Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Tinnitus with sudden onset hearing loss in absence of clear aetiology and/or associated with vertigo

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Nil

To contact the relevant service, please see HealthPathways: Acute ENT Assessment

Presenting issues
  • Disabling tinnitus associated with hearing loss, aural fullness and/or discharge or vertigo
  • Pulsatile tinnitus
Mandatory referral information (referral will be returned if this information is not included)


  • Relevant history, onset, duration, frequency, and quality of symptoms including:
    • Associated hearing and/or balance symptoms
  • Details of previous treatment and outcome including antibiotic or irrigation prescriptions
  • Relevant past medical history including past middle ear disease/surgery
  • Degree of functional impairment e.g. quality of life


  • Appearance of the ear canal effusion or cerumen history/presence


  • Audiology and audiogram results (where available and providing it will not cause significant delay)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
  • Mechanism of injury (barotrauma)
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • No defined category 1 criteria
Category 2
Appointment within 90 days
  • Pulsatile tinnitus
  • Severe communication difficulties due to hearing loss (bilateral downward sloping or severe) despite hearing aids
  • Sudden onset or chronic unilateral or bilateral pulsatile tinnitus or disabling tinnitus and any of the following:
    • Vertigo/dizziness
    • Hearing loss
Category 3
Appointment within 365 days
  • No defined category 3 criteria
Last reviewed: 02-10-2023