Cystic fibrosis Referral Access Criteria
Cystic fibrosis Referral Access Criteria
Referrers should use this page when referring patients to public adult respiratory and sleep medicine outpatient services for cystic fibrosis
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| 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. |
- Cystic fibrosis with any of the following concerning features:
- respiratory distress
- new haemoptysis (clots or more than streaks)
- pleural effusion
- consolidation/pneumonia/fever
- pneumothorax
- non-response to antibiotics for chest infection
- respiratory failure and pulmonary hypertension/cor pulmonale
- Cystic fibrosis related abdominal complications (e.g. renal colic, distal intestinal obstruction syndrome, acute pancreatitis or biliary cholic/cholecystitis)
- Any cystic fibrosis related deterioration, respiratory or other, should be referred onto tertiary cystic fibrosis clinic urgently or emergency
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Chronic suppurative lung disease with airflow obstruction and chronic airway infection
- Allergic bronchopulmonary aspergillosis
- Chronic rhinosinusitis with nasal polyposis
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| Mandatory information |
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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.
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| History |
- Duration and severity of symptoms including:
- non-pulmonary CF problems
- recent admissions
- Current medication list
- Any known allergies
- Previous centre of care (if transitioning patient)
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| Examination |
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| Investigations |
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| Highly desirable |
| History |
- Family history
- Weight history/trend
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| Examination |
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| Investigations |
-
FBC
- U&E
- LFT
- Ca
- Vitamin D3 (25 hydroxy Vitamin D3)
- Fat soluble vitamin levels (Vitamin A, D, E)
- Fe studies
- Coags
- Fasting glucose
- Spirometry
- CXR/CT and any other relevant imaging
- Any recent sputum culture results (within last 12 months)
- Genotype
- Sweat test
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- Newly diagnosed cystic fibrosis
- Patients with known cystic fibrosis transitioning from a paediatric or other adult centre who have recent clinical instability and/or severe lung disease (FEV1<40%)
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Category 2
Appointment within 90 days
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- Suspected but undiagnosed cystic fibrosis
- Patients with known cystic fibrosis transitioning from a paediatric or other adult centre who have recent clinical stability or moderate lung disease (FEV1>40%)
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Category 3
Appointment within 365 days
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No defined category 3 criteria
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| Useful information |
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- All patients diagnosed with cystic fibrosis should be managed by a cystic fibrosis service in a tertiary facility
Spirometry: Bulk-billed spirometry can be obtained via Respiratory Care WA (external site). A list of other providers undertaking lung function testing is provided on Clinician Assist WA: Respiratory Function Testing (external site).
See MBS: Item 11505 (external site) and MBS: Item 11506 (external site) for information on completing spirometry.
Clinician resources
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Feedback
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