Close Search
Open Menu Close Menu Open search

At a Glance

Admission/Entry

  • Walk in Children’s Triage
  • Emergency Services Triage
  • Planned follow up expectants on EDIS

Hours of Operation & Length of Stay

Main Children’s Area (Nine Cubicles)

  • 24/7 – 365 days of the year
  • LOS < 4hrs

Children’s Fast Track

  • 0800 to 2300 – 365 days of the year
  • LOS < 4hrs

Inclusion Criteria

Children’s Cubicle

Inclusion:

  • Children’s and neonate patients requiring  medical care <=16 years
  • Neonates to be transferred out post stabilisation

Exclusion:

  • Adult patients
  • Category one patients
  • High risk/intoxicated adolescents

Children’s Fast Track

Presentations Suitable for Children’s Fast Track

  • At the point of triage, the following clinical presentations can be considered for streaming to Children’s FT:
    • Uncomplicated medical illnesses, who do not need ongoing monitoring or nursing procedures e.g.:
      • Rashes – otherwise well – e.g. eczema;
      • Simple headache with normal vital signs and GCS;
      • ENT complaints.
    • Children returning for scheduled medical review (with stated improvement at triage).
    • Minor injuries including:
Limb injuries Eye injuries
Wound care/Lacerations Facial injuries
Minor burns Foreign bodies
Dental injuries Minor Head Injury (no LoC)
  • Note: Other patients may be suitable for FT in discussion with the Paediatric NP, Paediatric ED Consultant or Registrar.
  • The patient will be brought into the FT area in the order of priority.
  • Nurse initiated investigations and analgesia should be utilised wherever possible.
  • If there are queries regarding early interventions such as medication, imaging or other investigation, they can be discussed with a Paediatric Nurse Practitioner, Paediatric Emergency Consultant or Paediatric Emergency Registrar.
  • Following initial assessment and depending on demand, patients may be returned to the waiting room to await results of their tests/investigations.

Clinical Presentations not suitable for FT

  • The following presentations should not be triaged and streamed to FT:
    • < 1yrs of age (except at the discretion of the Paediatric ED Consultant/Registrar);
    • Children displaying any Behaviours of Concern or with previously documented alerts for BOC (These children will be cared for in a cubicle or resuscitation area);
    • Trauma call;
    • Significantly abnormal vital signs at triage. e.g. any vital signs in purple zone on VICTOR chart or >2 vital signs in orange zone;
    • Requiring continuous observation or care;
    • Infectious e.g. Suspected illness with potential airborne spread such as TB, SARS-COV2.
  • The overriding principle for the Children’s Fast Track is that if the patient appears unwell and requires an extensive workup they are not suitable for Fast Track.

Children’s Treatment/Plaster Room

Inclusion:

  • Plastering
  • Procedures +/- nitrous

Exclusion:

  • Critically unwell patients

 

Clinical Care

  • Children’s ED provides urgent care for children presenting with acute illness or injury
  • Management of an (un)differentiated patient presenting to an Emergency Department which may include medical and surgical emergencies and mental health emergencies
  • Coordinating the management of complex patients, including organising appropriate referral
  • Interacting with other health care service providers and providing assistance as appropriate
  • Management of primary, secondary, and tertiary conditions in the children’s population
  • Capability for initial emergency Resuscitation and the management of severely ill or injured children
  • Child and family centred care (CFCC) must be a priority for staff and managers through clinical practice, staffing, and environmental design
  • Working in accordance with RCH Clinical Practice Guidelines

Emergency Management & Escalation

Escalation Processes:

  • NIC /Consultant
  • DOS huddle
  • RiskMan
  • Code grey/planned code grey
  • Duress
  • Victorian Child Safe Standards: DHHS

Medical Emergencies:

Bedside emergency roll down equipment

Broselow Trolley’s:

  • 1x In Children’s Area (no Defibrillator)
  • 1x AV Triage (with Defibrillator for hospital response)
  • Transfer to Resuscitation Area

ALS transfer pack –  Medication Room

Paediatric resuscitaire in Resuscitation cubicle 4 & Children’s Treatment  room

Emergency Buzzer Responders:

  • ED NIC
  • Resus 1
  • Bedside Nurse
  • PCN
  • Paediatric Registrar
  • Resuscitation Registrar

Children’s Hospital Code Blue Response:

  • PCN  and Paediatric EP
  • Hospital wide Paediatric code response
  • Pager  and phone call to children’s consultant
  • Broselow Trolley (AV/Triage)

Disposition

  • Home
  • Ward
  • Inter hospital
  • Theatre
  • Out of home care
  • DPU
  • Discharge home with planned follow up in ED

Discharge Process

  • Script
  • Outpatient follow up
  • Certificate
  • Referrals
  • Discharge Letter

Staffing

March 2021

Nursing

AM/PM shift

  • 3 Nurses – 9 cubicles –  1:3 ratio
  • 1 PCN
  • 1 Nurse Practitioner – works in FT
  • 1 FT Nurse – 4 cubicles 1:3 ratio

ND shift

  • 3 Nurses 1:3 ratio
  • 1 PCN
  • 1 Nurse Practitioner – works in FT
  • 1 FT Nurse – 4 cubicles 1:3 ratio

Medical

AM Shift

  • 1 Consultant
  • 2 Registrar
  • 2 HMO
  • 1 Intern

PM shift

  • 1 Consultant
  • 2 Registrar
  • 2 HMO
  • 1 Intern

ND shift

  • 2 Registrar (In charge)
  • 1 HMO
  • Social Worker
Print this Page