Non-urgent referrals

Question 1

In normal and south Asian populations, what does the BMI need to be for a 2 week referral to the GP, unless they are seeing the DR. immediately after?

Answer 1

Normal
If BMI is above 35, OR if it is above 30 but they have comorbidities such as osteoarthritis, dyslipidemia or sleep apnoea.

South Asian
BMI above 32.5 or above 27.5 with Comorbidities

Both
BMI below 18.5

Question 2

For blood pressure, what would be a non urgent referral for normal and Diabetic people?

Answer 2

Normal
>140/90

Diabetic
>130/80

Question 3

What would constitute a 24hr referral to the GP, or a posting to A&E for BP?

Answer 3

24hr
>180/120

Immediate A&E
180/120 + any hematuria, confusion, chest pain, visual disturbances, nausea, tinnitus, abnormal headaches.

Question 4

What is the 2 week referral level for cholesterol?

Answer 4

> 6.2mmol/L

Non-HDL above 4mmol. total-HDL will provide this.

Question 5

What is a referral level for triglycerides?

Answer 5

> 4.5mmol/L

Question 6

What are the blood glucose values that would suggest a non urgent referral to a DR. in fasted and non fasted normal people and pregnant women?

Answer 6

Normal
Fasted = >7mmol
Random = >11.1mmol

Pregnancy
Fasted = >5.6mmol
Random =>7.8mmol

Question 7

What are the glucose values that would require an immediate referral to A&E, or the GP if in diabetics?

Answer 7

Normal people to A&E =>14mmol

Diabetics to GP = >14mmol

Question 8

What is the non urgent, and urgent referral to A&E for urine

Answer 8

Non urgent
+ (positive) for any blood, glucose, protein, ketones or leucocytes

A&E
Fasted blood glucose above 7.0 and positive for ketones

Random blood glucose above 11.1 and positive for ketones

If diabetic A&E if positive for ketones in urine

Question 9

what is the Qrisk3 percentage required for a non urgent GP referral ?

Answer 9

10 year risk above 10%

Question 10

What mmol/l values does Hba1c need to be at for a non urgent GP referral?

Answer 10

> 48mmol

Question 11

During a functional moment assessment, how many test do you need to score 0 on to get a physio referral in 2 weeks.

Answer 11

If even 1 test scores a zero, refer onwards.

Question 12

During a fitness test, what BP change would indicate an stop to the test and a non urgent referral to the GP?

Answer 12

An increase in diastolic of 20mmhg.

Diastolic reaches 110mmhg.

Systolic reaches 220mmhg.