Six children died in 2021 after a jumping castle became airborne during an end-of-year event at a school in Devonport, in Tasmania's north.
The incident was the most serious mass casualty event in north-west Tasmania in two decades and has led to protocol changes in the way patients are identified, a coronial inquest has heard.
The inquest, before Coroner Olivia McTaggart, is expected to run for four days this week before resuming in November and February.
The Hillcrest Primary School jumping castle incident preceded an emergency response at a level not seen at a northwest Tasmanian hospital in almost 20 years, a court has heard.
Tasmanian Health Service executive Paula Hyland said the nature of the incident meant some of the impacted children remained unidentified for hours, even as their families waited for news.
Ms Hyland gave evidence on Tuesday morning at the coronial inquest of the events that unfolded nearly five years earlier at the Devonport-area primary school, on December 16.
Students Addison Stewart, Chace Harrison, Jye Sheehan, Jalailah Jayne-Maree Jones, Peter Dodt and Zane Mellor died, and three of their classmates were seriously injured when a wind tossed a jumping castle across their school oval during end-of-year celebrations.
The children were in grades 5 or 6 on the day of the incident.
The inquest, now in its second day, is scheduled to run for four days this week ahead of further hearing blocks in November and February.
Ms Hyland told Coroner Olivia McTaggart the incident preceded a code brown at the Mersey Community Hospital, which is a nationally recognised emergency code for a mass casualty event.