Paediatric first aid differs from adult first aid because children’s bodies are still developing and experience injuries differently. Children depend on the adults around them to step in when something goes wrong. Whether you are a new parent, an expecting parent, a babysitter, a grandparent, or someone who works with children in any capacity, the first moments after an accident belong to you.
The Emergencies and Common Injuries Most Likely to Happen on Your Watch
Children are admitted to hospital for injury at higher rates than any other age group in Australia. Some of the most common childhood injuries requiring paediatric first aid are:
Falls are the leading cause of childhood injury hospitalisation in Australia, accounting for one in three cases. While most are only minor, falls that injure the head or neck require quick, professional treatment.
Burns and scalds are a particular risk for toddlers. Contact with hot drinks, food, and cooking liquids, often from tables and stovetops that sit at toddler head height, are among the leading injuries in children aged 1 to 4.
Choking is a significant risk for children under 3 years old, whose airways are narrow and who explore their environment by putting objects in their mouths. Any object smaller than a 20-cent coin can block a young child’s airway.
Severe allergic reactions can happen to anyone, but for a child an anaphylactic attack might be how you first discover they have an allergy.
When a Child Is Choking
Paediatric first aid for choking requires you to make two assessments before you act: whether the child can still cough forcefully, and how old they are. The first tells you whether to intervene at all. The second tells you how.
If the child is coughing strongly and can breathe, encourage them to keep coughing. If they become unable to keep coughing, deliver firm back blows to try and help dislodge the obstruction in their windpipe.
If the cough is weak, the child cannot breathe, or they have gone silent, call 000, or have someone nearby call while you take the following action.
The main difference in age is to do with how you position the child while helping them. For an infant under 1 year old, hold them face-down along your forearm or lap with their head lower than their body and their head firmly supported. For older children, have them lean forward with their hands on their knees, or sit them down and lean them forward. Do not slap a choking child on the back while they are upright as gravity can drive the blockage further down their airway.
From there, the steps are the largely same:
- Deliver up to 5 firm back blows between the shoulder blades using the heel of your hand. Check the mouth after each blow and remove any visible object.
- If the blockage remains, reposition the child. For an infant, turn them face-up while keeping their head lower than their body. For a child over 1 year, place one hand on their chest for support and use the heel of your other hand on the lower half of the breastbone.
- Deliver up to 5 short, sharp chest thrusts. Check the mouth after each thrust.
- Continue alternating 5 back blows with 5 chest thrusts until the object clears or emergency help arrives.
- If the child loses consciousness and is not breathing normally, begin CPR immediately.
Dealing With Burns and Scalds at Home
Burns can range from superficial to severe, but all burns can cause lasting damage. Before treating any burn, make sure the heat source has been removed and there is no further risk to you or the child. If the burn involves the child’s face, hands, feet, genitals, or airway or it appears to cover more than 10% of their body, call 000 immediately before beginning paediatric first aid.
- Remove any clothing or jewellery from near the burn. If the clothing has burned into the skin, leave it and work around it.
- Run cool water over the burned area continuously for 20 minutes.
- After cooling, cover the burn loosely with plastic cling wrap or a clean, non-fluffy cloth. Wrap firmly but not tightly.
- All burns should be assessed by a doctor after delivering paediatric first aid.
Ignore the common myths. Do not apply ice, iced water, butter, oil, toothpaste, flour, lotions, or ointment to a burn, and do not break any blisters.
Recognising a Severe Allergic Reaction
Anaphylaxis is the most severe form of allergic reaction and can become life-threatening within minutes. A paediatric first aid response begins with recognising the signs, which can include a combination of the following:
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing, wheeze, or a persistent cough
- A hoarse or changed voice
- Pale skin
- Going limp
- Hives or widespread flushing
- Dizziness or sudden collapse
- Abdominal pain and vomiting
What to do:
- Lay the child flat and do not allow them to stand or walk. If they are unconscious, place them on their side. If they’re struggling to breathe they can sit with their legs stretched out flat.
- If the child has an adrenaline autoinjector prescribed to them, use it now. Form a firm fist around the device and pull off the blue safety release. Place the orange end against the outer mid-thigh, either through clothing or directly on bare skin, at a 90-degree angle. Push down hard until you hear or feel a click and hold it in place for 3 seconds then remove the device.
- Call 000 immediately after.
- If there is no improvement after 5 minutes and a second device is available, administer a second dose.
- If the child becomes unresponsive and is not breathing normally, begin CPR.
If the child also has asthma, give the adrenaline first before any asthma medication. Do not give antihistamines as a first response to anaphylaxis.
A child who has experienced anaphylaxis needs medical assessment even when the adrenaline appears to have resolved the symptoms, as a second wave of the reaction can occur hours later.
Performing Cardiopulmonary Resuscitation (CPR) on an Infant, Toddler, Baby, and Child
CPR is a combination of chest compressions and rescue breaths that keeps blood moving through the body when a child has stopped breathing normally or their heart has stopped. Work through the DRSABCD steps below before moving to the age-specific compressions.
D (Danger): Check that the area is safe for you and the child before approaching. Never put yourself in danger to help someone else.
R (Response): Firmly tap the child and call their name to see if they are conscious and can react.
S (Send for help): Call 000, or have someone nearby call while you stay with the child.
A (Airway): Open the child’s mouth to check for obstructions such as food, teeth or vomit, and use two fingers to clear away anything you can see. Never perform a blind sweep as this can push unseen blockages even deeper.
B (Breathing): Quickly look, listen, and feel for signs of regular breathing. If the child is not breathing normally, begin CPR.
C (CPR): Begin CPR. For children over the age of one month, the technique is the same as it is for adults. Deliver 30 chest compressions followed by 2 rescue breaths. You can learn and practice the technique through CPR courses.
For infants under 12 months the technique is different. Chest compressions should be delivered using two fingers instead of a whole palm, and should be apprcoimately 4cm deep instead of 5cm. An infant will not need a head tilt for rescue breaths due to their still developing airways.
Continue CPR until the child recovers, help arrives to take over, or you are physically unable to continue.
D (Defibrillation): When someone’s heart has stopped beating correctly, you’ll need to use an automated external defibrillator (AED) in between cycles of chest compressions and rescue breaths to deliver a shock to restore their normal heart beat. For children under 1 year old, an AED should not be used by anyone other than a medical professional with the specific training to adjust the shock level.
Get Life-Saving Paediatric First Aid Training
There are countless ways children can get hurt, and paediatric first aid covers them all. If you’re a parent, teacher, babysitter, guardian, carer, family member, or anyone who spends time around children, then paediatric first aid can help save a life. HLTAID012 training is designed for teachers and educators of young children, but it can help anyone no matter the role that they play in a child’s life.
FAQs
What Items Should Be in a First Aid Kit?
A first aid kit should include bandages, sterile gauze pads, medical tape, disposable gloves, an instant cold pack, scissors, tweezers, saline solution, and a digital thermometer.
How Is HLTAID012 Different from a Standard First Aid Course?
HLTAID012 Provide First Aid in an Education and Care Setting is the nationally recognised qualification for people working in regulated childcare, preschool, and school environments. It builds on HLTAID011 Provide First Aid by adding child-specific content, including the legal obligations of education and care staff during emergencies.
Can I Get CPR Training Separately?
Yes. HLTAID009 Provide Cardiopulmonary Resuscitation is a standalone unit that covers CPR for adults, children, and infants. Unlike first aid courses which should be renewed every three years, CPR training should be refreshed annually.
