Chronic obstructive pulmonary disease
Red flags
Consider immediate referral for patients with the following:
Acute exacerbations of COPD showing the following features:
- Severely breathless (>24 breaths/min at rest)
- Unable to walk between rooms (when previously mobile)
- Unable to eat or sleep secondary to dyspnoea
- Altered mental state
- Worsening hypoxaemia or cor pulmonale
- Oxygen saturation <90% (if not known to retain CO2)
- Clinical signs of pneumonia
- New signs of heart failure
- New arrhythmia/chest pain
Referral requirements
A referral may be rejected without the following information.
- Reason for referral
- History of COPD
- Duration
- Severity
- Frequency of exacerbations
- Management to date
- Include last two specialist letters if seen previously at another centre
- Other relevant medical conditions
- Medications
- Include previously tried medications if associated with treatment failure or problems
- Include full medication list and allergies
- Investigations
- FBC (eosinophil count, anaemia, high WCC)
- Spirometry
- CXR
- Allergy testing (not essential but include if done)
Additional referral information (useful for processing the referral)
- Allergy testing
Consider referral if:
- COPD is poorly controlled despite optimal therapy.
- Considering long term oral steroids
- Doubt about diagnosis unable to be resolved despite investigation in primary care
- Considering the requirement for home oxygen therapy
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
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
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
Login to Brisbane North Health Pathways:
brisbanenorth.
Locations
Resources
Useful links
- Lung Foundation Australia COPD guidelines
- Lung Foundation Australia patient information and resources
- Australian pulmonary health rehab toolkit
- Smoking Quitline
- NICE guidelines on COPD
- NICE guiding pathways for diagnosis, management and other aspects of treatment and end of life issues
- Australian advance care directive
- Patient information leaflet on advance care planning
- Lung foundation - resources and fact sheets about home oxygen