Pediatric Referral Guidelines

As much as we like to create a medical home for our kids, there are times when we have to refer them to specialists to help diagnose or manage an issue.

It is sometimes hard to know when that time is though.

Or what you can do before you start the referral process.

Do you know what to do as part of pre-referral workup for a child with short stature?

Reviewing our collection of pediatric referral guidelines can help to make sure that you send the right patient to the right specialist at the right time. And can help avoid unnecessary referrals and testing!

This is especially important because it can sometimes take time to get a pediatric patient in to see a specialist, so you don’t want a sick child to wait months only to discover that you could have or should have done something else.

Most importantly, these types of guidelines can help you figure out when to refer a sick child to a specialist, how quickly you should get the child seen, and what to do as part of your pre-referral workup.

Do the specialists you routinely refer to have their own guidelines you can look to before referring a patient?

If not, consider reviewing these referral guidelines for:

adolescent medicine – abnormal uterine bleeding, eating disorders
pediatric allergy & immunology – allergic rhinoconjunctivitis, anaphylaxis, asthma, atopic dermatitis, drug allergy, eosinophilic esophagitis, food allergy, immunodeficiency, insect hypersensitivity, sinusitis, urticaria/angiodema
back pain
pediatric cardiology – heart murmur, palpitations, arrhythmia, abnormal ECG, chest pain, syncope, hypertension, Kawasaki, genetic disorders, premature and term infants, hyperlipidemia
concussions
developmental-behavioral pediatrics – speech/language delay, delayed milestones, ADHD, preschool behavior disorder, autism
eating disorders – anorexia nervosa, bulimia, avoidant/restrictive food intake disorder
pediatric endocrinology – hypothyroidism, hyperthyroidism, goiter, thyroid nodule, diabetes, obesity, acanthosis nigricans, short stature, failure to thrive, precocious puberty, premature thelarche, premature adrenarche, delayed puberty
pediatric gastroenterology – abdominal pain, celiac disease, chron’s disease, diarrhea, hematochezia, food allergy, peptic ulcer disease, GER, vomiting, constipation, failure to thrive, eosinophilic esophagitis
GI conditions – abdominal pain, constipation, reflux, failure to thrive, vomiting, diarrhea, celiac disease, Crohn’s Disease / Ulcerative Colitis, Suspected Eosinophilic Esophagitis (EoE)
pediatric headaches
pediatric hematology – anemia, thrombocytopenia, neutropenia, coagulation defects (bruising and bleeding)
infectious diseases – recurring fevers, recurrent sinusitis, FUO, recurrent abscesses
metabolic disorders – developmental regression, hypotonia, stroke like episodes, recurrent seizures, failure to thrive, hypoglycemia, abnormal labs, positive newborn screen
menstrual irregularity
pediatric nephrology – microhematuria, gross hematuria, proteinuria, acidosis, cystic kidneys, hypertension
pediatric neurology – recurrent seizures, febrile seizure, first seizure, developmental delay, tics, autism, concussion, headaches
pediatric ophthalmology – visual acuity, ptosis, dacryostenosis, glaucoma, nystagmus, strabismus,
pediatric orthopaedics – flat feet, intoeing, chronic knee pain, acute knee pain, scoliosis
physical or occupational therapy/hand therapy
pediatric pulmonology – apnea, asthma, BPD, chronic cough, cystic fibrosis, recurrent pneumonia
psychiatry
pediatric rheumatology – arthralgias, joint swelling, weakness, back pain, malar rash, extremitiy color changes, positive ANA
umbilical hernia
pediatric urology – balanitis, bladder stones, dysfunctional voider, dysuria, frequency, hematuria, hernia, hidden penis, hydrocele, hydronephrosis, incontinence, kidney stoney, labial adhesions, meatal stenosis, paraphimosis, penile adhesions, phimosis, testicular pain, varicocele, vesicoureteral reflux
urology – undescended testicle, phimosis, UTI, hydronephrosis

And if you’re lucky, you might learn enough in the referral guidelines to save your patient a referral!

More on Pediatric Referral Guidelines

Last Updated on February 19, 2021 by Vincent Iannelli, MD

Author: Vincent Iannelli, MD

Vincent Iannelli, MD View all posts by Vincent Iannelli, MD