Introduction to Paediatric First Aid
Why first aid knowledge is essential for anyone working with children
Why Paediatric First Aid Matters
Children are naturally curious and active, which means accidents and medical emergencies are common. As a tutor who works closely with children, you may be the first adult on the scene when an emergency occurs.
This course will give you the awareness and confidence to recognise common paediatric emergencies and provide appropriate first aid while waiting for professional medical help.
Course Objectives
By the end of this course, you will be able to:
- Assess an emergency situation safely
- Perform CPR on infants and children (awareness level)
- Manage choking in infants and children
- Recognise and respond to common childhood medical emergencies
- Treat minor injuries including bleeding, burns, and fractures
- Understand when and how to call emergency services
Definitions
Child: 1 year to puberty (approximately 12 years)
These definitions affect the techniques used for CPR and choking management.
The Resuscitation Council UK (RCUK) publishes updated guidelines that form the basis of UK first aid training. The 2025 guidelines are reflected throughout this course.
Assessing an Emergency — DRABC
The systematic approach to any emergency situation
The DRABC Framework
When you encounter any emergency, use the DRABC framework to assess the situation systematically:
- D — Danger
Check for danger to yourself, bystanders, and the casualty. Never put yourself at risk. Remove the danger if safe, or move the casualty away from danger. - R — Response
Check if the casualty is responsive. For a child: speak loudly and clearly, gently tap their shoulders. For an infant: flick the sole of their foot. Never shake an infant. - A — Airway
Open the airway using the head-tilt, chin-lift method. For an infant, use a neutral position (do not over-extend the neck). For a child, tilt the head slightly back. - B — Breathing
Look, listen, and feel for normal breathing for up to 10 seconds. Look for chest movement, listen for breath sounds, and feel for breath on your cheek. - C — Circulation / CPR
If the casualty is not breathing normally, begin CPR immediately and call 999/112.
Calling Emergency Services
When calling 999 or 112, be prepared to give:
- Your name and location (as precise as possible)
- The number you are calling from
- What has happened
- The age of the casualty
- The condition of the casualty (conscious? breathing?)
- Any treatment you are giving
Paediatric CPR
RCUK 2025 guidelines for infant and child resuscitation
CPR for Children (Age 1 to Puberty)
2. Give 5 initial rescue breaths — pinch the nose, seal your mouth over theirs, blow steadily for 1 second watching for chest rise
3. Give 30 chest compressions — use the heel of one hand on the lower half of the breastbone, compress to one-third of the chest depth
4. Continue at a ratio of 30 compressions : 2 rescue breaths
5. Compress at a rate of 100–120 per minute
6. If alone, perform CPR for 1 minute then call 999
CPR for Infants (Under 1 Year)
2. Give 5 initial rescue breaths — seal your mouth over the infant's mouth AND nose, blow gently for 1 second
3. Give 30 chest compressions — use two fingers on the lower half of the breastbone, compress to one-third of the chest depth
4. Continue at 30:2 ratio
5. Rate: 100–120 compressions per minute
Using an AED (Automated External Defibrillator)
If an AED is available, use it as soon as possible. For children under 8 or weighing under 25kg, use paediatric pads if available. If only adult pads are available, use them — do not delay defibrillation. Place the pads front and back on a small child/infant.
Recovery Position & Airway Management
Keeping the airway clear in an unconscious but breathing casualty
When to Use the Recovery Position
Place a casualty in the recovery position when they are unconscious but breathing normally. This keeps the airway open and allows fluids (like vomit) to drain, preventing choking.
Child Recovery Position
- Kneel beside the child. Place their nearest arm at right angles to their body.
- Bring the far arm across their chest and hold the back of their hand against their nearest cheek.
- With your other hand, pull the far knee up so the foot is flat on the floor.
- Keeping their hand against their cheek, pull the far knee towards you to roll them onto their side.
- Tilt the head back to maintain an open airway. Adjust the hand under the cheek if needed.
Infant Recovery Position
For infants under 1 year, hold them in your arms on their side with their head tilted slightly downward. This is sometimes called the "tiger in a tree" position. This prevents the tongue from blocking the airway and allows fluids to drain.
Choking
Managing choking in infants and children
Recognising Choking
Choking occurs when the airway is partially or completely blocked. Signs include: sudden difficulty breathing, inability to cry or speak, clutching at the throat, blue discolouration of the lips, and a silent or high-pitched cough.
Severe choking: The child cannot cough effectively, speak, or breathe. Act immediately using the procedures below.
Child Choking (Over 1 Year)
- Back blows: Lean the child forward. Give up to 5 sharp back blows between the shoulder blades with the heel of your hand.
- Abdominal thrusts: Stand behind the child, place a fist between the navel and ribcage, grasp with the other hand, and pull sharply inwards and upwards. Give up to 5 thrusts.
- Alternate between 5 back blows and 5 abdominal thrusts until the object is dislodged or the child becomes unconscious.
- If the child becomes unconscious, begin CPR and call 999.
Infant Choking (Under 1 Year)
- Back blows: Lay the infant face-down along your forearm (supporting the head). Give up to 5 sharp back blows between the shoulder blades.
- Chest thrusts (NOT abdominal thrusts): Turn the infant face-up. Using two fingers, give up to 5 chest thrusts (similar position to CPR compressions but sharper and slower).
- Alternate between 5 back blows and 5 chest thrusts.
- If the infant becomes unconscious, begin infant CPR and call 999.
Bleeding, Wounds & Shock
Managing bleeding and recognising shock in children
Controlling Bleeding
For external bleeding, apply direct pressure to the wound using a clean pad or dressing. If blood soaks through, add another pad on top — do not remove the first. Elevate the injured area above the heart if possible.
2. Elevate the injured limb above the heart
3. Call 999 if bleeding is severe or won't stop
4. Keep the child warm and still
5. Monitor for signs of shock
Recognising and Treating Shock
Shock occurs when the body's circulatory system fails to supply enough oxygenated blood. In children, signs include: pale, cold, clammy skin; rapid breathing; weakness; thirst; nausea; and eventually loss of consciousness.
Nosebleeds
Sit the child down, lean them forward, and pinch the soft part of the nose firmly for at least 10 minutes. Do not tilt the head back. If the bleeding lasts more than 20 minutes, seek medical help.
Burns & Scalds
Immediate first aid for thermal injuries in children
First Aid for Burns
2. Call 999 for serious burns (larger than the child's palm, on the face/hands/feet/joints, or full-thickness)
3. Remove clothing and jewellery near the burn unless stuck
4. Cover with cling film (loosely, lengthways) or a sterile dressing
5. Keep the child warm (cooling the burn can cause hypothermia in small children)
6. Do NOT apply creams, butter, toothpaste, or burst blisters
Head Injuries & Fractures
Recognising and managing skeletal and head injuries
Head Injuries
All head injuries in children should be taken seriously. Call 999 if the child: loses consciousness (even briefly), has seizures, has clear fluid coming from ears or nose, has unequal pupils, has persistent vomiting, or is increasingly drowsy or confused.
Fractures
Signs of a fracture include: pain, swelling, deformity, loss of movement, and bruising. Do not try to straighten or move the limb. Support and immobilise it in the position found using padding and bandages. Apply ice wrapped in cloth to reduce swelling and call for medical help.
Medical Emergencies
Seizures, anaphylaxis, asthma, diabetes, and meningitis
Febrile Seizures
Common in children aged 6 months to 5 years, triggered by a rapid rise in temperature. Do NOT restrain the child or put anything in their mouth. Clear the area of hazards, note the time, and call 999 if the seizure lasts more than 5 minutes or it is their first seizure. Once it stops, place in the recovery position.
Anaphylaxis
A severe allergic reaction that can be life-threatening. Signs include: swelling of the face/throat, difficulty breathing, rash/hives, dizziness, and collapse.
2. If the child has a prescribed auto-injector (e.g., EpiPen), help them use it — inject into the outer mid-thigh
3. Sit them upright if breathing is difficult, or lay them down with legs raised if they feel faint
4. A second dose can be given after 5 minutes if no improvement
5. Monitor and be prepared to start CPR
Asthma Attack
Help the child sit upright (do not lie them down). Help them use their blue reliever inhaler (ideally through a spacer). Give 1 puff every 30–60 seconds, up to 10 puffs. Call 999 if there is no improvement after 10 puffs, if the child is too breathless to speak, or if their lips turn blue.
Diabetic Emergency
A child with diabetes may experience hypoglycaemia (low blood sugar). Signs include: shakiness, confusion, sweating, pale skin, and irritability. If conscious, give a sugary drink or glucose tablets. If unconscious, do NOT give food or drink — place in recovery position and call 999.
Meningitis
Signs include: high fever, stiff neck, dislike of bright lights, severe headache, a rash that doesn't fade under pressure (glass test), drowsiness, and seizures. Call 999 immediately. Meningitis can progress rapidly and is life-threatening.
Poisoning & Other Injuries
Accidental poisoning, bites, stings, and eye injuries
Poisoning
Children under 5 are most at risk of accidental poisoning from household substances. If you suspect poisoning:
- Call 999 or take the child to A&E
- Try to identify what they took, how much, and when
- Keep a sample of the substance or the container
- Do NOT make the child vomit
- If unconscious, place in the recovery position and monitor breathing
Bites and Stings
For insect stings: remove the sting by scraping with a flat edge (do not use tweezers), wash the area, and apply a cold compress. Call 999 if signs of anaphylaxis develop. For animal bites: wash thoroughly with soap and water, control bleeding, and seek medical advice (risk of infection/tetanus).
Eye Injuries
For chemicals in the eye: irrigate with clean water for at least 20 minutes, tilting the head so water runs away from the unaffected eye. For embedded objects: do NOT remove — pad around the object and seek emergency help.
Recording & Infection Control
Documentation requirements and hygiene practices
Recording First Aid Incidents
All first aid incidents must be recorded. Include: date and time, name and age of the child, what happened, injuries sustained, treatment given, whether parents were contacted, and whether the child was referred to hospital.
Infection Control
When providing first aid, always practise good infection control:
- Wear disposable gloves when dealing with blood or body fluids
- Wash hands thoroughly before and after treatment
- Dispose of contaminated materials safely in clinical waste bags
- Cover any cuts or wounds you have yourself
- Use a face shield for rescue breaths if available
Paediatric First Aid Assessment
You need 80% (12/15) to pass. You have 3 attempt(s) remaining.
Congratulations!
You have completed the Paediatric First Aid Awareness Level 2 course
Your official certificate has been emailed to you and is also available to download below.