Tiredness/Lethargy

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Rapidity of onset
  • Symptoms of sleep disorders
  • Symptoms of depression
  • Associated symptoms (dyspnoea, chest pain, GI bleeding, joint/muscle pain, polyuria or polydypsia or tremor)
  • Impact on daily life and work
  • Co-morbidities and medications
  • * Weight loss or symptoms of malignancy
  • * Anaemia
  • * Falling asleep while driving
  • Examination:
    • Lymphadenopathy
    • Presence of goitre or abnormal thyroid examination
    • Signs of cardiac disease
    • Neurological examination

Tests

  • FBC
  • U&ECr
  • Calcium, Magnesium and Phosphate
  • TFT
  • ESR
  • Fasting glucose
  • Creatinine Kinase if muscle weakness or pain
  • CT chest/abdo/pelvis if lymphadenopathy

Interim/GP management

To refer a patient with this condition, please see the General Medicine clinic page for the full referral process and templates.

The presence of (*) could indicate a serious condition. Consider phoning the General Physician on-call.

Should a blood or iron transfusion be required, please indicate this in the referral and we can arrange this within the Ambulatory Care Centre.  Please advise whether you would like an opinion also OR just the transfusion/infusion.

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

Anaemia requiring transfusion: Try to avoid sending patient to Emergency Department. Please contact the General Medicine Team on-call to facilitate.

Rapid unexplained weight loss

Semi-urgent / category 2

Iron infusion. Please indicate this requirement on your referral

Routine / category 3

Symptoms over months/years -  undulating course

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

None of the general physicians has an interest in chronic fatigue syndrome nor expertise in immunology.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

We will endeavour to see these patients within two weeks.

Please contact the General Medicine Consultant on-call if you have an urgent case to be reviewed. All referrals viewed by Consultant and allocated to Consultant or Unit Registrar. Registrar cases will be discussed with Consultant.

Semi-urgent:

We will endeavour to see these patients within eight weeks

Routine:

Next available appointment