Addison Stewart, Chace Harrison, Jye Sheehan, Jalailah Jayne-Maree Jones, Peter Dodt and Zane Mellor died after a freak wind gust lifted the castle into the air in December 2021.
An inquest into the primary school students' deaths, which began on Monday, is examining safety procedures and whether there were education department shortcomings or other deficiencies.
Hospitals North West's executive manager on Tuesday detailed the difficulties with keeping families abreast of developments in the hours after the incident.
None of the children who arrived at the Mersey Community Hospital were initially identified, Paula Hyland said.
"It made it difficult to provide the families with up-to-date information on their child as we didn't know which child was which," the health department official said.
Ms Hyland was asked about claims that the mother of Chace, 11, was told he had died while he was still being treated.
"I'm sorry I was not aware of that," she replied.
Georgie Burt, the mother of Zane, told the inquest on Monday she was told to go to the Mersey Community Hospital and later found out her son had died on the school oval.
"As far as I'm aware (he was) deceased at the scene and taken directly to the ... mortuary," Ms Hyland said.
Ms Hyland was unable to say where Jalailah Jayne-Maree was taken in the aftermath of the incident.
A four-hour delay in Jye's family being told he had died was related to problems with identification and a desire to not provide wrong information, Ms Hyland said.
Hospital staff were primarily focused on providing life-saving treatment and identification wasn't a clear priority during those initial stages, Ms Hyland said.
Every possible person at the hospital was involved in helping, including security and administration staff, and the lack of identification didn't impact the treatment provided, she said.
Ms Hyland, however, said the presence of a police officer at the hospital might have helped identify the children and provide intel to loved ones.
Some injuries made identification difficult, with a teacher from the school helping figure out which children were in the hospital, Ms Hyland said.
Changes to record-keeping for patients and around simulation training for emergency events had been made since the tragedy, she said.
The students, all aged 11 or 12, were enjoying end-of-year celebrations when a freak wind gust lifted the castle 16 metres into the air.
Ms Hyland said the tragedy had a lasting impact on health workers in the tight-knit northwest community as many would have known the children or their families.
Delays on the release of the children's bodies were also canvassed after Zane's mum testified she couldn't see his body until three days after the accident.
State forensic pathologist Andrew Reid said autopsies were conducted as quickly as possible and bodies were released to families as quickly as they could be.
The inquest will hold more hearings on Wednesday and Friday before further sittings in November and February, and will also examine related Australian safety standards.
The operator of the jumping castle, Rosemary Gamble, who was cleared of criminal workplace safety breaches in 2025, is also expected to give evidence.
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