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.
- concerns of systemic infection including:
- febrile greater than 38°
- haemodynamic instability
- febrile greater than 38°
- ongoing high output stoma with clinical signs of dehydration or acute renal impairment
- peri-stomal bleeding
- peri-stomal cellulitis
- severe/uncontrollable pain unresponsive to first-line management
- stomal change in colour from red/pink to blue or black
- stomal prolapse causing circulatory compromise
- suspected bowel obstruction/non-functioning stoma, potential symptoms include
- inability to pass any bowel motions or gas
- significant change in bowel habits
- distended abdomen, abdominal pain and cramping
- nausea/vomiting
- inability to pass any bowel motions or gas
Please contact the on-call registrar to discuss your concerns prior to referral.
For clinical advice, please telephone the relevant specialty service.
Patients who have concerns related to stomal appliances can seek assistance from stomal therapy nurses if they are already connected to a service. If patients are not currently in contact with stomal therapy services, they can be referred by their general practitioner (GP).
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Northern Adelaide Local Health Network
- Lyell McEwin Hospital (08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Category 1 (appointment clinically indicated within 30 days)
- high volume stoma output unresponsive to first-line management
- peri-stomal complications including bleeding/granuloma/dermatitis/pressure injury/wound
- poor fitting/leaking stoma appliances
- suspected pyoderma gangrenosum
- parastomal hernia
Category 2 (appointment clinically indicated within 90 days)
- additional appliance consideration for people who have exhausted stoma appliance scheme funding
Category 3 (appointment clinically indicated within 365 days)
- annual routine stoma review
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
- relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter required
- past medical/surgical history – including site and service where stoma was created
- medications and allergies
- presenting symptoms
- stoma output, frequency
- stool texture, for example soft, watery, hard
- aperients if needed, including microlax/suppository use/frequency
- fluid volume intake/output (ileostomy/urostomy)
- previous management trialled and outcomes
- abdominal examination
- abdominal Xray if concerns of constipation or faecal loading
- reports of prior colonoscopies and pathology of specimens removed
- relevant diagnostic/imaging reports, including location of company and accession number
Clinical management advice
Patients who have concerns related to stomal appliances can seek assistance from stomal therapy nurses if they are already connected to a service. If patients are not currently in contact with stomal therapy services, they can be referred by their general practitioner (GP).
Clinical resources
- Australian Association of Stomal Therapy Nurses – Resources
- Department of Health and Aged Care - Stoma appliance scheme