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Neck mass Referral Access Criteria

Neck mass Referral Access Criteria

Referrers should use this page when referring patients to public paediatric ENT outpatient services for neck mass. 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 (button batteries – inhaled or ingested). if suspicion of button battery immediate emergency review
  • Acutely enlarging neck mass with any associated airway symptoms e.g., stridor, drooling, dysphagia etc
  • Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/ severe odynophagia
  • Trauma
  • Abscess or haematoma (e.g., peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
  • Post-tonsillectomy haemorrhage
  • Hoarseness associated with neck trauma or surgery
  • If new onset hoarse voice and any airway obstructive symptoms             
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).
  • Neck mass/lumps            
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
  •  USS neck (if likely reactive lymph node, then allow 6-8 weeks for resolution before referral)                 
Examination
  • Nil
Investigations
  • Nil
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • Thyroid function
  • FBC
  • LFT
  • CRP
  • ESR
Indicative clinical urgency category

Category 1

Appointment within 30 days           
  • Neck mass that has any of the following:
    • increasing in size and/or
    • not responding to antibiotics and/or
    • persists for >6 weeks

Category 2

Appointment within 90 days

  • Suspected thyroid mass
  • All other neck masses

Category 3

Appointment within 365 days

  • No defined category 3 criteria
Exclusions
  • Nil
Useful information
  • Nil

Feedback

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Last reviewed: 27-05-2024
wa.gov.au