• Reference Number: HEY1204/2021
• Departments: Emergency Department, Paediatrics
• Last Updated: 31 January 2021

Introduction

For some patients, the Emergency Department (ED) is not the most appropriate place to manage their symptoms. In order to improve the experience for those patients, our nursing staff are able to “fast-track” certain patients to a specialty team or area. 

Which conditions can be fast-tracked?

The Paediatric ED nursing team can fast-track conditions such as:

• Some chronic or long-term conditions (for example severe neuro-disability, cystic fibrosis, chronic lung disease with home oxygen)
• Some first febrile convulsions
• Some rashes
• Some types of overdose
• Some mental health conditions
• Some ear, nose or throat conditions
• Some facial injuries
• Some children with care plans or care pathways
• Some children who have already been seen by a doctor or primary care practitioner and now need specialist input

Any child who is fast-tracked must be stable and not in any imminent danger. The nurse will have decided that it is more appropriate for them to be seen by a specialty doctor rather than an emergency doctor.

What happens next?

Once your child has been “fast-tracked” they will be removed from the Emergency Department (ED) queue as there is no longer any need to see an ED doctor or practitioner. For some children, they will be seen in ED by a specialty doctor (for example the Ear, Nose and Throat (ENT) doctor or Max Fax (facial) doctor. For others, they will be transferred to another area such as the Paediatric Assessment Unit (PAU), Acorn ward or a clinic area. If your child is stable, we may ask you to take them there yourself.

My child has been fast-tracked – why are they still waiting?

If your child is waiting in ED to be seen by a specialty doctor, then it is likely to be because that doctor is busy elsewhere in the hospital. The ED nursing team will keep in contact with them and ensure your child is seen as soon as possible.

If your child is waiting in ED to be transferred to a different area, then it is likely to be because there is no room available in that other area. The ED nursing team will keep in contact with the other area and ensure your child is moved as soon as possible.

If you are unsure what is happening about your child’s care, please ask and we will be happy to explain.

My child has a care pathway

Please let us know if your child has a care pathway. Wherever possible and appropriate, children with a care pathway should have this followed by the ED team, including starting any important medications, fluids or tests. If your child’s care pathway states that they should be fast-tracked to PAU, then the ED team will aim to make this happen.

Reasons why you may have to wait in ED include:

• No free space on PAU for you to be seen
• PAU staff may be busy with a very sick child and may ask the ED team to keep your child in ED for a short period
• Staff from ED or PAU may consider that your child is not well enough to move directly to PAU
• The ED team may be busy and not able to safely transfer your child to PAU straightaway

What if my child gets worse?

Please let us know about any changes in your child whilst they are waiting to be seen. Our team will re-assess to see if any treatment is needed and whether fast-track is still appropriate.

What if I prefer my child to see an ED doctor?

The ED nursing team has decided that it would be more appropriate for your child to see a specialty doctor rather than an ED doctor or practitioner. However, if you feel you would still prefer your child to be seen by an ED doctor, please ask. The ED doctor may still refer you to the specialty team if they think it appropriate to do so. 

What if I am not happy?

Please let us know if you have any concerns and we will aim to rectify them as soon as possible.