Otitis externa Referral Access Criteria

Referrers should use this page when referring patients to public paediatric ENT outpatient services for otitis externa. 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.
  • Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
  • Foreign body
  • Trauma
  • New onset facial nerve palsy
  • ENT conditions with associated neurological signs e.g., facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
  • Acute and/or complicated mastoiditis
  • Auricular haematoma
  • Any suspicions of the complications of Acute Suppurative Otitis Media i.e., Mastoiditis (proptosis of pinna), meningitis etc
  • Acutely unwell diabetic patients
  • Patients experiencing facial weakness             
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):
  • Facial cellulitis
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).
  • Chronic otitis externa (≥1 months duration) causing significant morbidity and not responding to recommended treatment 
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, onset, duration of symptoms including details of:
    • otalgia, otorrhoea, hearing loss, pruritic ear canal, history or ear canal trauma e.g., cotton bud/hair pin
  • Details of previous treatment and outcome
  • Relevant past medical history including diabetic history
  • Degree of functional impairment e.g., quality of life
  • Nil
  • Ear swab M/C/S
Highly desirable
  • Nil
  • Nil
  • Nil            
Indicative triage category

Category 1

Appointment within 30 days           

  • Confirmed chronic otitis externa and persistent symptoms/pain and hearing loss despite maximal medical management 

Category 2

Appointment within 90 days

  • Confirmed chronic otitis externa without pain
  • Associated dermatitis

Category 3

Appointment within 365 days

  • No defined category 3 criteria
  • Nil
Useful information


If you would like to submit feedback on the contents of the Referral Access Criteria, please complete this form.

Last reviewed: 27-05-2024