Triage Framework

Urgent Referral Pathway

Use this clinical guide to determine referral urgency and access pathways for patients presenting with suspected cranial, spinal, or peripheral nerve pathology.

Tier 1 • Emergency / Same-Day Escalation

Emergency Department Routing

Key Presentations & Symptoms

  • Cauda Equina Syndrome (CES): New or progressive urinary retention/incontinence, fecal incontinence, saddle anaesthesia, or sudden bilateral sciatica/leg weakness.
  • Acute Cervical Myelopathy: Rapid onset or progressive clumsiness in both hands, loss of balance, or gait spasticity.
  • Severe Intracranial Mass Effect: Sudden onset hemiparesis, sudden vision loss, severe headache accompanied by projectile vomiting or altered conscious state.

Required Action

Do not send an electronic referral. Direct the patient immediately to the nearest tertiary Emergency Department.

To discuss emergency neurosurgical transfer, contact Dr Aliashkevich directly via the GP-only hotline:

+61 3 9000 0001
Tier 2 • Urgent Outpatient Clinic (1 - 2 Weeks)

Priority Consultation Review

Key Presentations & Symptoms

  • Stable Myelopathy: Cervical myelopathy with mild, long-standing, or stable symptoms.
  • Progressive Monoparesis: Lumbar radiculopathy with mild-to-moderate motor weakness (e.g., new foot drop).
  • Incidental Intracranial Lesion: Small meningioma, stable brain aneurysm, or suspected low-grade brain tumour without acute symptoms.

Required Action

Submit a secure referral via HealthLink (EDI: mineuro) or Argus. Mark the subject line prominently as "URGENT REVIEW".

Please attach all relevant MRI or CT scan reports. We will contact the patient within 24 hours to schedule a consultation within 7 to 14 days.

Tier 3 • Standard Outpatient (2 - 6 Weeks)

Standard Consultation Review

Key Presentations & Symptoms

  • Chronic Back & Neck Pain: Axial spinal pain of arthritic origin without radicular weakness or myelopathy signs.
  • Stable Radicular Pain: Sciatica or arm pain controlled with oral medication.
  • Peripheral Nerve Entrapment: Symptoms of carpal tunnel syndrome or ulnar neuropathy without severe motor muscle wasting.

Required Action

Submit a standard secure electronic referral. We will coordinate directly with the patient to arrange the next available consultation slot, typically within 2 to 6 weeks.