Amid political fallout from a two-year-old’s death while awaiting treatment in ED, a study has suggested parental concerns can predict a child’s clinical deterioration better than abnormal vital signs.

Joe Massa waited two-and-a-half hours for a hospital bed before dying at Sydney’s Northern Beaches Hospital last year.

An independent review found that staff ignored his parents’ concerns and multiple requests for IV fluids, prompting the NSW Government to rename its protocols for parents to escalate concerns as Joe’s Rule.

A prospective observational study has now concluded that carer concerns are a stronger predictor of ICU admission than any individual vital sign.