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How does the Children’s Emergency Department work?

The sickest are seen quickest
  • The sickest or most severely injured children are prioritised and seen before others.
  • When you have booked your child into the Children’s Emergency Department (ED), they will have a rapid visual (eyeball) assessment at the nurses’ station. At the eyeball assessment, we will ask some screening questions and make a visual evaluation.
  • If your child does not need immediate treatment, you will be asked to wait until the triage nurse is available. The triage nurse will carry out a more in-depth assessment.
  • This triage assessment determines the order in which children are assessed by a clinician (doctor or nurse practitioner). Again, if your child does not need immediate treatment, you will be asked to wait until they are called in to be seen.
  • If your child becomes more unwell while waiting, please alert medical or nursing staff so your child can be reassessed urgently.

You can use this symptom checker on NI Direct to see what condition your child may have.

NI Direct screenshot

The sections below have information on how conditions are considered in terms of urgency.


  • Most urgent
    • Cardiac arrest (heart not beating or not pumping enough for survival)
    • Blocked airway (may be indicated by noisy breathing)
    • Not breathing or inadequate breathing
    • Life-threatening bleeding
    • Having seizures / fits
    • Unresponsive or very low level of consciousness
    • Shock – inadequate oxygen delivery / blood flow to organs or tissues
    • Clinician decision based on assessment
  • Very urgent
    • Bleeding that can’t be controlled by sustained direct pressure (not life-threatening)
    • Significant trauma (for example major road traffic accident)
    • Severe pain
    • Confused state / lethargic / floppy
    • Rash that doesn’t fade under the glass test
    • New abnormal pulse
    • Increased breathing effort / low oxygen levels
    • Very low blood sugar
    • Severe testicular pain / swelling
    • Hot baby (temperature greater than 38.5 degrees and baby less than 12 months old)
    • Very hot (temperature greater than 41 degrees)
    • Cold (temperature under 35 degrees)
    • History of overdose / poisoning
    • Swallowed a dangerous object, for example a button battery
    • Immunosuppressed (weak immune system)
    • Injury causing an obvious deformity
    • High risk of self-harm or harm to others
    • Severe allergic reaction
    • Significant eye injury
    • Clinician decision based on assessment
  • Urgent
    • Minor uncontrollable bleeding
    • History of unconsciousness
    • Moderate pain
    • Warm newborn baby (temperature between 37.5 and 38.4 degrees and baby less than 28 days old)
    • Significant mental health issues
    • Not passing urine for more than 12 hours
    • Clinician decision based on assessment
  • Less urgent / not urgent
    • Everything not mentioned in sections above
    • Warm (temperature over 37.5 degrees)
    • Recent mild pain (past seven days)
    • Recent problem (past seven days)

Important information
  • Waiting times will depend on the number of patients in the Children’s Emergency Department with urgent needs. Please be aware that the situation in Children’s ED can change very quickly and waiting times may increase from what you were told at triage.
  • If your child requires admission to hospital and this is not their local hospital (and they do not require specialist services) your child may be transferred to another paediatric inpatient facility.
  • If your child requires outpatient follow-up and this is not their local hospital (and they do not require specialist services) your child will be referred to their local hospital.
  • If your child arrives at the Emergency Department by ambulance, they will be triaged in the same way as other arrivals. Your child will not be seen quicker because they arrived in an ambulance.
  • Emergency Departments in Antrim Hospital, Ulster Hospital, Craigavon Hospital, Daisy Hill Hospital, Altnagelvin Hospital, Causeway Hospital and South West Acute Hospital are all equipped to assess and treat children with inpatient paediatric services if required.

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