Rehabilitation Medicine

  • 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.

    Adult

    Rehabilitation medicine (Adult)

    • Acute change in functional ability: sudden loss of independence or significant decline in the ability to perform basic activities which may represent a significant medical or surgical event or complications from pre-existing condition e.g. sudden change in neurological functions including but not limited to bowel or bladder dysfunction
    • Patient cannot perform basic daily tasks (e.g., feeding, mobility) safely with existing levels of support or sudden change in support level resulting in an unsafe living situation.
    • Patients with severe/acute exacerbations of chronic pain, or those experiencing a pain crisis that cannot be managed with their current pain management plan.

    Hypertonicity/Spasticity

    • Unstageable pressure injury in association with worsening hypertonicity/spasticity or other systemic symptoms
    • Acute neurological decline with new or increased hypertonicity/spasticity
    • Suspected adverse event associated with intrathecal baclofen use*
    • Suspected acute condition potentially contributing to increased/worsening hypertonicity e.g., fall and fracture, infection/sepsis
    • Intra-Thecal Baclofen (ITB) pump malfunctions

    *Prior to presentation, call the service that is managing your pump within standard business hours

    Mild Traumatic Brain Injury (TBI) (including Concussion)

    • Patients with severe symptoms indicating potential life-threatening complications or immediate neurological risks, such as:
      • Rapidly deteriorating consciousness or sudden confusion
      • Increasingly restless, agitated, or combative behaviours
      • Acute neurological change (e.g., weakness, hypertonicity, sensory changes)
      • ­Seizures or uncontrollable vomiting
      • ­Signs of raised intracranial pressure (e.g., severe headache, vision changes, unequal pupils)
    • Severe neck pain with suspected spinal cord involvement

    Acquired Brain Injury (Moderate - Severe) Rehabilitation

    • Patients with severe symptoms indicating potential life-threatening complications or immediate neurological risks, such as:
      • Rapidly deteriorating consciousness or sudden confusion
      • Increasingly restless, agitated, or combative behaviours
      • Acute neurological change (e.g., weakness, hypertonicity, sensory changes)
      • ­Seizures or uncontrollable vomiting
      • ­Signs of raised intracranial pressure (e.g., severe headache, vision changes, unequal pupils)
    • Severe neck pain with suspected spinal cord involvement

    Spinal Cord Injury

    • Autonomic dysreflexia that does not respond immediately to non-pharmacological strategies or two doses of glyceryl trinitrate (Management of Autonomic Dysreflexia and Autonomic dysreflexia | QSCIS)
    • Sepsis due to any cause e.g., urosepsis, pneumonia, pressure injury
    • Intra-Thecal Baclofen (ITB) pump malfunctions
    • Deteriorating respiratory function, especially in a person with tetraplegia and those requiring ventilation.
    • Sudden significant loss of existing neurological function

    Paediatric

    Rehabilitation Medicine

    • Patients with severe symptoms indicating potential life-threatening complications or immediate neurological risks, such as:
      • ­Rapidly deteriorating consciousness or sudden confusion
      • ­Increasingly restless, agitated, or combative behaviours
      • ­Acute neurological change (e.g., before severe weakness, hypertonicity, sensory changes)
      • ­Seizures or uncontrollable vomiting
      • ­Signs of raised intracranial pressure (severe headache, vision changes, unequal pupils)
    • Autonomic dysreflexia not responding to home management plan.
    • Acute change in functional ability
    • Severe acute on chronic pain or pain crises not manageable with existing pain management plan.
    • Significant deterioration in mental health, self-harm or suicidal ideation not able to be managed through community outpatient services
    • New bowel or bladder incontinence: A sudden loss of control, indicating a need for urgent care.

    Paediatric Hypertonicity and movement disorders.

    • Status dystonicus
    • New or increased hypertonicity associated with acute neurological decline
    • Suspected adverse event associated with intrathecal baclofen or deep brain stimulation use.

    Paediatric Mild Traumatic Brain Injury (TBI) (including Concussion)

    • Severe neck pain with suspected spinal involvement
    • Patients with severe symptoms with recent concussion indicating potential life-threatening complications or immediate neurological risks, such as:
      • ­Rapidly deteriorating consciousness or sudden confusion
      • ­Increasingly restless, agitated, or combative behaviours
      • ­Acute neurological change (e.g. weakness, hypertonicity, sensory changes)
      • ­Seizures or uncontrollable vomiting
      • ­Signs of raised intracranial pressure (severe headache, vision changes, unequal pupils)

  • Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.

  • The following are not routinely provided in a public Rehabilitation Medicine service.

    • Complex chronic pain management without rehabilitation goals
    • Drug and alcohol rehabilitation
    • Mental health services
    • Diagnosis of dementia where geriatric services are available
    • Review/assessment of chronic conditions without functional change/decline for conditions/diagnoses eligible for a General Practice Chronic Condition Management Plan where a GP Management Plan or Team Care Arrangements are available
    • Instrumental swallowing assessment (e.g. VFSS, FEES) - may be provided as part of a rehabilitation program at some facilities. Please verify beforehand
    • Formal driving assessments. Whilst an OT could support a decision regarding fitness or safety to drive, most don’t offer formal OT driving assessments. This may be offered as part of a rehabilitation program at certain facilities. Please verify beforehand.
    • NDIS applications / updates without rehabilitation goals.
    • Patients who may not see benefits from service include those covered by an insurance claim, such as Workcover, or those currently receiving treatment in the private healthcare system.
    • Patients presenting with active, unstable mental health conditions should receive acute management as a priority, to ensure that subsequent rehabilitation management is safe and sustainable.
    • Patients engaging in harmful, non-therapeutic and/or recreational substance misuse should only be considered if they are also undergoing concurrent treatment managed by a specialist in drug and alcohol dependence.

Last updated: 5 May 2026

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