One of the most important aspects of care for children in emergency departments (EDs) is the initial assessment of their conditions and circumstances. Paediatric nurses, or other nurses who have had adequate training and skills in the care of children and younger people, should use the appropriate tools to undertake these assessments so that they can identify and manage children's physical, mental or social problems. This article discusses the use of such tools in the initial assessments of children at Ipswich Hospital NHS Trust ED, and how this use has improved practice while raising the profile of paediatric emergency care.