Crash Team Response: Paediatric & Paediatric Trauma 2222 Calls to Leeds General Infirmary - Emergency Department

Publication: 29/01/2014  --
Last review: 04/04/2017  
Next review: 04/04/2020  
Standard Operating Procedure
ID: 3664 
Approved By: Trust Clinical Guidelines Group 
Copyright© Leeds Teaching Hospitals NHS Trust 2017  


This Standard Operating Procedure is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Crash Team Response: Paediatric & Paediatric Trauma 2222 Calls to Leeds General Infirmary - Emergency Department

Background and indications for standard operating procedure

Given the unique skill base of multidisciplinary healthcare professionals present 24/7 within the Leeds General Infirmary (LGI) Emergency Department (ED), All members of the Paediatric and Paediatric Trauma team may not be required to deal with a 2222 event in the department. Due to space available within the ED Paediatric Resuscitation area, it is essential that (with the exception of Paediatric Consultants) Only individuals carrying a paediatric crash bleep attend the department when a 2222 call is placed. No one else is to accompany these staff; as potentially this may lead to an unsafe situation/impact on care provided.
In order to ensure optimal event management, the existing process has been reviewed to ensure a clear process is in place that ensures key team members with appropriate knowledge, training & skill sets are present/rapidly identified. The process will also minimize additional Health care professionals present. Factors which directly contribute to enhancing effective team working and communication during medical emergencies.

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Procedure method (step by step)

The procedure method is as follows:

  1. Only the individuals carrying a Paediatric Crash Bleep are to attend a crash call in the Emergency Department Resuscitation area. No other staff, in whatever capacity, other than Paediatric Consultant, is to accompany the crash bleep holder.

  2. A Team Leader Role (most appropriate skills) must be established. On occasion due to skill set/events the Team Leader role may need to alter/be reassigned.

  3. The designated Team Leader must ensure the ‘Team Lead’ sticker is worn and clearly visible at all times.

  4. The Team Leader must ensure that there is appropriate Anaesthetic support available to manage ‘airway’. On occasion this may mean that a second crash call is placed for ‘Paed Anaesthetist SPR only’. Anaesthesia must respond, if they are unable to attend they must call a colleague to attend STAT, if necessary contact Consultant Anaesthetist.
    The PICU Fellow may also need senior PICU Consultant support.

  5. The Team Leader is responsible for assigning clear roles (appropriate to skill set and knowledge) to all identified/required team members.

  6. No Staff must enter the Paediatric Resuscitation Bay without appropriate large print sticky label - clearly identifying allocated team role. (E.g. Anaesthetist, ED/PAED/PICU Doctor/Nurse, Vascular, Surgeon. Orthopaedic)

  7. Any nursing or medical staff NOT assigned a role MUST make sure they stand clear of the paediatric resuscitation bay. The Team Leader will inform team members not required to return to their place of work and leave the department.

  8. All Staff involved must log their name, position, bleep number, arrival & departure time prior to departing. This must be legible. Standard ED ‘2222 attendance documentation’ must be available.

  9. Current Paediatric Resuscitation Council UK (RCUK) Resuscitation Guidelines should be followed. LTHT ‘Paediatric Emergency Red Files’ with standardized emergency information, algorithms & clinical guidelines must be available in each Paediatric Resuscitation Bay/be accessed via LTHT Intranet

  10. SBARR is the preferred method of communication to be used.

  11. Team Members must ensure all communication is directed via the Team Leader.

  12. As soon as possible an appropriate person should be identified by the Team Leader to time, record and document all A-E actions & events occurring Additional documentation by team members after the resuscitation/medical emergency event should add value to the notes.

  13. Post event the Team Leader must ensure that the 2222 event is clearly and fully documented in the medical notes using the standard RCUK A-E format. All specialist medical reviews/procedures undertaken (anaesthetic/surgical /orthopaedic must be documented by that individual.

  14. The Paediatric Resuscitation Officer/Resuscitation Service will liaise with staff, audit & monitor performance either at the event or retrospectively within 24 hours.

  15. Wherever possible immediate team debrief must occur. The Resuscitation Service are available to support the debrief process post event.

  16. The Paediatric Resuscitation Officer/Resuscitation Service will monitor compliance. 2222 Event Feedback will be provided quarterly via monthly Paediatric ED meetings. Any compliance issues should be discussed with appropriate Paediatric/ED line manager & or the Lead Paediatric Resuscitation Officer ASAP.


Record: 3664
  • To standardize crash team member response to both Paediatric Medical Emergency and Paediatric Trauma 2222 Calls in the Emergency Department Resuscitation Area at Leeds General Infirmary.
  • To promote effective multidisciplinary health professional medical emergency communication, decision making and team leadership
  • To optimize morbidity and mortality at paediatric medical emergencies within this arena.
Clinical condition:

Infants and children in LGI ED Resuscitation Area

Target patient group: Infants and children in LGI ED Resuscitation Area where a
2222 crash call is initiated.
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Adapted from:

Evidence base

RCUK 2015 Guideline

Department of Health (2008) Competencies for Recognising and Responding to Acutely Ill Patients in Hospital. Crown, London.

National Institute for health and Clinical Excellence (2007) Acutely Ill Patient in Hospital; recognition of and response to acute illness in adults in hospital.  Crown, London.

National Patient Safety Agency (2005) Safer care for the acutely ill patient: learning from serious incidents. Crown, London.

Brannick MT, Prince A, Prince C, Salas E. The measurement of team process. Hum Factors. 1995: 37(3): 641-651

Gaba DM. (2004) The future vision of simulation in healthcare. Quality and Safety in Health  Care. 13 (Suppl 1): i2-i10

Evidence Levels:
A. Expert consensus.
B. Leads consensus.

Approved By

Trust Clinical Guidelines Group

Document history

LHP version 1.0

Related information

Not supplied

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