Respiratory concerns

​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Abscess or haematoma (e.g., peritonsillar, parapharyngeal, salivary, retropharyngeal)
  • Acute airway obstruction (e.g. sudden voice change, drooling, stridor, odynophagia)
  • Acute respiratory illness failing to respond to treatment
  • Acute, severe asthma
  • Acutely enlarging neck mass with airway symptoms
  • Apnoea or cyanosis, with or without cough
  • Frank haemoptysis
  • Inhaled or ingested button battery
  • Moderate to severe respiratory distress, unable to feed and/or apnoea
  • Post-tonsillectomy haemorrhage
  • Stridor with respiratory distress
  • Suspected anaphylaxis
  • Suspected bacterial epiglottitis (particularly if unimmunised)
  • Suspected inhaled foreign body and/or history of choking with persistent cough, wheeze or recurrent pneumonia (particularly if aged between 6 months and 4 years)

When public outpatient services are not routinely provided

  • Exposure to contacts with confirmed tuberculosis
  • History of asthma without first-line management
  • Recurrent upper respiratory tract viral infections​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.​​
  • Chronic cough or respiratory symptoms present > 4 weeks with any of the following features:
    • Systemic features (e.g. fever, night sweats,
      weight loss, faltering growth, clubbing)
    • Abnormal cardiac examination
  • History of > 2 serious bacterial infections (i.e. meningitis, abscess)
  • Persistent stridor without respiratory distress and feeding difficulties with or without faltering growth Persistent tachypnoea affecting feeding, sleep or quality of life
  • Recent history of severe or life-threatening respiratory illness
  • Recent history of acute asthma requiring intensive care unit (ICU) ​admission
  • Respiratory infection with an opportunistic organism


Note: if urgent assessment is clinically indicated within 1 week, consider contacting the on-call paediatrician​

​Category 2
Recommended to be seen within 90 calendar days.

  • ​Aged < 2 years requiring inhaled corticosteroids
  • Asthma or refractory cough that has failed to respond to first-line preventer therapy or requires frequent oral steroid use
    Note: refer to the Australian Asthma Handbook
  • Follow-up of cystic fibrosis or chronic suppurative lung disease
  • Intermittent stridor without respiratory distress Recurrent episodes of chronic, wet, productive cough or wheeze despite treatment (especially if aged < 2 years)
  • Mild respiratory distress with normal saturations without clear benign cause
  • Recurrent bacterial pneumonia > 2 episodes in 12 months
​Category 3

Recommended to be seen within 365 calendar days.

  • Recurrent uncomplicated lower respiratory tract infections​

Information to include within a referral

Required​

  • Reason for referral
  • Details of the presenting condition, including exercise tolerance, nocturnal symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Frequency of oral steroid use in the previous 12 months
    • History of paediatric intensive care unit (ICU) or hospital admission for respiratory concern
    • History of chronic lung disease
    • History of infections
    • History of extreme prematurity
    • Current asthma plan (if relevant)
    • Personal or family history of asthma, atopy or cystic fibrosis
    • Use of or exposure to smoking or vaping
    • Severity, frequency and triggers for exacerbations
    • Treatments trialled and response to interventions
    • Cardiac, respiratory and ENT examination findings
    • Chest X-ray or relevant imaging (where appropriate)​

​If available

  • ​​Spirometry report (if aged > 8 years)

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing