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Ear, Nose and Throat (ENT)

Emergency Immediate transfer to the Emergency Department

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergent medical advice if in a remote region.

Adult

Ear

  • ENT conditions with associated neurological signs
  • Sudden onset hearing loss in absence of clear aetiology and/or associated with vertigo and tinnitus
  • Sudden onset debilitating constant vertigo where the patient is very imbalanced (vestibular neuritis/stroke)
  • Sudden onset facial weakness
  • Barotrauma with sudden onset vertigo 
  • Foreign body
  • Complicated mastoiditis/cholesteatoma or sinusitis (periorbital cellulitis, frontal sinusitis with persistent frontal headache)
  • Ear canal oedema/unable to clear discharge
  • Trauma

Nose

  • Acute bacterial rhinosinusitis - visual disturbance/signs, neurological signs/frontal swelling/severe unilateral or bilateral headache
  • Unilateral facial swelling with or without dental sepsis
  • Acute nasal fracture with septal haematoma
  • Severe or persistent epistaxis

Throat

  • Airway compromise- stridor/drooling breathing difficulty/acute or sudden voice change/severe odynophagia
  • Ludwig’s angina
  • Acute tonsillitis with airway obstruction and/or unable to tolerate oral intake and/or uncontrolled fever
  • Tonsillar haemorrhage
  • Abscess or haemorrhage, (e.g. peritonsillar abscess/quinsy, salivary abscess, septal or aurricular haematoma, paranasal sinus pyocele) with or without associated cellulitis
  • Acute hoarseness associated with neck trauma or surgery
  • Laryngeal obstruction and/or fracture
  • Pharyngeal/laryngeal foreign body
  • Accidental dislodgement or obstruction of permanent tracheostomy
  • New onset of bleeding or shrinkage of laryngectomy stoma
  • Profiund dysphagia i.e. inability to manage secretions
  • Supraglittis

Paediatric

Ear

  • Foreign body
  • Trauma
  • New onset facial nerve palsy
  • ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
  • Acute and/or complicated mastoiditis
  • Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
  • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc. 
  • Auricular haematoma

Nose

  • Foreign body (button batteries) inhaled or ingested - if suspicion of button battery immediate emergency review
  • Trauma with other associated injuries i.e. other facial fractures e.g. orbit
  • Periorbital cellulitis with or without swelling with or without sinusitis
  • Severe or persistent epistaxis
  • Septal haematoma

Throat

  • Foreign body (button batteries) inhaled or ingested - if suspicion of button battery immediate emergency review
  • Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/ severe odynophagia
  • If new onset hoarse voice and airway obstructive symptoms
  • Trauma
  • Abscess or haematoma (e.g. peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
  • Post-tonsillectomy haemorrhage
  • Hoarseness associated with neck trauma or surgery
  • Acutely enlarging neck mass with any associated airway symptoms (e.g. stridor, drooling, dysphagia etc.)

Are you referring to the right service?

  • General Practitioners are able to directly refer patients to a Queensland Health (QH) Audiologist.
  • QH Audiologists are able to offer diagnostic hearing assessments which can result in a recommendation of hearing aids or an ENT opinion; however they do not fit hearing aids.
  • Queensland public hospitals do not dispense conventional or standard hearing aids.
  • Patients with mild, moderate or severe hearing loss, which is symmetrical, should be referred to a local hearing aid provider.
  • Hearing aids are provided for children, veterans and pensioners through the Office of Hearing Services, a division of the Federal Department of Health, and are dispensed by local audiologists.

Urgent referrals Arranging urgent review

To arrange a very urgent outpatient appointment, please phone the relevant hospital’s switchboard and ask to speak to the Registrar of the relevant specialty.

Out of scope services

The following are not routinely provided in a public ENT service:

  • Chronic bilateral tinnitus
    • referral is not indicated unless tinnitus is disabling or associated with changes in hearing loss, aural fullness and/or discharge or vertigo
  • Mild/brief orthostatic dizziness
  • Hearing aid dispensation (Hearing service program)
  • Uncomplicated/chronic symmetrical hearing loss in over 70 years old
  • Mild acute rhinosinusitis
  • Simple ear drum perforation as part of acute otitis media
  • Aesthetic surgery

NB: General Practitioners are able to directly refer patients to a Queensland Health (QH) Audiologist. QH Audiologists are able to offer diagnostic hearing assessments which can result in a recommendation of hearing aids or an ENT opinion; however they do not fit hearing aids. Queensland public hospitals do not dispense conventional or standard hearing aids. Patients with mild, moderate or severe hearing loss, which is symmetrical, should be referred to a local hearing aid provider. Hearing aids are provided for children, veterans and pensioners through the Office of Hearing Services, a division of the Federal Department of Health, and are dispensed by local audiologists.

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.  Due to high demand it is not possible to accept referrals from outside this catchment area.  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 8 February 2019