Asthma/Respiratory (Paediatric)

Availability

North South North West Statewide

Pre-referral work-up

History

This clinic is for difficult to control asthma or complex or recurrent respiratory conditions in children to 18 years of age.

Pre-referral work-up

All referrals should comply with Referral Standards and must include:

  • Current assessment of asthma control: good, partial, poor
  • Current medications
  • Frequency of oral steroid use in the previous 3 months
  • Note if the child has been hospitalized or not, and how often
  • Report presence or absence of concerning features
    • Paediatric ICU admission
    • History of chronic lung disease
    • Extreme prematurity

Tests

  • Peak functional severity assessment
  • Copies of any CXRs

Interim/GP management

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

Highly desirable information – may change triage category

  • Note symptom frequency over the last 3 months:
    • every day
    • episodes of wheeze every week but not every day
    • episodes every month but not every week
    • episodes less than once per month
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Presence or absence of sleep, feeding or exercise related symptoms.
  • Copy of asthma management plan, if applicable

Desirable information- will assist at consultation

  • Assessment of adherence to medication
  • History of allergic/atopic disease (and family history of same)
  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports, urinalysis result
  • Spirometry Reports, if available in children able to perform test (children over 8)

For more information please see the Tasmanian Health Pathways website.

Emergency

Severe uncontrolled asthma

Urgent / category 1

Recurrent attacks requiring hospitalisation or steroids

Semi-urgent / category 2

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

Asthma Australia

Asthma Foundation of Tasmania

Australian Asthma Handbook

National Asthma Council Australia

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

We will endeavour to see these patients within 1 month.

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

For any urgent sexual abuse/assault concerns please phone RHH switchboard and ask Paediatric Sexual Assault Consultant or Registrar on call for advice.

Semi-urgent:

We will endeavour to see these patients within 3 months

Routine:

Next available appointment