Children with surgical/medical problems may be considered for direct admission if they are clinically stable. These children will be triaged at Children’s Emergency and admitted directly to the wards. No medical attention will be rendered at Children’s Emergency.

All children who are ill or clinically unstable, requiring urgent medical attention should be referred to Children’s Emergency for emergency management.

The following condition may be considered for direct admission:

A. Surgical Problems
    • Head injury for observation (associated with vomiting/headache) 
    • Suspect acute abdomen (acute appendicitis, acute torsion of testis,intussusception

B. Medical Problems
    • Febrile seizures in children under 18 months 
    • Gastroentertis (with vomiting / poor feeding / reduced urine output) 
    • Viral gastritis (with persistent vomiting / poor feeding / reduced urine output) 
    • Acute exacerbation of Asthma (no response to bronchodilators / inheld B2 agonist more
        frequent than four hourly / severe chronic asthma / past history of acute life-threatening
        asthma) 
    • Bronchiolitis (mild respiratory distress / poor feeding / vomiting) 
    • Pneumonia (mild respiratory distress / poor feeding / vomiting) 
    • Pyrexia in infants below 3 months with temperature > 38 C 
    • Neonatal Jaundice (in term infants)
        - SB > 255 mmol in those < 7 days old
        - SB > 300 mmol in those < 8-14 days old

• Procedures for Direct Ward Referral