'Referral advice' recommendation details
Source guidance details
- Babies who appear to have ankyloglossia should be evaluated further (non-urgent action).
- Babies who develop jaundice within the first 24 hours after birth should be evaluated (emergency action). If jaundice first develops after 7 days or jaundice remains after 14 days in an otherwise healthy baby and a cause has not already been identified, it should be evaluated (urgent action).
- If a baby has not passed meconium within 24 hours, the baby should be evaluated to determine the cause, which may be related to feeding patterns or underlying pathology (emergency action).
- A baby who is experiencing increased frequency and/or looser stools than usual should be evaluated (urgent action).
- Nappy rash: If after a course of treatment the rash does not resolve, it should be evaluated further (non-urgent action).
- A baby who is crying excessively and inconsolably, most often during the evening, either drawing its knees up to its abdomen or arching its back, should be assessed for an underlying cause, including infant colic (urgent action).
- Women with severe or persistent headache should be evaluated and pre-eclampsia considered (emergency action). If diastolic blood pressure is greater than 90 mm Hg and accompanied by another sign or symptom of pre-eclampsia, evaluate further (emergency action). If diastolic blood pressure is greater than 90 mm Hg and accompanied by another sign or symptom of pre-eclampsia, evaluate further (emergency action).
- Women with unilateral calf pain, redness or swelling should be evaluated for deep venous thrombosis (emergency action). Women experiencing shortness of breath or chest pain should be evaluated for pulmonary thromboembolism (emergency action).
- Assessment of vaginal loss and uterine involution and position should be undertaken in women with excessive or offensive vaginal loss of blood, abdominal tenderness or fever. Any abnormalities in the size, tone and position of the uterus should be evaluated. If no uterine abnormality is found, consider other causes of symptoms (urgent action). Sudden or profuse blood loss, or blood loss accompanied by any of the signs and symptoms of shock, including tachycardia, hypotension, hypoperfusion and change in consciousness, should be evaluated (emergency action).
- At 10-14 days after birth, women should be asked about resolution of symptoms of baby blues (for example, tearfulness, feelings of anxiety and low mood). If symptoms have not resolved, the woman should be assessed for postnatal depression, and if symptoms persist, evaluated further (urgent action)
- Women with a severe, swollen or prolapsed haemorrhoid or any rectal bleeding should be evaluated (urgent action). Women with faecal incontinence should be assessed for severity, duration and frequency of symptoms. If symptoms do not resolve, evaluate further (urgent action).
- Temperature should be taken and documented if infection is suspected. If the temperature is above 38 degrees Celsius, repeat measurement in 4-6 hours. If the temperature remains above 38 degrees Celsius on the second reading or there are other observable symptoms and measurable signs of sepsis, evaluate further (emergency action).
- When a baby is suspected of being unwell, the temperature should be measured using electronic devices that have been properly calibrated and are used appropriately. A temperature of 38 degrees Celsius or more is abnormal and the cause should be evaluated (emergency action). A full assessment, including physical examination, should be undertaken.
- Gynaecology, pregnancy and birth
- Obstetrics and gynaecology
This page was last updated: 22 August 2012