Capability Framework – Werribee Mercy Hospital Emergency Department

Locations:

The following services are not currently available at WMH:

  • acute specialties including ear, nose and throat (ENT), gastroenterology, neurology, vascular and plastics
  • management of haematemesis and melaena
  • cardiac catheter laboratory
  • magnetic resonance imaging (MRI)
  • acute gastrointestinal scoping
  • interventional radiology
  • electroencephalogram (EEG)
DepartmentAvailability at Werribee Mercy Hospital
Emergency DepartmentYes (24 hours)
Intensive Care Unit (ICU)Yes (24 hours)
Critical care unit (CCU)No
PathologyYes (24 hours)
RadiologyYes (24 hours)

Accidents/injuries

FallsYes – No to suspected NOF fractures
FracturesYes – No longbone
DislocationsYes – simple
Fractured FemurNo
WoundsYes
Wounds PlasticsNo
PneumothoraxYes
Children under 16 – FracturesNo – if ongoing treatment or admission needed
ConcussionYes

Emergency surgery

Children under 16No
General SurgeryYes
Orthopaedic – AdultYes – simple
Orthopaedic – PaediatricNo
UrologyYes
NeurologyNo
VascularNo

Medical

Children under 18Yes
Angina – unstableNo
APO –SevereYes
AnaphylaxisYes
AsthmaYes
Cardiac Arrest – PostYes
Chest painYes – No ST Elevation (no cath lab onsite)
COPDYes
Endocrinology – (DKA & HONK)Yes
GastroenterologyNo
HeadachesYes
Heart FailureYes – if stable
Infectious DiseaseYes
OncologyYes – preferably home hospital
RespiratoryYes
Seizures – MultipleYes
Seizures – UncomplicatedYes
SepticaemiaYes
Stroke / TIAYes – VST onsite
SyncopeYes

Mental Health

Children PsychYes
Adult PsychYes
Geriatric PsychYes

Women’s health

GynaecologyYes – adults and children
ObstetricsYes – adults only

Specific presentations as per Statewide referral Criteria

ENT

Yes:

Recurrent tonsillitis

Acute tonsillitis with:

  • difficulty in breathing
  • unable to tolerate oral intake
  • uncontrolled fever

Vertigo (ENT)

  • Sudden onset debilitating vertigo where the patient is unsteady on their feet or unable to walk without assistance
  • Barotrauma with sudden onset vertigo, or symptoms suggestive of stroke or transient ischaemic attacks

Gastroenterology

Yes:

Chronic refractory constipation

  • Suspected large bowel obstruction
  • Faecal impaction that has not responded to adequate medical management.

Constipation with sentinel findings

  • Suspected large bowel obstruction
  • Faecal impaction that has not responded to adequate medical management.

Diarrhoea with sentinel findings

  • Severe diarrhoea with dehydration or when the person is systemically unwell.

Persistent iron deficiency

  • Shortness of breath or chest pain, syncope or pre-syncope with iron deficiency (ferritin below the lower limit of normal). **Refer to HealthPathways for iron deficiency management in primary care. See also management of anaemia and Werribee Mercy Hospital Medical Day Stay)

Gynaecology

Yes:

Endometriosis

  • Severe, uncontrolled pelvic pain
  • Known endometriosis with:
    • hydronephrosis or
    • bowel obstruction.

Ovarian and other adnexal pathology

  • Acute, severe pelvic or abdominal pain
  • Ectopic pregnancy
  • Suspected torsion of ovary
  • Suspected pelvic sepsis
  • If the woman is haemodynamically unstable.

Persistent pelvic pain

  • Acute, severe pelvic or abdominal pain.

Persistent vaginal bleeding

  • Uncontrolled vaginal bleeding, or if the woman is haemodynamically unstable

Neurology

Yes:

Epilepsy and seizures

  • Seizure with:
    • focal deficit post-ictally
    • seizure associated with recent trauma
    • persistent severe headache for more than 1 hour post-ictally
    • fever.
  • Prolonged or recurrent seizure (more than one in 24 hours) with incomplete recovery
  • Persisting altered level of consciousness.

Headache

  • Headache with:
    • sudden onset or thunderclap headache
    • severe headache with signs of systemic illness (fever, neck stiffness, vomiting, confusion, drowsiness, dehydration)
    • severe disabling headache
    • severe headache associated with recent head trauma.
  • Headache suggesting temporal artheritis (focal neurological symptoms, altered vision, elevated erythrocyte sedimentation rate and C-reactive protein in patients more than 50 years of age).

Stroke or transient ischaemic attack

  • Transient ischaemic attack(s) in last 48 hours
  • Multiple or recurrent transient ischaemic attack episodes in the last seven days
  • Amaurosis fugax in last 48 hours
  • Persistent neurological deficit

Vertigo (neurology)

  • Sudden onset debilitating vertigo where the patient is unsteady on their feet or unable to walk without assistance
  • Sudden onset vertigo with other neurological signs or symptoms (e.g. dysphasia, hemiparesis, diplopia, facial weakness)
  • Barotrauma with sudden onset vertigo

Urology

Yes:

Haematuria

  • Severe urinary tract bleeding.

Lower urinary tract symptoms

  • Acute, painful urinary retention.

Renal tract stones or renal colic

  • Acute or severe renal or ureteric colic
  • Proven ureteric stone in people with a single kidney or kidney transplant
  • Infected or obstructed kidney.

Scrotal abnormalities

  • Acute scrotal pain
  • Torsion of the testes

Vascular

Yes:

Deep vein thrombosis

  • Present or suspected acute iliofemoral or supra-inguinal deep vein thrombosis
  • Present or suspected acute axillary or subclavian vein thrombosis

Contacts

Primary Care Liaison Team

  • Email address: primarycare@mercy.com.au
  • About:

    The team is available on a part time basis to assist general practice with navigating hospital services and accessing GP education and credentialing. Email and voicemail messages will be responded to during business hours.

Statewide Referral Criteria for Specialist Clinics - Victoria

  • Website: Statewide Referral Criteria
  • About:

    The Department of Health and Human Services has developed statewide referral criteria to assist GPs and clinicians referring patients to specialist clinics. These referral criteria have been developed to improve access to specialist clinics in public hospitals by improving the quality and appropriateness of referrals.

HealthPathways Melbourne

  • Email address: info@healthpathwaysmelbourne.org.au
  • Website: HealthPathways Melbourne
  • About:

    HealthPathways Melbourne provides clinicians with a single website to access clinical and referral pathways, and resources. Pathways are created by local GPs, working in partnership with specialists, nurses, allied health and other health professionals.

    Mercy Health recommends clinicians to access HealthPathways Melbourne for guidance in assessing, managing and referring for patient conditions (login required).

    Referrals to outpatient clinics at Mercy Health will be triaged against clinical information and investigations based on these guidelines.

    Referrals that do not meet the required clinical information and investigations will not be accepted.

    HealthPathways Melbourne is available for free to health professionals working in the North Western Melbourne and Eastern Melbourne Primary Health Network catchments.

    Email HealthPathways to request access or if you need to confirm your username and password.

Last reviewed March 9, 2020.

Referral instructions and templates

To assist with appropriate referral triage and management, please use the Mercy Health referral templates including all required information. Referrals using your own template are also accepted providing that it includes all information required to triage.

Referral instructions and templates

Referral contact details

A quick listing page for our most commonly used referral contact details. To refer a patient, please complete a referral and fax to the relevant area, service or specialist clinic.

Referral contact details

Minimum referral requirements

The non-admitted specialist services access policy advises that referrers are responsible for including the minimum referral content required for all referrals. Learn more about the mandatory information required for a referral request to be accepted and clinically prioritised.

Minimum referral requirements