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Children account for nearly one-fourth of all care provided in emergency departments (EDs) in the UK and the USA.1–6 Two issues highlight the differences between children and adults who seek care in ED: first, there are physiological differences between adults and children; and second, the variety of disease and injury patterns seen in children are different from those in adults.7 8 In the USA, it is estimated that children receive their emergency medical care from paediatric emergency medicine physicians (PEMPs) only 23 % of the time4 8 and in separate paediatric EDs (PEDs) only 7 % of the time.2 8 With children receiving the majority of their care in general emergency departments (GEDs), and the minority in PEDs, it is possible that th