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australia clinical guidance

Anxiety & panic disorder

A Queensland-specific acute anxiety and panic assessment pathway that prioritises exclusion of physical emergencies, supportive care and appropriate mental-health follow-up.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team · Clinical editorial review · reviewed 2026-08-20 · due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. This is an explicitly Queensland-bounded acute pathway. Do not use Queensland contacts, authorities or referral processes outside Queensland; replace them with the applicable state or territory system.

Scope

Adults and children presenting with anxiety symptoms or an acute panic attack in rural or remote primary care. The sole clinical source is the current Queensland PCCM anxiety section. It supports immediate assessment, exclusion of physical causes, supportive techniques and referral, but is not a comprehensive national anxiety-disorder guideline and does not establish a national long-term medicine or psychotherapy sequence.
sources for this section:Queensland PCCM anxiety

The Bottom Line

  • Characterise whether fear peaks abruptly or persists over months, the physical and cognitive symptoms, triggers, avoidance, functional effect and recurrence rather than applying the label anxiety to undifferentiated distress.
  • Check observations, oxygenation and bedside glucose when indicated and investigate chest pain, dyspnoea, syncope, arrhythmia, endocrine disease, intoxication, withdrawal and medicine effects before assuming a primary panic disorder.
  • During a panic attack, remain with the person in a calm environment, explain what is being assessed and use paced breathing or grounding without dismissing symptoms or repeatedly promising that serious disease is impossible.
  • Assess trauma, depression, other mental illness, substance use, social stress, pregnancy or postpartum context and the person’s ability to work, study, care for dependants and remain safe.
  • For recurrent or functionally important symptoms, arrange local medical and mental-health review, including access to evidence-based psychotherapy; the Queensland source does not justify indefinite sedative prescribing.
sources for this section:Queensland PCCM anxiety

Practical clinical workflow

1
Triage airway, breathing, circulation, consciousness and current danger, then record symptom onset, peak, duration, recurrence, precipitants and previous response to care.
2
Perform a focused cardiopulmonary, neurological and mental-state assessment with source-directed tests when a physical mimic is plausible, using the chest-pain, pulmonary-embolism or other emergency pathway when indicated.
3
Reduce stimulation, offer a chosen support person where appropriate and coach a simple coping technique while observing whether physiology and distress resolve as expected.
4
After the acute episode, assess persistent anxiety, avoidance, trauma, mood, substances and supports and agree a referral or follow-up plan rather than ending care when autonomic symptoms settle.
5
Communicate the provisional formulation, tests, safety assessment and recurrence instructions, naming who will review ongoing symptoms and how the person can access urgent help.
sources for this section:Queensland PCCM anxiety

Safety boundaries and escalation

  • Ongoing chest pain, hypoxia, syncope, focal neurology, severe headache, haemodynamic abnormality or a presentation inconsistent with previous panic requires urgent physical assessment.
  • Suicidal intent, psychosis, mania, severe intoxication or withdrawal, inability to care for self or a child, or rapidly collapsing function requires urgent mental-health or emergency care.
  • Pregnancy and postpartum anxiety can coexist with depression, psychosis or intrusive thoughts about infant harm and requires the jurisdiction’s perinatal pathway rather than generic reassurance.
  • Sedative medicine can impair breathing, coordination and driving and create dependence; this source set supplies no national repeat-prescribing regimen, so any use requires current product information and a defined review plan.
sources for this section:Queensland PCCM anxiety

Implementation

Every clinical recommendation on this page is bounded to the Queensland PCCM, whose service contacts, authorised roles and escalation arrangements apply to Queensland rural and remote practice. Australia has no current comprehensive national panic or anxiety CPG identified in this audit. Clinicians elsewhere must use their own state or territory emergency and mental-health pathway and local prescribing rules.
sources for this section:Queensland PCCM anxiety

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:Queensland PCCM anxiety

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Queensland Health and Royal Flying Doctor Service Queensland SectionPrimary Clinical Care Manual, 12th edition: Anxiety and panic attack — adult/childISBN 978-1-876560-22-5 · 12th edition 2025, v1.03 with updates through 21 July 2026; section 5, printed pages 344–346 · accessed 2026-08-20
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