Ear wax Referral Access Criteria

Referrers should use this page when referring patients to public paediatric ENT outpatient services for ear wax. This RAC is applicable to referrals for patients aged <16 years only. Please refer to the ENT (Adult) RAC for referrals for patients aged 16 years or more.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Conductive hearing loss if acute event with dizziness
  • Foreign body       
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate paediatric ENT assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute Paediatric ENT assessment (external site)
Presenting issues
 If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Abnormal tissue in the ear canal
  • Chronic wax impaction causing significant hearing loss or pain with contradictions to syringing or mircosuction, or where microsuction is not available
  • Non-healing perforation of eardrum
  • Resistant ear wax despite appropriate management, and at least one of:
    • the eardrum needs to be seen
    • symptoms affect the patient’s quality of life
    • the patient is a child with a hearing aid            
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

  • Relevant history of symptoms
  • Details of previous treatment and outcome, including reason why syringing or microsuction is contraindicated or not available
  • Degree of function impairment e.g., quality of life
  • Relevant past medical history                 
  • Otoscopy findings
  • Hearing test results
Highly desirable
  • Nil
  • Nil
  • Nil            
Indicative triage category

Category 1

Appointment within 30 days           

  • No defined category 1 criteria 

Category 2

Appointment within 90 days

  •   No defined category 2 criteria 

Category 3

Appointment within 365 days

  • Residual ear wax despite treatment with no other complications
  • Discharging ear: Waxy ear discharge
Useful information

See HealthPathways: Ear Wax


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Last reviewed: 27-05-2024