Paediatric Referrals CUH (for Gps)



Background

These guidelines are for GPs referring children for further assessment or admission to the Children’s Unit of CUH

  • Children with surgical, orthopaedic or neurosurgical problems must be discussed with the appropriate surgical team .
  • The following guidelines apply on a 24-hour basis including out of hours GP services (for example Southdoc).
  • All referrals to the unit must be discussed and accepted by a medical staff member, either Registrar or Consultant. A senior doctor will assess the child on arrival in the unit when a decision regarding admission will be made. Following this assessment a decision may be made that admission is not necessary. In that event the referring doctor will be informed.
  • The Neonatology Service at Cork University Maternity Hospital provides a Consultant-led outpatient clinic service for infants referred for a Neonatologist outpatient assessment via their General Practitioner, AMO or Consultant Paediatricians in Cork and HSE South region. Neonates who require urgent review or admission for acute illness should continue to be referred to the Paediatrics Service in Cork University Hospital, according to the pathways described below.
  • A referral letter should accompany the child.
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Emergency Department

  • Children requiring resuscitation or emergency treatment should be referred to the Emergency Department in accordance with current practice. If in doubt consult the paediatric registrar on call.
  • When a child with medical illness is referred to the Emergency Department they will be seen by the Emergency Department doctors who will liaise with the Paediatric team if appropriate.
  • If the Paediatric Registrar advises a GP to send a child to the ED, the Paediatric Registrar will inform the Triage Nurse in the ED, thus ensuring that the child will not be discharged from the ED without review by the Paediatric team.
  • A child who is re-presenting to the ED with ongoing or unresolving problems will be reviewed by the paediatric team and a plan for follow up will be made before discharge.

Direct Ward Referrals

Children not needing resuscitation, but who may require admission will be reviewed on the children’s ward.

  • The referral must be discussed with and accepted by the registrar on-call before the child is sent to the Children’s Unit.
  • Please advise parents that their child will be assessed and may not be admitted if it is not deemed necessary.
  • Children arriving on the ward without prior acceptance by the registrar on-call will be referred to the Emergency Department for assessment.
  • Some children with exacerbation of chronic illnesses (Diabetes/Cystic Fibrosis/ Neurodisability) will be reviewed directly on the ward. The arrangement will have been made directly between the paediatric medical and nursing teams and the family prior to discharge.
  • The referring doctor should address the letter of referral to the doctor who accepted the admission.

Children's Day Unit

Children NOT requiring immediate admission but who do need early paediatric assessment may be reviewed in the Children’s Day Unit.

  • Referrals for review in the Day Unit are accepted only by the Consultant Paediatrician “on take” for that Day (via switchboard).
  • The registrar on-call is not able to accept such referrals.
  • Following discussion between the referring doctor and the consultant on-take it may be agreed to:
    • See the child that day in the Day Unit
    • See the child in the Day Unit later (in the near future)
    • Refer the child to a Neonatologist or the breast feeding clinic
    • Direct the referral to the Out-Patient Service
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Outpatients

Referral letters for General Paediatric Medical problems can be addressed specifically to one of the Consultant Paediatricians or generically to the Paediatric Department. The referral will then be triaged appropriately by a Consultant Paediatrician.

Where the Outpatient referral involves a sub-specialty the letter of referral should be addressed to the named Consultant for that specialty.

  • Cork University Hospital Switch 021 4546400
  • Bed Management/Admissions Sister 021 4922491/4922497
  • Paediatric Registrar on call 24hr 087 6182512
  • Fax for referrals 9am-5pm Mon-Friday 021 4922199

Consultant - Specialty

  • Prof. Jonathan Hourihane -Allergy/Immunology
  • Dr. Louise Gibson - Community Paediatrics
  • Dr. David Mullane -Respiratory/Cystic Fibrosis
  • Dr. Muireann Ní Chróinín - Respiratory/Cystic Fibrosis
  • Dr. Olivia O’Mahony -Neurology
  • Dr. Brian Fraser - Cardiology
  • Dr. Deirdre Murray General Paediatrics
  • Dr. Noel Tangney - General Paediatrics

Content by Dr Íomhar O' Sullivan Prof. J. Hourihan 29/07/2010. Last review Dr IOS 31/08/14