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Faints, syncope and funny turns

PAEDIATRIC

Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Children with funny turns where it appears most likely they are having atypical epileptic seizures
    • Children with unexplained loss of consciousness
    • 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)
    • Children with probable breath-holding spells.
    • Episodes most suggestive of benign events including: vaso-vagal, sleep related, behavioural or self-stimulatory
  • Category 3
    (appointment within 365 calendar days)
    • Children referred for re-assessment of previously investigated events without significant change in description

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

  • Description of event(s) including date of onset, nature of the events, duration and frequency
  • Report presence or absence of concerning features
    • Loss of consciousness
    • Falls
    • Injury
    • Cyanosis or pallor
    • Chest pain or palpitations
  • Confirmation of OOHC (where appropriate)

3. Additional referral information Useful for processing the referral

Highly desirable Information – may change triage category.

  • Note if there are triggers or associations with the events or not. For example, pain, frustration, exercise, feeding, sleep
  • Family history of sudden unexplained death in children or young adults
  • Family history of genetic cardiac arrhythmia (e.g. long QT or HOCM [hypertrophic obstructive cardiomyopathy])
  • Height/weight/head circumference and growth charts with prior measurements if available.
  • Burden of disease information:
    • is the child missing school? How many days missed in the last month?
    • parents missing work
    • parental distress

Desirable information- will assist at consultation

  • 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 Children, Youth Justice and Multicultural Affairs involvement)
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports, urinalysis result
    • ECG
    • EEG and neuroimaging if available. Do not order these tests for the referral if they are not clinically required

4. Request

Last updated: 13 June 2023