Welcome

Welcome to Learning Hive's Paediatric First Aid Awareness course. This CPD-accredited programme has been designed for tutors, educators, and anyone working with children aged 0–16 in education, alternative provision, and childcare settings.

This course aligns with the Resuscitation Council UK (RCUK) 2025 Guidelines, the Health and Safety (First-Aid) Regulations 1981, and Early Years Foundation Stage (EYFS) requirements.

What is Paediatric First Aid?

Paediatric first aid is the immediate care given to an infant (under 1 year) or child (1–16 years) who is injured or becomes suddenly ill. It is not a substitute for professional medical treatment — it is the crucial first response before emergency services arrive.

The Three Aims of First Aid

Legal Requirements

The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate first aid equipment, facilities, and trained personnel. In education and childcare settings, this includes:

• A suitably stocked first aid kit accessible at all times
• An appointed person to take charge of first aid arrangements
• Adequate numbers of trained first aiders based on risk assessment
• All first aid incidents must be recorded in an accident book

Under the EYFS statutory framework, at least one person with a current paediatric first aid certificate must be on the premises and available at all times when children are present.

Knowledge Check

Scene Safety and the Primary Survey

Before approaching any casualty, you must first ensure the scene is safe. Never put yourself at risk — you cannot help if you become a casualty too.

The Primary Survey: DRABC

Use the DRABC approach to assess every emergency systematically:

Checking Response in Children

• Child (over 1 year): Gently tap their shoulders and ask loudly "Can you hear me? Open your eyes!"
• Infant (under 1 year): Flick the sole of their foot gently. Never shake an infant.

Opening the Airway

• Child: Head tilt, chin lift — one hand on the forehead, two fingers under the chin, tilt head back gently
• Infant: Keep the head in a neutral position (not tilted back) — over-extension can close an infant's airway

The Secondary Survey: SAMPLE

Once the primary survey is complete and any life-threatening conditions addressed, use SAMPLE to gather more information:

• S — Signs and Symptoms (what can you see? what do they feel?)
• A — Allergies (any known allergies?)
• M — Medication (are they taking any medication?)
• P — Previous medical history (any relevant conditions?)
• L — Last meal (when did they last eat or drink?)
• E — Events leading up to the incident (what happened?)

Interactive Scenario

When to Start CPR

If a child or infant is unresponsive and not breathing normally, you must start CPR immediately. In children, cardiac arrest is most commonly caused by respiratory failure (lack of oxygen), not a heart problem — this is why rescue breaths are critical.

CPR for a Child (Age 1–16)

1. Give 5 initial rescue breaths — seal your mouth over the child's mouth, pinch their nose, blow steadily for about 1 second watching for chest rise
2. Begin chest compressions — place the heel of one hand on the centre of the chest, compress to one-third of the chest depth
3. Continue at a ratio of 15:2 — 15 compressions to 2 rescue breaths
4. Compress at a rate of 100–120 per minute
5. Call 999 — use hands-free if possible; if alone, give 1 minute of CPR first then call
6. Continue until help arrives, the child starts breathing normally, or you are physically unable to continue

CPR for an Infant (Under 1 Year)

1. Give 5 initial rescue breaths — seal your mouth over the infant's mouth AND nose, blow gently for about 1 second
2. Begin chest compressions using the two-thumb encircling technique — place both thumbs side by side on the lower third of the sternum, encircle the chest with your fingers, press down to one-third of the chest depth
3. Continue at a ratio of 15:2
4. Compress at a rate of 100–120 per minute
5. Call 999 after 1 minute of CPR if alone

Using an AED (Automated External Defibrillator)

RCUK 2025 confirms that AEDs can be used on people of any age, including infants. Most infant cardiac arrests are not in a shockable rhythm, but for those that are, an AED — even an adult-only AED — can be life-saving.

• Children under 8 / under 25kg: Use paediatric pads if available. Place one pad mid-chest (just left of sternum) and one on the back between the shoulder blades
• Children over 8: Use standard adult pads in the standard position
• If only adult pads are available, use them — ensure pads do not touch each other
• Follow the AED voice prompts — it will only deliver a shock if needed

Knowledge Check

When to Use the Recovery Position

Place a child or infant in the recovery position if they are:

• Unconscious but breathing normally
• At risk of choking on vomit or fluids
• Not suspected of having a spinal injury

Recovery Position for a Child (Over 1 Year)

1. Kneel beside the child and ensure their legs are straight
2. Place the arm nearest to you at a right angle to their body, with the palm facing up
3. Bring the far arm across the chest and hold the back of their hand against their cheek nearest to you
4. With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground
5. Keeping their hand pressed against their cheek, pull on the upper leg to roll the child towards you and onto their side
6. Adjust the upper leg so the hip and knee are both bent at right angles
7. Tilt the head back to ensure the airway remains open
8. Monitor breathing continuously until help arrives

Recovery Position for an Infant (Under 1 Year)

Infants should be held in the recovery position in your arms:

1. Cradle the infant in your arms with their head tilted downward
2. This prevents the tongue from blocking the airway and allows fluids to drain
3. Monitor breathing continuously

Quick Quiz

Recognising Choking

Choking occurs when the airway is partially or fully blocked by a foreign object. In children, this is commonly food, small toys, or coins. Choking can escalate rapidly and requires immediate action.

Signs of Choking

• Mild obstruction: Coughing, able to cry or speak, distressed but still breathing
• Severe obstruction: Unable to cough, cry, or breathe; silent; may turn blue (cyanosis); clutching at throat

Choking — Child (Over 1 Year)

If the child can cough effectively: Encourage them to keep coughing. Do not intervene — let them clear it themselves.

If the child cannot cough, speak, or breathe (severe):

1. Give up to 5 back blows — lean the child forward, support their chest with one hand, give up to 5 sharp blows between the shoulder blades with the heel of your hand
2. Check the mouth — if the object is visible and can be easily removed, do so. Never perform a blind finger sweep
3. If back blows fail, give up to 5 abdominal thrusts (Heimlich manoeuvre) — stand behind the child, place a fist between the navel and ribcage, pull sharply inwards and upwards
4. Alternate between 5 back blows and 5 abdominal thrusts
5. If the child becomes unconscious, begin CPR immediately and call 999

Choking — Infant (Under 1 Year)

1. Give up to 5 back blows — lay the infant face down along your forearm (supporting the head), give up to 5 sharp back blows between the shoulder blades
2. Check the mouth — if the object is visible and easily removable, remove it
3. If back blows fail, give up to 5 chest thrusts — turn the infant face up, use the two-thumb encircling technique, give up to 5 sharp chest thrusts (similar to CPR compressions but sharper and slower)
4. Alternate between 5 back blows and 5 chest thrusts
5. If the infant becomes unconscious, begin CPR and call 999

Scenario

Managing Bleeding

Severe Bleeding

1. Wear gloves if available (infection control)
2. Apply direct pressure to the wound using a clean pad or dressing
3. If possible, raise the injured limb above the level of the heart
4. Bandage the pad firmly in place — do NOT remove the original pad if blood soaks through; add more dressings on top
5. Call 999 for any severe bleed
6. Treat for shock (see below)

Nosebleeds

• Sit the child down and lean them forward
• Pinch the soft part of the nose firmly for 10 minutes
• Do NOT tilt the head back — this can cause blood to run down the throat
• After 10 minutes, release the pressure. If bleeding continues, reapply for another 10 minutes
• Seek medical help if bleeding continues after 30 minutes

Embedded Objects

Never remove an embedded object. Apply pressure around (not on) the object, build up padding either side, and bandage over the padding without pressing on the object. Call 999.

Recognising Shock

Shock is a life-threatening condition where the circulatory system fails to deliver enough blood to the body's organs. In children, it can develop rapidly after significant bleeding, burns, severe allergic reactions, or serious infections.

Signs of Shock in Children

• Pale, cold, clammy skin (may be grey or blue in darker skin tones)
• Rapid, weak pulse
• Fast, shallow breathing
• Dizziness, weakness, or confusion
• Nausea or vomiting
• In infants: unusually quiet, floppy, poor feeding

Treatment for Shock

1. Call 999 immediately
2. Lay the child down and raise their legs (if no suspected fracture)
3. Keep them warm with a blanket or coat — do NOT overheat
4. Do NOT give food or drink
5. Reassure the child and monitor their breathing continuously
6. Be prepared to begin CPR if they become unresponsive

Burns and Scalds

Burns and scalds are among the most common injuries in children. Scalds from hot liquids account for the majority of paediatric burn injuries.

Treatment — Cool, Call, Cover

1. Cool — cool the burn under cool running water for at least 20 minutes. Do NOT use ice, iced water, creams, butter, or toothpaste
2. Call — call 999 for any burn larger than the child's palm, any burn on the face, hands, feet, or genitals, any full-thickness burn, any chemical or electrical burn, or any burn in a child under 5
3. Cover — after cooling, cover the burn loosely with cling film (lengthways, not wrapped around) or a clean, non-fluffy dressing

Chemical Burns

If caused by a chemical: wear gloves, brush off any dry chemical, then flush with running water for at least 20 minutes. Remove contaminated clothing carefully. Call 999.

Electrical Burns

If caused by electricity: do NOT touch the child until the power source is disconnected. Call 999. There may be internal injuries not visible externally. Treat any visible burns as above.

Knowledge Check

Head Injuries

Head injuries are common in children and must always be taken seriously. Even a seemingly minor bump can cause significant harm.

When to Call 999

• Loss of consciousness (even briefly)
• Persistent vomiting
• Seizures
• Clear fluid or blood leaking from the ear or nose
• Unequal pupil sizes
• Increasing drowsiness or difficulty staying awake
• Worsening headache that doesn't respond to paracetamol
• Unusual behaviour or confusion

Fractures, Sprains & Dislocations

Signs of a Fracture

• Pain at or near the site of injury
• Swelling, bruising, or deformity
• Difficulty moving the affected area
• A grating sensation or sound (crepitus)
• In open fractures: bone visible through the skin

Treatment

• Do NOT attempt to straighten or realign a broken bone
• Immobilise the injury — support the limb in the position found
• Apply a cold pack wrapped in cloth to reduce swelling
• For open fractures: cover the wound with a sterile dressing, build padding around the bone, and call 999
• Treat for shock if needed

Spinal Injuries

If you suspect a spinal injury (e.g. after a fall from height, diving accident, or significant impact):

• Do NOT move the child unless in immediate danger
• Keep the head, neck, and spine aligned
• Place your hands either side of the head to stabilise it
• Call 999 immediately
• Monitor breathing and be prepared to begin CPR if needed

Seizures (Including Febrile Convulsions)

Seizures in children can be caused by epilepsy, head injury, high fever (febrile convulsions), poisoning, or other medical conditions.

What to Do During a Seizure

• Protect the child from injury — clear the area around them
• Do NOT restrain them or put anything in their mouth
• Note the time the seizure started
• Once the seizure stops, place them in the recovery position
• Call 999 if: this is their first seizure, it lasts more than 5 minutes, they don't regain consciousness, they have repeated seizures, or they are injured

Febrile Convulsions

These are seizures triggered by a high temperature, most common in children aged 6 months to 5 years. After the seizure, help cool the child gradually by removing excess clothing. Do NOT sponge with cold water. Seek medical advice.

Anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction. Common triggers in children include food (nuts, eggs, milk), insect stings, and medications.

Signs of Anaphylaxis

• Difficulty breathing, wheezing, or stridor
• Swelling of the face, throat, or tongue
• Skin rash, flushing, or hives
• Abdominal pain, nausea, or vomiting
• Feeling faint, dizzy, or collapsing

Treatment

1. Call 999 immediately — say "anaphylaxis"
2. If the child has a prescribed adrenaline auto-injector (EpiPen / Jext), help them use it immediately — inject into the outer mid-thigh
3. Help the child into a comfortable position — sit them up if breathing is difficult, lay them down if feeling faint
4. A second auto-injector can be given after 5 minutes if no improvement
5. Monitor continuously — be prepared to begin CPR

Asthma Attacks

• Help the child sit upright (do NOT lay them down)
• Help them use their blue reliever inhaler — 1 puff every 30–60 seconds, up to 10 puffs
• Call 999 if: the inhaler has no effect, symptoms worsen, the child is too breathless to talk, or they become exhausted

Meningitis & Sepsis

Meningitis and sepsis are medical emergencies that can develop rapidly in children.

Key Warning Signs

• High temperature with cold hands and feet
• Non-blanching rash (glass test — press a glass tumbler against the rash; if it doesn't fade, call 999)
• Stiff neck, dislike of bright lights
• Severe headache, drowsiness, confusion
• In infants: bulging fontanelle (soft spot), high-pitched cry, floppy/unresponsive

Diabetic Emergencies

Low Blood Sugar (Hypoglycaemia)

Signs: shaking, sweating, confusion, dizziness, hunger, irritability, pale skin

Treatment: If conscious, give a fast-acting sugar source (glucose tablets, fruit juice, sugary drink). Follow with a slow-release carbohydrate (sandwich, cereal bar). If unconscious, do NOT give food/drink — place in recovery position and call 999.

Poisoning

Children are naturally curious and may ingest harmful substances including medications, household chemicals, plants, or berries.

What to Do

• Call 999 or the National Poisons Information Service if you suspect poisoning
• Try to identify what was taken, how much, and when
• Do NOT make the child vomit
• If the substance is corrosive, do NOT give anything to drink
• Keep any containers, bottles, or samples of the substance to show paramedics
• If the child becomes unconscious, place in the recovery position and monitor breathing

Allergic Reactions

Mild allergic reactions (localised rash, itching, minor swelling) can usually be managed with antihistamines (if available and age-appropriate). Monitor for any escalation to anaphylaxis (see Module 9).

Eye Injuries

• Foreign object: Rinse the eye with clean water or saline. Do NOT rub the eye or try to remove embedded objects
• Chemical splash: Flush the eye with clean running water for at least 20 minutes, holding the eyelids open. Call 999
• Blow to the eye: Apply a cold compress. If vision is affected, seek immediate medical attention

Hypothermia

Children lose body heat faster than adults. Signs include shivering (which may stop in severe cases), pale/blue skin, slurred speech, drowsiness.

Treatment: Move the child to shelter, remove wet clothing, wrap in warm dry layers and blankets. Give warm drinks if conscious. Call 999 if severe. Do NOT rub their skin or use direct heat (hot water bottles against skin).

Recording First Aid Incidents

Every first aid incident must be recorded accurately. This is a legal requirement under the Health and Safety (First-Aid) Regulations 1981 and the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013.

What to Record

• Date, time, and location of the incident
• Name, age, and details of the child
• Nature of the injury or illness
• Treatment given and by whom
• Whether emergency services were called
• Whether parents/carers were informed
• Details of any witnesses
• Signature of the first aider and date

Infection Control

When delivering first aid, you must protect yourself and the child from infection:

• Wear disposable gloves whenever dealing with blood or bodily fluids
• Cover any cuts or wounds on your own hands
• Wash hands thoroughly before and after giving first aid
• Dispose of contaminated materials in clinical waste bags
• Clean any blood spills with appropriate disinfectant
• Use a face shield or pocket mask for rescue breaths where available

First Aid Kit Contents

A paediatric first aid kit should include:

• Disposable gloves (various sizes)
• Sterile wound dressings (various sizes)
• Triangular bandages
• Adhesive plasters (hypoallergenic, various sizes)
• Sterile eye pads
• Conforming bandages
• Safety pins, adhesive tape, scissors
• Resuscitation face shield
• Foil blanket
• Clinical waste bags
• Accident report book

Generate Your CPD Certificate

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Important Notice