Otitis media – with effusion / Glue Ear (OME/Glue Ear) – Recent Audiology (ENT) (PAED)

PAEDIATRIC

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • No emergency indicators identified; routine prioritisation applies

    • Refer to HealthPathways or local guidelines
    • Antihistamines, decongestants and antibiotics have no beneficial effect in the management of otitis media with effusion (OME)
    • Review at 3 months for persistent middle ear effusion or hearing loss
    • If child wears a hearing aid, consider impact of the condition on the ability to wear the device
    • Consider referral to speech pathology or child health clinician for developmental speech and language screening in children
    • Management of environmental factors
    • Arrange diagnostic audiology assessment (Highly desirable where available and not cause significant delay)
    • Clinical urgency is the dominant consideration in the prioritisation of a referral for a child currently in out of home care (OOHC), or at risk of entering or leaving OOHC.
    • Consider auto-inflation for management of middle ear effusion for children likely to cooperate (RACGP Auto inflation for glue ear in children)

    Clinical resources

    • Otitis media guidelines for Aboriginal and Torres Strait Islander children (2020).
    • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: Department of Families, Seniors, Disability Services and Child Safety
    • Statement of intent – the prioritisation of health services for children and young people in the child protection system

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service
Category 2
(appointment within 90 calendar days)
  • Confirmed or suspected structural damage to the tympanic membrane e.g. significant eardrum retraction, cholesteatoma
  • Effusion with confirmed hearing loss:
    • in the setting of confirmed speech or other developmental delay and/or
    • lasting more than 3 months with audiometry showing significant bilateral conductive hearing loss (45dB or greater better ear)
  • Children with physical/structural/ medical comorbidities e.g. cleft palate, craniofacial abnormalities, diabetes, SNHL
  • Aboriginal and/or Torres Strait Islander
Category 3
(appointment within 365 calendar days)
  • Effusion (Glue Ear), lasting more than 3 months confirmed by audiology with hearing thresholds less than 45dB
  • Unsteady gait/balance problems

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Recent audiology reports and/or audiograms
  • Details of speech and/or developmental delays
  • Any other relevant ENT concerns
  • Confirmation of OOHC (where appropriate)
  • Indigenous Status

3. Additional referral information Useful for processing the referral

  • Aboriginal And Torres Strait Islander Peoples Health Assessment (MBS Item 715) ear and hearing assessment

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 16 January 2025

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