Direct to an emergency department for:

  • Life threatening asthma, including thunderstorm asthma (after initial emergency management)
  • Severe asthma, including thunderstorm asthma, if symptoms have not resolved after initial emergency management
  • Oxygen saturation < 90%
  • Soft or absent breath sounds, cyanosis, or poor respiratory effort
  • Bradycardia or hypotension
  • Exhaustion, confusion, or coma.

Criteria for referral to public hospital service

  • Previously diagnosed asthma that requires further advice on, or review of, the current management plan or management of treatment related adverse effects (e.g. recent emergency treatment or hospital admission, frequent use of oral corticosteroids, prolonged use of high-dose inhaled corticosteroids, frequent chest infections)
  • Asthma with clinical or spirometry features suggestive of an alternative or additional diagnosis
  • Asthma caused or exacerbated by workplace exposure that is impacting on the person’s ability to work.

Information to be included in the referral

Information that must be provided

  • Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
  • Description of onset, nature, progression, recurrence and duration of symptoms (e.g. breathlessness chest tightness, wheezing, cough). Include details of previous emergency treatment or hospitalisations for asthma and oral prednisolone or high-dose inhaled corticosteroids use
  • Details of previous management including the course of treatment(s), assessment of adherence to current management plan and outcome of treatment(s)
  • Any known or suspected allergies or triggers
  • Approximate age at diagnosis
  • Smoking history (cigarettes and all forms of tobacco, nicotine, vaping and cannabis)
  • At risk occupational history (if relevant)
  • Current and complete medication history (including non-prescription medicines, herbs and supplements)
  • History of any other inhalant use, including if the patient is still using
  • Past medical history and comorbidities.

Provide if available

  • Spirometry
  • Height
  • Other lung function tests
  • Relevant sputum culture results
  • Recent (previous 6 months) full blood examination (FBE) results
  • Chest x-ray (including date and details of the diagnostic imaging practice)
  • Current vaccination status.
  • If the person identifies as an Aboriginal and Torres Strait Islander.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Spirometry can be performed in primary care if reliable equipment and appropriately trained staff are available. Where it is not available, patients can be referred to an appropriate provider such as an accredited respiratory function laboratory.

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

Stable asthma that is controlled with the current management plan.