Direct to an emergency department for:
- Acute liver failure
- Sepsis in a patient with cirrhosis
- Severe hepatic encephalopathy
- Severe ascites restricting movement and breathing.
Criteria for referral to public hospital specialist clinic services
- Suspected cirrhosis suggested by one or more of the following:
- evidence of cirrhosis on imaging
- platelet count < 120 x 109 per litre
- hepatic encephalopathy
- AST to platelet ratio index (APRI) > 2.0.
Information to be included in the referral
Information that must be provided
- History of alcohol intake
- History of injectable drug use
- Current and historical liver function tests
- Full blood examination
- International normalised ration (INR) result
- Urea and electrolytes
- Upper abdominal ultrasound results
- Hepatitis B virus and Hepatitis C virus serology results
- History of diabetes
- Iron studies
- Current and complete medication history (including non-prescription medicines, herbs and supplements).
Provide if available
- Height, weight and body mass index.
The Summary and referral information lists the information that should be included in a referral request.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for