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Respiratory

Find assessment and management information on Respiratory conditions at:

Brisbane South HealthPathways

Emergency Immediate transfer to the Emergency Department

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

Asthma

  • Acute exacerbation of asthma not responding to therapy
  • Asthma with any of the following concerning features:
    • coexistent pneumothorax
    • pneumonia
    • silent chest
    • cardiovascular compromise
    • altered consciousness
    • relative bradycardia
    • decreasing rate and depth of breathing

Bronchiectasis / chronic suppurative lung disease (CSLD)

  • Bronchiectasis / CSLD with any of the following concerning features:
    • altered consciousness
    • hypoxia (<90% oxygen saturation) when this is not normal for the patient
    • evidence of significant infective exacerbation (fever and/or high-volume purulent sputum)
    • new haemoptysis (clots or more than streaks)
    • new CXR changes indicative of cavitation, consolidation or pneumonia

Chronic obstructive pulmonary disease (COPD)

  • Acute exacerbation not responding to outpatient therapy
  • Acute respiratory failure

Cystic fibrosis

  • Cystic fibrosis with any of the following concerning features:
    • respiratory distress
    • new haemoptysis (clots or more than streaks)
    • pleural effusion
    • consolidation/pneumonia/fever
    • non- response to antibiotics for chest infection

Haemoptysis without known lung disease

  • Significant haemoptysis defined as repeated expectoration of 5mL (1tsp) of blood or single episode of >20mL (1tbsp)
  • Any haemoptysis with acute dyspnoea, measured hypoxia, altered consciousness, hypotension, tachycardia or chest pain

Interstitial lung disease (ILD)

  • Acute exacerbations of known ILD with any of the following concerning features:
    • severely breathless/Class 4 dyspnoea  (ADLs affected by dyspnoea)
    • demonstrated worsening hypoxaemia
    • new arrhythmia/chest pain
  • Newly diagnosed or suspected ILD with radiographic evidence with Class 4 dyspnoea  (ADLs affected by dyspnoea)

Lung cancer

  • Suspected or known lung cancer with any of the following concerning features:
    • massive haemoptysis
    • suspected large airway obstruction
    • severe dyspnoea
    • SVC obstruction
    • hypercalcaemia/hyponatremia with confusion
    • symptomatic pleural effusion

Pleural disorders

  • Large symptomatic pleural effusion
  • Acute pneumothorax

Pulmonary hypertension

  • Acute decompensation (hypoxia or right heart failure) with pulmonary hypertension

Pulmonary Embolism

Sarcoidosis

  • Hypercalcaemia with acute kidney injury

Shortness of breath / dyspnoea without a known cause

  • Dyspnoea of uncertain origin with any of the following concerning features:
    • acute dyspnoea at rest
    • demonstrated hypoxia (SpO2 < 90%) 
    • accompanied by confusion
       

Tuberculosis / non-tuberculosis mycobacterial infections

  • Suspected tuberculosis with significant haemoptysis (defined as repeated expectoration of 5mL (1tsp) of blood or single episode of >20mL (1tbsp))

Are you referring to the right service?

Metro South Health does not manage Cystic Fibrosis - patients should be referred to the Mater Hospital (South Brisbane).

Urgent referrals Arranging urgent review

For very urgent Respiratory referrals to Logan Hospital for patients with a working diagnosis of locally advanced or metastatic lung cancer who are clinically stable, please call (07) 3299 8899 and ask to speak to the consultant on call about arranging an appointment in the Respiratory Rapid Access Clinic for specialist review within a clinically appropriate timeframe, or direct admission if required.

Conditions

Adults

Out of scope services

  • Chest wall pain 
  • Non-cardiac chest pain 
  • Occupational Lung assessment 
  • Respiratory function testing in absence of a consultation 
  • Direct screening TB – should be referred to contact and immigration screening (TB control centre)
     

Notes

  • 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.

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 16 February 2024