Learning Cubs — Paediatric First Aid Awareness Level 2

Module 1 of 11

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.

🔑 Key Point This is an awareness course. It does not replace practical, hands-on first aid training. You are strongly encouraged to attend a face-to-face Paediatric First Aid course for full certification.

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

📖 Age Definitions in Paediatric First Aid Infant: Under 1 year old
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.

💡 Knowledge Check

In paediatric first aid, at what age is a person classified as an 'infant'?

Under 6 months

Under 1 year old

Under 2 years old

Under 5 years old

✅ Correct! An infant is classified as under 1 year old. Different CPR techniques apply to infants vs children.

❌ An infant is under 1 year old in paediatric first aid definitions.

Module 2 of 11

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

⚠️ Important If you are alone with an unresponsive child or infant, perform CPR for 1 minute before calling 999. This is different from adult first aid where you call 999 first. Children's cardiac arrests are usually caused by breathing problems, so early rescue breaths are critical.

💡 Knowledge Check

What does the 'R' in DRABC stand for?

Recovery

Resuscitation

Response

Respiration

✅ Correct! R stands for Response — check if the casualty is responsive.

❌ R stands for Response — checking whether the casualty responds to you.

Module 3 of 11

Paediatric CPR

RCUK 2025 guidelines for infant and child resuscitation

CPR for Children (Age 1 to Puberty)

🫀 Child CPR Procedure (RCUK 2025) 1. Open the airway (head-tilt, chin-lift)
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)

🫀 Infant CPR Procedure (RCUK 2025) 1. Open the airway in a neutral position (do NOT over-extend)
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.

🔑 Key Point The ratio of compressions to breaths for paediatric CPR is 30:2 for single rescuers. Always start with 5 rescue breaths before compressions.

💡 Knowledge Check

How many initial rescue breaths should you give before starting chest compressions on a child?

5

2

3

10

✅ Correct! Give 5 initial rescue breaths before starting compressions.

❌ You should give 5 initial rescue breaths before starting chest compressions.

Module 4 of 11

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.

💡 Knowledge Check

When should you place a child in the recovery position?

When they are conscious and breathing

When they are unconscious but breathing normally

When they are not breathing

When they have a broken arm

✅ Correct! The recovery position is for casualties who are unconscious but breathing normally.

❌ The recovery position is used when a casualty is unconscious but breathing normally.

Module 5 of 11

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.

⚠️ Mild vs Severe Choking Mild choking: The child can still cough, speak, or cry. Encourage them to cough — do not interfere.
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.

❗ Never use abdominal thrusts on an infant Abdominal thrusts can damage internal organs in infants. Use chest thrusts instead.

💡 Knowledge Check

What technique should you use for a choking infant instead of abdominal thrusts?

Finger sweeps

Abdominal thrusts but more gently

Chest thrusts

Heimlich manoeuvre

✅ Correct! Use chest thrusts for infants — never abdominal thrusts.

❌ For infants, use chest thrusts instead of abdominal thrusts to avoid organ damage.

Module 6 of 11

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.

🩹 Severe Bleeding Steps 1. Apply firm direct pressure with a sterile dressing or clean cloth
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.

⚠️ Treating Shock Lay the child down and raise their legs (unless a fracture prevents this). Keep them warm with a blanket. Do NOT give them anything to eat or drink. Call 999 and monitor constantly.

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.

💡 Knowledge Check

If blood soaks through the first dressing on a wound, what should you do?

Add another dressing on top of the first one

Remove the first dressing and apply a new one

Apply a tourniquet immediately

Clean the wound thoroughly first

✅ Correct! Never remove the first dressing — add another on top and continue applying pressure.

❌ You should add another dressing on top — removing the first could disturb clotting.

Module 7 of 11

Burns & Scalds

Immediate first aid for thermal injuries in children

First Aid for Burns

🔥 Burns Treatment 1. Cool the burn under cool running water for at least 20 minutes (not ice or iced water)
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

⚠️ Chemical Burns For chemical burns, brush off any dry chemicals first, then flood with water for at least 20 minutes. Wear gloves if possible to protect yourself.

💡 Knowledge Check

How long should you cool a burn under running water?

5 minutes

10 minutes

15 minutes

At least 20 minutes

✅ Correct! Cool burns under running water for at least 20 minutes.

❌ Burns should be cooled under running water for at least 20 minutes.

Module 8 of 11

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.

⚠️ Concussion Red Flags After any head injury, watch for: worsening headache, repeated vomiting, confusion, unusual behaviour, difficulty staying awake, or weakness on one side. Seek immediate medical attention.

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.

💡 Open vs Closed Fractures An open fracture (bone piercing the skin) requires covering the wound with a sterile dressing without pressing on the bone, and calling 999 immediately. Treat for shock and bleeding.

💡 Knowledge Check

A child falls and you suspect a broken arm. What should you do first?

Try to straighten the arm gently

Support and immobilise the arm in the position found

Apply a splint tightly

Ask the child to move their fingers to test for breaks

✅ Correct! Support and immobilise in the position found — never try to straighten a fracture.

❌ Always support and immobilise a suspected fracture in the position found.

Module 9 of 11

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.

💉 Anaphylaxis Treatment 1. Call 999 immediately
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.

❗ The Glass Test Press the side of a clear glass firmly against the rash. If the rash does not fade under pressure, it may indicate meningitis or septicaemia. Call 999 immediately. Note: the rash may not be present in early stages.

💡 Knowledge Check

Where should an adrenaline auto-injector (EpiPen) be administered?

Upper arm

Buttock

Outer mid-thigh

Abdomen

✅ Correct! Auto-injectors should be administered into the outer mid-thigh.

❌ An auto-injector should be administered into the outer mid-thigh.

Module 10 of 11

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.

💡 Knowledge Check

A child has swallowed a household cleaning product. What should you NOT do?

Call 999

Keep a sample of the substance

Monitor their breathing

Make the child vomit

✅ Correct! Never induce vomiting — it can cause further damage, especially with corrosive substances.

❌ You should never make a child vomit after poisoning as it can cause further damage.

Module 11 of 11

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.

🔑 RIDDOR Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), certain serious incidents must be reported to the Health and Safety Executive (HSE).

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

💡 Knowledge Check

What should you always wear when dealing with blood?

Disposable gloves

A face mask

A full apron

Safety goggles

✅ Correct! Always wear disposable gloves when dealing with blood or body fluids.

❌ You should always wear disposable gloves when dealing with blood or body fluids.

Final Assessment

Paediatric First Aid Assessment

You need 80% (12/15) to pass. You have 3 attempt(s) remaining.

🎓 Complete

Congratulations!

You have completed the Paediatric First Aid Awareness Level 2 course

Learning Cubs

Confirmation of Completion

—

Paediatric First Aid Awareness — Level 2

Certificate No.—

Date—

Valid Until—

Score—

Your official certificate has been emailed to you and is also available to download below.