Hearing loss Referral Access Criteria

Referrers should use this page when referring patients to public paediatric ENT outpatient services for hearing loss. This RAC is applicable to referrals for patients aged <16 years only. Please refer to the ENT (Adult) RAC for referrals for patients aged 16 years or more.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • 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
  • Auricular haematoma
  • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis, etc          
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate paediatric ENT assessment (seen within 7 days):
  • Nil
To contact the relevant service, see Clinician Assist WA: Acute Paediatric ENT assessment (external site)
Clinical indications for outpatient referral
 If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Hearing loss of any severity 
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History
  •  Details of previous treatment and outcome
Examination
  • Otoscopy findings
Investigations
  • Diagnostic audiology assessment (where available and providing it will not cause significant)
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • Nil             
Indicative clinical urgency category

Category 1

Appointment within 30 days           

  • Sudden, unexplained hearing loss
  • Recently diagnosed unilateral/bilateral sensorineural hearing loss (SNHL) or congenital hearing loss
  • Conductive hearing loss if acute with discharge             

Category 2

Appointment within 90 days

  • Confirmed structural damage
  • Hearing loss in the setting of speech delay or educational handicap
  • Hearing loss requiring hearing aid authorisation
  • Recent diagnosis of bilateral conductive hearing loss

Category 3

Appointment within 365 days

  • Recent diagnosis of unilateral conductive hearing loss 
Exclusions
  • Hearing aid dispension
  • Excluded condition when the following features apply:
    • Symmetrical gradual onset hearing loss
    • Patients with a normal audiogram
Useful information
  • Nil

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Last reviewed: 27-05-2024