February 2021 Update

The ESCALATION system is scheduled for implementation at Perth Children’s Hospital in April. Education is underway with nurses and doctors attending face to face education and online educational packages are also available. The staged roll will be supported by dedicated Staff Development Nurses who will support staff in clinical areas in the transition to using the new system. The ESCALATION system was also presented this month at a Grand Round focusing on sepsis (see pictures). Based on the results of earlier trials the system has been refined and key features include:

• Composite scoring system with 10 weighted variables; assessment of respiratory distress, respiratory rate, oxygen saturations, oxygen therapy, heart rate, central capillary refill time, blood pressure, level of consciousness (or level of sedation), pain score, and clinician/family concern
• 5 age-specific charts: <3 months, 3-12 months,1-4 years, 5-11years, 12 years +
• Respiratory distress assessment and oxygen delivery succinct and objective
• Standardised, clear escalation pathway appropriate for different contexts
• Standardised, clear sepsis pathway to facilitate sepsis recognition and early senior medical review for suspected sepsis
• iSoBAR NOW timely escalation of care communication
• Posters and flyers to promote family involvement