The Infusion Centre is a day unit that sees patients for various types of infusions, including iron.
Referrals
Please complete the referral form and fax the referral together with all the required information to the Infusion Centre. Please note that incomplete referrals will be returned to the referring practitioner.
We accept GP and specialist referrals to this service. All referrals are triaged by a clinician and patients are offered appointments according to clinical urgency.
Please note: A referral for an iron infusion is not considered a request for investigation of the cause of iron deficiency. Please direct referrals for further investigation to the relevant speciality clinic depending on clinical suspicion.
Categories for Appointment
| Clinical Description | Timeframe | |
|---|---|---|
| Category 1 Urgent | – Iron deficiency anaemia (Hb ≤ 100g/L) | Within 2 weeks |
| Category 2 Semi-Urgent | – Iron deficiency with mild anaemia (Hb 101 to 109 g/L) | Within 4 weeks |
| Category 3 Routine | – Hb ≥ 110 g/L | Within 6 weeks |
| Emergency | – Severe anaemia Hb ≤ 70g/L – Symptomatic patient with chest pain/shortness of breath or any other concerning symptoms – Patient is haemodynamically unstable – Patient is actively bleeding – Anaemic patient with an acute drop in haemoglobin – Acutely unwell patient | Please refer patient to the nearest emergency department for further management |
Eligibility criteria
- Patient age >16 years
- Patients with iron deficiency (ferritin <30) and Hb ≥ 110 who have been on at least 60-100mg elemental iron on an alternate day dosing for the last 12 weeks without a demonstrated improvement in haemoglobin level or ferritin.
- Patients with mild iron deficiency anaemia, ferritin <30 with Hb 101 to 109 who have been on at least 60-100mg elemental iron on an alternate day dosing but have not achieved a demonstrable adequate haemoglobin rise of at least (10g/L) after 4 weeks.
- Patients with iron deficiency anaemia and Hb ≤ 100g/L
- Patients with chronic medical conditions (eg: chronic kidney disease, heart failure, inflammatory bowel disease)
- Patients with functional iron deficiency
- Please refer to the Lifeblood -Haemoglobin assessment and optimisation in maternity guidelines for referral criteria for pregnant patients.
- Requirement for rapid iron repletion eg: preoperatively for non-deferrable surgery
- Chronic bleeding diathesis
Exclusion criteria
- Patients ≤ 16 years
- Anaemia not due to iron deficiency
- Patients with an elevated haemoglobin level
- Iron overload conditions/disturbances in utilisation of iron
- Polycythemia vera/essential thrombocytosis
Alternative referral options
- Other public health services
- Local GP clinics that offer iron infusions
- Paediatric hospitals
Make a referral
All referrals to this clinic must contain the following information.
Referral: Date of referral, Speciality, Referring practitioner, Provider Number, Referrer’s signature.
Patient Demographic: Full name, Date of birth, Postal address, Contact numbers, Medicare Number, Interpreter required.
Clinical: Reason for referral, Duration of symptoms, Management to date, Past medical history, Current medications, Allergies, Diagnostics as per referral guidelines X-ray results/reports must be within the last 6 months.
Considerations
Cause of patient’s iron deficiency or specify if further investigation is being undertaken to determine cause.
Any previous reaction to IV iron preparation and details of type of iron and nature of reaction.
Information as per the referral eligibility criteria outlined above.
Is your patient taking an adequate amount of oral iron?
The amount of elemental iron in different preparations vary significantly. A supplement with at least 60mg to 100mg elemental iron is recommended.
How is the patient taking their oral iron?
Iron is best absorbed on an empty stomach at least 1 hour before or 2 hours after a meal with water or orange juice. Certain medications and beverages (tea, coffee,cola) impair the absorption of oral iron and an iron tablet is best taken by itself.
Is the patient experiencing side effects from their oral iron tablets?
Gastrointestinal side effects due to oral iron is dose dependent. Consider an alternate day dosing and consider a lower dose (60mg elemental iron) then incrementing the dose slowly.
Assessing response to oral iron therapy?
Oral iron therapy is effective for the management of iron deficiency when taken correctly and at the right dose. Follow-up after 2-4 weeks post commencement of oral iron therapy is important to identify and troubleshoot any side effects. In patients with mild anaemia (Hb > 101 to 109) a repeat hb check after 4 weeks is recommended to assess haemoglobin response with an adequate response defined as an increase in haemoglobin of at least 10 g/L. It is important to continue oral iron supplement for a minimum of 3 months after anaemia has been corrected to replenish stores.
Follow-up post infusion
Please reassess haemoglobin levels in a non -anaemic patient at least 4 weeks post final iron infusion to allow adequate time for erythropoiesis and iron utilisation. Occasionally hypophosphatemia can occur post ferinject infusion. Please check phosphate levels in patients experiencing signs and symptoms of hypophosphatemia and replace phosphate accordingly.
Australia Red Cross Lifeblood Iron Deficiency Patient Information
Clinic information
Opening hours: Monday to Friday 8am to 4.30pm, closed on weekends and public holidays
Patients will be contacted via phone for the appointment. If there are any concerns about a delay in the appointment or if there is any deterioration in your patient’s condition please contact the centre and speak to the nurse unit manager in charge.
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