What does LIONS do?
LIONS is a group of nurses who work alongside ward staff to prevent and manage patient deterioration. This includes averting critical care admissions, facilitating appropriate and timely admissions to Paediatric Intensive Care Unit (PICU) where required and providing support following discharge from critical care. The team also attend emergency calls within Leeds Children’s hospital.
The service is designed to support patients and their families, nursing staff, medical teams and other members of the multidisciplinary team across Leeds Children’s Hospital. Anyone can refer to the service whether for advice, patient reviews or support. Please see Information for Healthcare Professionals and Information for Families for more details on the referral process including when and how to refer.
Meet the LIONS team
Leeds Inpatient Outreach Nursing Service is a team of six nurses from a variety of backgrounds. Leanne Lane is the Lead Nurse for the service.
There will usually be one nurse on per shift, however, the service runs 24 hours a day, 7 days of the week. The team can be contacted and referrals made at any time day or night.
Information for families
Leeds Inpatient Outreach Nursing Service is available for support or advice if you are concerned your child may be deteriorating. Please note this service is only available if your child is currently an inpatient on one of our wards within Leeds Children’s Hospital.
The team work closely with the nursing and medical teams and will liaise with the specific team who are caring for your child.
It is important that patients and their families feel supported and listened to during their time here at Leeds Children’s Hospital. The team accept referrals direct from families. If you are concerned your child is becoming more unwell you can request a discussion and review from one of the LIONS nurses. Please ask the ward nurse looking after your child and they will contact the team to request this support.
Another role of LIONS is to provide additional support for patients who are discharged from critical care. If your child has transitioned from PICU to a ward, one of the team will visit your child within the first 24 hours after discharge from PICU.
We’d love to hear from you…
Feedback helps us shape our service to the needs of both staff and our patients across Leeds Children’s Hospital. We actively welcome any feedback or comments from colleagues, patients and families.
Email the LIONS: [email protected]
Information for Healthcare professionals
Leeds Inpatient Outpatients Nursing Service is available for patient reviews, nursing advice, support with specific patient needs, and liaison with critical care.
Below are the referral criteria for the service. If the patient you are caring for meets any of the following criteria then a referral should be made as soon as possible.
If your patient has any of the following please contact the LIONS.
20 to 60 Minute Acute Action Referral Criteria
Referral to LIONS does NOT override emergency calls. If you have a life threatening concern about a child call 2222.
Patient Scoring PAWS >7 + clinical concerns
Patient Scoring PAWS of 3 in any domain + clinical concern
Patient Scoring PAWS > 10 warrants urgent medical review
(DO NOT FORGET BP) and call on-call registrar
Respiratory
Patient has increase in high flow requirements to maximum for their age + more than 60% oxygen requirement
Patient has increased work of breathing and episodes of desaturation below 88% despite oxygen therapy
Patients commencing High Flow Therapy for clinical deterioration
Patient has stridor with increased work of breathing and episodes of desaturation below 88% despite oxygen therapy
Patient has stridor with increased work of breathing +/- any airway compromise
Patients requiring IV aminophylline/IV salbutamol in a ward environment
Heart rate
Patient has persistent heart rate outside the acceptable range for their age after initial interventions
| Term – 11 months | <65mmhg |
| 1-2 years | <70mmhg |
| 2-3 years | <75mmhg |
| 4-7 years | <80mmhg |
| 8-12 years | <85mmhg |
| 13-16 years | <90mmhg |
General
Following criteria after initial intervention for eg. (20ml/kg fluid, High Flow)
Patient has pH <7.3
Patient has pCO2 >6 on gas if not normal for them
Patient has base deficit >-7 on the gas if not normal for them
Patient has lactate >3 on the gas eg. after fluid bolus
Patient has not passed urine for >6 hours
Patient GCS <12 or patient is confused or drowsy
Patient with prolonged seizures