Pediatric Referral Guidelines

These referral 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.

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?
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!

Pediatric Referral Guidelines

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

Author: Vincent Iannelli, MD

Vincent Iannelli, MD