For referring doctors
Melbourne Hand Surgery welcomes referrals from GPs, hospital emergency departments, urgent care centres, hand therapists and other specialists. We also accept self-referrals from doctors.
A referral is required before booking. This lets us determine that we are able to offer suitable treatment for the specific urgent and emergency condition, assess whether a telehealth consultation is suitable, and identify any imaging or additional information needed before the appointment. Routine new-patient appointments are generally booked several months ahead, so please refer time-critical problems early.
How to refer
Secure messaging
HealthLink EDI: drjtomli
info@melbournehandsurgery.com
Fax
03 8677 9116
Via your patient
They can upload the referral through our online registration form, through HotDoc, or email it to us
For new hand and wrist fractures, you can also refer directly to our Melbourne Hand Surgery’s Online Fracture Assessment – a rapid-access virtual fracture clinic.
What to include
Please include the following with every referral:
- ✓Patient details and contact information
- ✓Date and mechanism of injury (for injuries)
- ✓Radiology provider details (so we can access imaging)
- ✓Any specific clinical concern(s)
We write back. Following the patient’s appointment, Dr Tomlinson sends a letter to the referring doctor, via secure messaging where possible.
Guide to timely referral of hand and wrist injuries
This guide is written for general practitioners and emergency clinicians. It outlines suggested timeframes for referral. If you believe your patient needs more urgent review than the table suggests, please act on your clinical judgement and refer accordingly.If we are unable to accommodate your patient in the recommended timeframe we will, with apology and regret, decline the referral.
| Timeframe for review | Clinical problem | Action | Suggested first aid |
|---|---|---|---|
| ASAP | Vascular compromise (for example amputation) | Refer to nearest accepting hospital emergency department via ambulance | Apply a simple non-stick dressing that can be removed easily; advise the patient not to eat or drink |
| Within 24 hours | Infected or contaminated wounds (for example septic arthritis, flexor tenosynovitis, felon, animal or human bites), open dislocations, irreducible dislocations | Refer to nearest accepting hospital emergency department or contact MHS on (03) 9427 9596 | Irrigate open wounds (saline or clean tap water); commence antibiotics if treatment will be delayed; advise the patient not to eat or drink |
| Within 48 to 72 hours | Clean or closed wounds with suspected injury to nerve, tendon or other vital structures | Contact MHS on (03) 9427 9596, email or secure message us | Splint the affected hand and/or wrist; x-ray |
| Within 7 days | Fractures (surgery, if needed, is ideally performed within 14 days); splinted closed injuries with unstable joints | Contact MHS on (03) 9427 9596, email or secure message us | Splint the affected hand and/or wrist; x-ray |
| Within 10 to 14 days | Sprains or strains with no fracture on x-ray; dislocations that have been reduced and splinted | Contact MHS on (03) 9427 9596, email or secure message us | Splint the affected hand and/or wrist; x-ray |
Where surgery is required, all patients are admitted to The Avenue Hospital.
Correct splinting position
When splinting, aim for a safe, comfortable position: interphalangeal joints straight, metacarpophalangeal joints flexed, and the wrist comfortably extended, with the thumb comfortably extended. When in doubt in the first week, over-splint (cover more joints than the minimum) rather than under-splint. If a fracture is known or suspected, splint the joint above and below.
After-hours and urgent contact
Existing (active) patients of Melbourne Hand Surgery can contact us for urgent support on 0467 666 862. Melbourne Hand Surgery does not offer an on-call service to individuals who are not currently patients of the practice.
Ready to refer a patient?
Send your referral by secure messaging, email or fax — or ask your patient to upload it through our online forms.