Criteria for referral to public hospital service
Unexplained chronic pathological breathlessness where any of the following explanations have already been excluded:
- anaemia
- anxiety or hyperventilation
- cardiac conditions (e.g. congestive cardiac failure, ischaemic heart disease, cardiac arrhythmias, myocardial infarct)
- occupational exposure
- respiratory conditions (e.g. chronic obstructive pulmonary disease (COPD), interstitial lung disease, lung malignancy, upper airway obstruction)
- smoking (cigarettes and all forms of tobacco, nicotine, vaping and cannabis) or inhalant use
- thyroid disease.
Information to be included in the referral
Information that must be provided
- Symptoms including duration, severity and any diurnal variation
- How symptoms are impacting on activities of daily living including impact on work, study or carer role
- Findings on physical examination, including oxygen saturation
- Weight
- Details of previous management including the course of treatment(s) and outcome of treatment(s)
- Any known or suspected allergies or triggers
- Smoking history (cigarettes and all forms of tobacco, nicotine, vaping and cannabis)
- History of occupational or environmental exposure risks, or radiotherapy treatment (if relevant)
- Chest x-ray (including date and details of the diagnostic imaging practice)
- Recent (in previous 6 months) full blood examination (FBE) results
- Current and complete medication history (including non-prescription medicines, herbs and supplements)
- Past medical history and comorbidities.
Provide if available
- Spirometry
- Height
- Other lung function tests
- Chest CT scan (including date and details of the diagnostic imaging practice)
- Transthoracic echocardiogram report (including date and details of the diagnostic imaging practice)
- Current vaccination status.
Additional comments
The Summary and referral information lists the information that should be included in a referral request.
Referrals for pulmonary rehabilitation should be directed to a pulmonary rehabilitation service.
Referrals for assessment of asthma management, suspected or confirmed chronic obstructive pulmonary disease or suspected or confirmed interstitial lung disease should be directed to a respiratory service provided by the health service.
Referrals for heart failure or palpitations should be directed to a cardiology service provided by the health service.
Referrals for persistent iron deficiency should be directed to a gastroenterology service provided by the health service.
Referrals for hyperthyroidism or hypothyroidism should be directed to an endocrinology service provided by the health service.
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
Referrals that do not meet the criteria.