Seizures
Emergency referrals
If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergent medical advice if in a remote region.
It is proposed that the following conditions should be sent directly to emergency. This is not a list of all conditions that should be sent to the emergency department, it is intended as guidance for presentations that may otherwise have been directed to general paediatric outpatients:
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
- All children with recent onset of clinically obvious seizures
Children who have been seen by a paediatric consultant in emergency with a first seizure may not require a category 1.Most children seen in emergency following a first seizure will be discharged when stable and specialist follow up should be arranged by their GP if required.
- Unstable epilepsy requiring re-evaluation and management
Category 2
Appointment within 90 days is desirable
- Known epilepsy with stable management who are transferring care and do not have a specialist available for advice or management
- Children with episodes that may be suggestive but are not conclusively epilepsy
Category 3
Appointment within 365 days is desirable
- Known epilepsy with stable management who are transferring care and have appropriate interim care arrangements in place
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
- An EEG should be performed only to support a diagnosis of epilepsy in children and young people. If an EEG is considered necessary, it should be performed after the second epileptic seizure but may, in certain circumstances, as evaluated by the specialist, be considered after a first epileptic seizure. An EEG should not be performed in the case of probable syncope because of the possibility of a false-positive result. The EEG should not be used to exclude a diagnosis of epilepsy in a child, young person or adult in whom the clinical presentation supports a diagnosis of a non-epileptic event.
- Encourage parents to keep diaries of events and video an event if possible
- Epilepsy Queensland: http://www.epilepsyqueensland.com.au/
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: https://www.communities.qld.gov.au/
- In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Referral requirements
A referral may be rejected without the following information.
- General referral information
- Detailed seizure description, duration, frequency, date of onset
- Associated problems such as cyanosis or injuries during events
- Details of current medications used to control epilepsy, if any
- Report presence or absence of red flags
Presence of red flags- Headaches
- Focal seizures
- Personality change
- Polyuria or polydipsia
- Recent change in sleep behaviour
- Recent onset of clumsiness or poor coordination,
- Unexplained vomiting
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category
- Additional history of events including post event drowsiness, incontinence or injuries during events
- Past treatments/medications offered and efficacy Including previous acute anticonvulsant management
- Other neurological or development conditions present
- Either:
- current developmental status (age appropriate, some delay, significant delay) OR
- brief comment on current school educational attainments (good, average, poor, very poor [>2 years behind])
- Any previous EEG results (note advice on ordering EEGs in other useful information section. Generally it is not required to order an EEG for referral. If previous results are available please include with referral)
Desirable information — will assist at consultation
- Other past medical history
- Immunisation history
- Developmental history
- Medication history
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
- Height/weight/head circumference and growth charts with prior measurements if available.
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports, urinalysis result
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.)
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
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For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.