presence of suspected cervical spine infection
    • upper limb nerve compression in association with trauma or acute event
  • Upper limb radiculopathy in the presence of suspected cervical spine malignancy

Category 2

Appointment within 90 days is desirable

  • Continuous pain and / or muscle weakness in distribution of peripheral upper limb nerve
  • Recurrent symptoms after surgical decompression
  • Rapid progressive deterioration

Category 3

Appointment within 365 days is desirable

  • Intermittent symptoms without weakness or wasting in distribution of peripheral upper limb nerve
  • Carpal tunnel syndrome refer after 6 months of maximal management
  • Ulnar entrapment neuropathy when no response to ≥ 6 months of maximal management

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

Other important information for referring practitioners

Not an exhaustive list

Management

  • Analgesia/NSAIDs as appropriate
  • Consider steroid injection (e.g. carpal tunnel syndrome) if clinically appropriate
  • Night splint (e.g. carpal tunnel syndrome)
  • Occupational therapy / physiotherapy – for splinting, joint ROM exercises to maintain mobility, neural gliding exercises
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • General referral information
  • Management to date

Additional referral information (useful for processing the referral)

  • X-ray results – AP and lateral (of region) if available
  • Nerve conduction studies (where available and does not cause significant delay to patient accessing outpatient service)

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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