Referral to emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- nil
For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.
If clinical advice is required urgently or out of hours, please contact Flinders Medical Centre or the Women’s and Children’s Hospital.
Northern Adelaide Local Health Network
- Lyell McEwin Hospital (08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Category 1 (appointment clinically indicated within 30 days)
- severe obstructive sleep apnoea (OSA) confirmed with sleep study or overnight oximetry
Category 2 (appointment clinically indicated within 90 days)
- excessive day-time sleepiness
- mild to moderate OSA confirmed with sleep study or overnight oximetry
- mouth breathing
- snoring with obvious obstructive features (apnoea/choking) and:
- associated with failure to thrive
- witnessed sleep apnoea
Category 3 (appointment clinically indicated within 365 days)
- hypertrophic tonsils
- chronic intermittent snoring without disordered breathing
For more on outpatient referrals, see the general referral information page.
Essential referral information
Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
- identifies as Aboriginal and/or Torres Strait Islander
- identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
- interpreter required
- age
- past medical/surgical history
- current medications
- allergies and sensitivities
- onset, duration, and progression of symptoms
- observations and description of sleep patterns including:
- apnoeic episodes
- disturbed sleep/night terrors
- enuresis/bruxism
- restlessness
- snoring
- snorting arousals
- symptoms when awake including:
- behavioural concerns including irritability/hyperactivity
- poor school performance
- excessive tiredness/sleepiness
- gagging on solid food (hypertrophic tonsils)
- progressive weight loss or poor weight gain
- epworth sleepiness scale
- naso-oropharyngeal examination including:
- hypertrophic tonsils (grading scale)
- nasal obstruction
- craniofacial features
- relevant diagnostic/imaging reports including location of company and accession number
Additional information to assist triage categorisation
- sleep study
Clinical management advice
Consider joint referral for sleep physician to confirm obstructive sleep apnoea diagnosis whilst waiting for ear, nose and throat review.
Triaging for referrals is based on clinical symptoms and is not affected by the size of tonsils.
Please utilise the relevant Aboriginal Liaison Units (ALU) to provide support to Aboriginal families.
Clinical resources
- Australasian Sleep Association - Health professionals information
- Australian Family Physician - Tonsillotomy: An alternative surgical option to total tonsillectomy in children with obstructive sleep apnoea
- Epworth Sleepiness Scale - Assessment Tool
- Therapeutic Guidelines – Sleep-disordered breathing in children
- Women's and Children's Hospital Aboriginal Liaison Unit / Taikurrinthi
- Flinders Medical Centre Aboriginal Hospital Liaison Unit / Karpa Ngarrattendi
- Alternative ear health services and resources for Aboriginal children in South Australia
Consumer resources
- Sleep Health Foundation - Fact sheets
- Lung Foundation Australia – Obstructive sleep apnoea patient information
- Alternative ear health services and resources for Aboriginal children in South Australia