The importance of Paediatric First Aid training is something everyone in a childcare setting will likely be aware of, but what exactly does the role of a paediatric first aider involve and what are the responsibilities of an employer?
Working in the childcare sector has many intricacies that those working in other industries likely don’t appreciate. On top of ensuring that children are cared for and educated, there are a host of different guidelines and regulations that need to be adhered to, including those affecting first aid.
If you work alone as a childminder, all these responsibilities will likely sit on your shoulders, which can initially seem overwhelming. Whereas, in larger settings such as nurseries, responsibilities may be split between different people or job roles. However, there are no hard and fast rules, and you need to ensure that whoever is assigned a responsibility for first aid has the appropriate skills to carry out the task.
Fortunately, paediatric first aid requirements are one of the simpler areas to navigate, after all, the Early Years Foundation Stage Statutory Framework provides clear information such as the level and type of training that is needed. But is it as simple as just attending or sending a member of staff on a Paediatric First Aid training course?
Within this blog, we hope to explain the different responsibilities of a paediatric first aider, and where appropriate, the employer’s responsibilities for first aid provision in a childcare setting.
Who is responsible for assessing first aid needs?
It is likely that by reading this blog you have already established you need to be thinking about who needs training in first aid and what equipment you need.
The employers responsibility for first aid will usually include completing the first aid needs assessment, but it is also good practice to consult others throughout the business to make sure decisions are well informed, e.g. a child’s key person may identify a specific health condition that needs to be considered, or a first aider may be able to identify equipment for a first aid kit based on their training and experience in the role.
Don’t forget, once a first aid needs assessment has been completed it will need to be reviewed regularly to make sure it remains up to date. You will also need to make sure you keep people informed about first aid arrangements, so they know how to access help and/or equipment in an emergency.
Does a first aid needs assessment change when working with children?
The Health and Safety (First aid) regulations 1981 (HSFAW) explain that workplaces need to complete a first aid needs assessment to ensure that there is immediate first aid support available if somebody becomes ill or is injured at work.
In addition to the usual workplace requirements, there are paediatric first aid requirements when working with children. These mean you need to also consider the children in your care and the types of injuries or illnesses they may face.
When working with younger children there are minimum standards outlined in the Early Years Foundation Stage Statutory Framework. Not all childcare settings or children are the same, so your needs assessment will need to look at the specific hazards, risks and people in your care to ensure any first aid provision put in place is adequate.
Who is responsible for first aid kit and equipment?
The equipment contained in a first aid kit is usually identified as part of the first aid needs assessment. As explained above, this is usually completed by the employer but ideally informed by others who may have localised knowledge of the children and setting.
First aid kits need to be checked regularly to ensure they are complete and the items within them are in date and undamaged. This is usually the responsibility of a nominated first aider. When something in the first aid kit has been used, whoever used it should also inform them so they can arrange for it to be restocked.
Training records, certificates and expiry
This responsibility is often allocated to a person who would have access to training records, this doesn’t need to be a first aider or an employer specifically.
For an individual to act as a first aider or paediatric first aider they need to hold a valid first aid certificate.
In addition to identifying who needs first aid training, it is important to have a process for monitoring when people’s qualifications expire. First aid at Work, Emergency first aid at work and Paediatric First Aid certificates expire every 3 years.
Details of qualified first aiders must also be easily available; you may choose to display the information in some way or ensure it is made available on request.
Responsibilities when someone is injured or becomes unwell
When a first aid situation involving a child arises, most of the immediate responsibilities sit with the paediatric first aider. These include:
Assessing the situation quickly and calmly.
By assessing the situation quickly and calmly the paediatric first aider is able to determine if it is safe for them and others to be in the environment. For example, children may need to be moved away from the situation to prevent them becoming injured also.
Assessing the situation by looking at the environment and clues within it will help the first aider decide the best way to approach and manage the situation.
Assessing the casualty
The duties of a paediatric first aider include properly assessing the injured person. How they do this will depend on what they know about the situation and what is obvious to them when they approach. For example, if a child is talking or crying then the paediatric first aider can assume they are responsive and breathing. If more than one person is involved the first aider may need to work out whose situation is more serious as they will be higher priority.
Giving first aid
Although probably obvious, the first aider is responsible for carrying out any first aid interventions needed. This can include practical first aid or asking others to help.
Comforting, reassuring, and calming the casualty and others
Although important to comfort and reassure all casualties, it is even more important with children who are likely scared and don’t understand what is happening. The paediatric first aider will need to be aware of the other children in the environment who may also be worried or concerned as they may need reassurance or calming during or after the incident.
Arranging right kind of help
The duties of a paediatric first aider include determining the right kind of help. Most incidents are relatively minor and can be managed locally by a first aider. In some situations you might need to ask a parent to keep an eye on them as they had a bump on the head, or ask them to arrange an assessment by a GP or at a minor injuries unit. For more serious situations it may be necessary to call an ambulance.
First aiders should also try to reduce the risk of infection by wearing suitable protective clothing such as gloves and making sure any fluids such as blood and vomit are cleaned up and/or disposed of safely. Any first aid equipment such as plasters or bandages should be clean and sterile before being applied to a wound.
Accident reporting and record keeping
When working with children it is important that you record and report accidents and incidents appropriately. These records are usually completed by the first aider at the time or shortly after the incident but can be completed by another person so long as they capture accurate information.
We recommend you keep a record of all accidents while the child is in your care (including whilst on outings) with details such as:
- the date, time and place the accident happened,
- personal details of those involved (name, age)
- a brief description of the nature of the accident and/or injury
- details of any treatment given
Both the early years register and the childcare register require a record of accidents to be kept.
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR)
For some types of injury or specific types of incident you may be required to report the incident to RIDDOR or (RIDDOR NI 1997)
Only 'responsible persons' including employers, the self-employed and people in control of work premises should submit reports under RIDDOR. For full details on what type of injuries or situations need to be reported and how visit the HSE RIDDOR pages.
Ofsted and the child protection agency
Ofsted and the child protection agency may also need informing depending on the nature and severity of the incident. For more information visit ‘report a serious childcare incident’ from Gov.uk
It is down to the individual setting to agree on local processes and responsibilities for this.
It is important that the parent or guardian is informed about any injury or incident that occurs involving their child. In some instances this may be a relatively informal discussion, with other injuries you may want them to sign an accident record or similar.
It is down to the individual setting to agree on local processes and responsibilities for this also.
Aftercare and mental health
After a first aid incident it can be useful for employers to revisit what happened and look for opportunities for improvement such as measures to prevent the incident happening again by reducing the risk or removing a hazard. This can be particularly important if the same type of accidents or incidents are happening regularly.
For more serious incidents’ employers may also want to consider if any mental health support is needed for those involved and arrange this as required. Some employers find offering training in mental health and wellbeing can prepare first aiders for challenging situations, enabling them to respond in a more resilient way when they are faced with one.
Responsibilities should be linked to skills not job roles
In summary, there is no fixed set of responsibilities that all first aiders should have. The nature of the role will differ depending on the business and the skills of the individuals within it. When assigning responsibilities you should consider who is the most appropriate person with the right set of skills to complete the task. Those administering first aid must be trained specifically but for many other aspects the employer, or others, may be better placed to take responsibility.
Topics: Paediatric first aid