Paediatric first aid training is a subject area full of hearsay and confusion. This is fully understandable as syllabi and approvals have been pushed from pillar to post. Here are just a few items that often cause confusion.
From EYFS guide the criteria for effective paediatric first aid training is as follows:
In order to meet the requirements of the EYFS, paediatric first aid courses must be approved by the local authority in whose area the early years provision is located, and must meet the following criteria:
1 Training is designed for workers caring for children in the absence of their parents.
2 The training leading to a certificate or a renewal certificate is a minimum of 12 hours.
3 The first aid certificate should be renewed every three years.
4 Resuscitation and other equipment includes baby and junior models, as appropriate.
5 Training covers appropriate contents of a first aid box.
6 Training should include recording accidents and incidents.
7 Training should be appropriate to the age of the children being cared for.
8 The course covers the following areas:
8.1 Planning for first aid emergencies.
8.2 Dealing with emergencies.
8.3 Resuscitation procedures appropriate to the age of children being cared for.
8.4 Recognising and dealing with shock.
8.5 Recognising and responding appropriately to anaphylactic shock.
8.6 Recognising and responding appropriately to electric shock.
8.7 Recognising and responding appropriately to bleeding.
8.8 Responding appropriately to burns and scalds.
8.9 Responding appropriately to choking.
8.10 Responding appropriately to suspected fractures.
8.11 Responding appropriately to head, neck and back injuries.
8.12 Recognising and responding appropriately to cases of poisoning.
8.13 Responding appropriately to foreign bodies in eyes, ears and noses.
8.14 Responding appropriately to eye injuries.
8.15 Responding appropriately to bites and stings.
8.16 Responding appropriately to the effects of extreme heat and cold.
8.17 Responding appropriately to febrile convulsions.
8.18 Recognising and responding appropriately to the emergency needs of children with chronic medical conditions, including epilepsy, asthma, sickle cell anaemia, diabetes.
8.19 Recognising and responding appropriately to meningitis and other serious sudden illnesses.
Also Training should also take account of any guidance on first aid for schools issued by the DCSF.
First aid relating to the Childcare Register is contained in Annex A, this gives more detailed instruction on requirements, certificates etc. than the EYFS giude.
Childcare Register - Annex A. First aid guidance
It is important that childcare provision is safe. Providers must have measures in place to prevent and minimise injuries to children and take precautions to avoid infection. Regulations for the Childcare Register require the childminder or home childcarer to have an appropriate first aid qualification.
Registered providers of childcare on domestic or non-domestic premises must ensure that at least one person caring for children has an appropriate first aid qualification. First aid provision must be available at all times that children are cared for either on the childcare premises or off the premises on visits and outings. The registered provider is responsible for ensuring these requirements are met.
This guidance sets out the minimum first aid requirements for most childcare provision. However, it is for the provider to determine whether these minimum standards are appropriate for the type of care they provide and whether more advanced training or qualification is required. For example, childcare that features certain activities such as water sports may need to have more specific first aid training. In these circumstances, we advise that the provider undertakes an additional risk assessment to determine what first aid provision is necessary.
This guidance draws on existing practice and reflects consultation with a voluntary first aid organisation. It provides common questions and answers and includes a checklist of criteria for an appropriate first aid certificate.
This is non-statutory guidance. It does not constitute an authoritative legal interpretation of the provisions, is subject to review, and changes at any time during the year. It also does not replace the existing Health and Safety at Work Act 1974 that places duties on employers for the health and safety of their employees and anyone else on the premises.
Question and answers
What are the requirements?
1. For a person registering on the Childcare Register, the regulations require that:
- at least one person who is to care for the children for whom the care is to be provided has an appropriate first aid qualification. This means that it is appropriate to the ages of the children in the childcare provision and for the types of activity provided.
Who needs to have a certificate?
2. If you are applying as a childminder or home childcarer then you must have a current first aid certificate. You need to have this before you apply to us for registration and must keep it up to date at all times by renewing it before it expires.
3. If you are a childcare provider on domestic or non-domestic premises you do not need to hold the certificate yourself. Instead you must ensure that at least one person who cares for the children has a first aid qualification and is on the premises at all times while childcare is being delivered and is present on any visits or outings. To meet this requirement you may have to have several members of staff trained. It is good practice for first aiders to:
- be reliable and have good communication skills
- have the aptitude and ability to absorb new knowledge and learn new skills and
- the ability to cope with stressful and physically demanding emergency procedures.
How often does the certificate need to be renewed?
4. People must renew their first aid certificate every three years after the date the training was completed. You may wish to make sure relevant people undertake refresher courses annually. By the time a certificate expires, the individual will have to undertake another full course of training to become a first aider. You should keep a record of first aiders and certification dates.
How long should a course take?
5. There is no set minimum length of time for a first aid course for the Childcare Register. Many standard courses take 12 hours to complete. It may be possible for you to undertake, or arrange for others to undertake an intensive course in less than 12 hours. However, you must ensure that the course covers all of the criteria specified below and has adequate practical training. The outcomes of the course should be that the person receiving the training can demonstrate independently how they would handle each of the conditions specified below.
6. People who are renewing their certificate after three years may feel that a shorter course will suffice. However, you should ensure that it still covers all of the criteria specified and provides sufficient practical training to refresh skills and learn any new techniques.
What is a sufficient level of practical training?
7. First aid courses should offer the opportunity to practice practical techniques - for example resuscitation - until individuals feel comfortable performing all of the techniques independently.
What is an appropriate first aid certificate?
8. You must determine whether your first aid training or that of your staff is appropriate based on the type of care you provide. An 'appropriate' first aid certificate will depend on the type of provision offered. For example, first aid suitable for a nanny caring for young children may be different to an activity-based provider caring for older children. As a minimum, a certificate should meet the criteria set out below. You must consider whether it would be appropriate to have additional training based on what you provide.
9. Childcare that features certain activities or that provides for children with disabilities may need to have specific first aid training. You are responsible for determining whether specific additional first aid training is needed and you may want to contact your relevant professional body for advice on what they recommend.
Who needs paediatric and who needs adult first aid certificates?
10. The need for a paediatric or an adult first aid certificate will depend upon the ages of the children you care for. if you care for children who have not yet reached puberty you should have a paediatric first aid certificate. If you care for children who have reached puberty you should have an adult first aid certificate. If you care for a wide age range of children, you may need to have, or employ staff with both adult and paediatric training.
How do I know which certificates will be accepted for registration?
11. We will accept any certificate that meets the minimum criteria below for registration. However you are responsible for determining whether specific additional first aid training is needed.
How will you inspect first aid certificates?
12. You are responsible for demonstrating to us that you have met all of the registration requirements. As part of an application, you must declare that you have met the first aid requirements and provide us with a copy of the certificate. If you are a childminder or home childcarer this must be your own certificate. If you are applying as a childcare provider on domestic or non-domestic premises this may be the certificate of a member of staff who will be responsible for first aid.
13. When we inspect providers to check that the requirements are being met, the inspector will expect to see the first aid certificates of the relevant member(s) of staff (those who are caring for children and have first aid certificate(s) at that point). We may also request further details of the course content or evidence that it is local authority, Health and Safety Executive (HSE) or Qualifications and Curriculum Development Agency (QCDA) approved.
What additional first aid equipment and materials are required?
14. You must have available proper materials and equipment which should be clearly labelled, secured away from children and easily accessible to the first aider. You may need additional first aid equipment if you are providing sports activities or high risk activities.
15. There is no mandatory list of items for a first aid box. However the Health and Safety Executive website provides some helpful guidance on the minimum provision of first-aid items (where there is no special risk identified) www.hse.gov.uk/firstaid/faqs.htm.
Criteria for an appropriate first aid certificate
1. Generalist first aid certificates that are the normal requirements for employers, although required in work settings, are not sufficient for working with children and babies.
2. For settings that provide care to children who have not reached puberty childcarers should have a paediatric first aid certificate.
3. For settings that provide care to children who have reached puberty childcarers should have an adult first aid certificate.
4. The certificate should be appropriate to the nature of the childcare being provided. (For example, particular types of activities may need specific additional first aid training.)
5. Training should be designed for workers caring for children in the absence of their parents.
6. The certificate must be renewed every three years after the date the training was completed.
7. All training should be either approved by a local authority, the HSE or QCA, or provided by a reputable body, such as the Red Cross, St John Ambulance or St Andrew Ambulance.
8. The training must include sufficient practical training.
9. Resuscitation and other equipment should include baby, and junior models as appropriate.
10. Training should cover appropriate contents of first aid kit.
11. Training should include recording accidents and incidents.
12. The course should include learning outcomes covering the following areas:
- planning for first aid emergencies
- dealing with emergencies
- resuscitating
- recognising and dealing with shock
- recognising and responding appropriately to anaphylactic shock
- recognising and responding appropriately to electric shock
- recognising and responding appropriately to bleeding
- responding appropriately to burns and scalds
- responding appropriately to choking
- responding appropriately to suspected fractures
- responding appropriately to head, neck and back injuries
- recognising and responding appropriately to cases of poisoning
- responding appropriately to foreign bodies in eyes, ears and noses
- responding appropriately to eye injuries
- responding appropriately to bites and stings
- responding appropriately to effects of extreme heat and cold
- responding appropriately to febrile convulsions
- recognising and responding appropriately to the emergency needs of chronic medical conditions including: epilepsy, asthma, sickle cell, diabetes
- recognising and responding appropriately to meningitis and other serious sudden illness
Glossary / Terms:
I've listed a few terms that should be of interest from both guides:
From EYFS Glossary:
- Childminder: An early years childminder provides early years provision on domestic premises for reward.
- Setting : Any out-of-home provider of education and care for children from birth to five, such as childminders, local authority nurseries, nursery or early years centres, children's centres, playgroups, pre-schools, or schools in the independent, private or voluntary sector and maintained schools.
From Guide to Registration on the Childminders Register:
- Childcare providers on domestic premises : People providing care on domestic premises with at least three other people.
The difference between childminding and childcare on domestic premises is the number of people involved. If four or more people look after children at any time, they are providing childcare on domestic premises, not childminding.
- Childcare providers on non-domestic premises:
Registered providers that care for children on premises that are not someone's home. These premises can range from converted houses to purpose built nurseries and are usually known as day nurseries, private nursery schools, pre-schools, playschemes and before- and after-school clubs for children.
- Childcare Register: The register of providers who are registered by Ofsted to care for children from birth to 17 years. The register has two parts:
- the voluntary part
Providers who are not eligible for compulsory registration may choose to register here. These are mainly people looking after children aged eight and over, or providing care in the child's home.
- the compulsory part
Providers must register on this part if they care for one child or more from 1 September following their fifth birthday until they reach their eighth birthday.
- Childminder: A person who is registered to look after one or more children to whom they are not related on domestic premises for reward. Reward does not include reciprocal care arrangements between friends where there is no exchange of money or payment for things like electricity or food.
Childminders work with no more than two other childminders or assistants.
They:
- care for children on domestic premises that are not the home of one of the children, or
- care for children from more than two families wholly or mainly in the home of one of the children
and:
- must register to care for children under the age of eight
- can choose to register to care for older children.
Childminders care for at least one individual child for a total of more than two hours in any day. This is not necessarily a continuous period of time. For example if you provide care for the same child aged under eight for an hour before and an hour and a half after school then registration is due; however, if you provide care for one child aged under eight for an hour before school and provide care for a different child aged under eight for an hour and a half after school then registration is not required.
NOTES:
- You will see that the two requirements for training are the same however, it is only EYFS that states a minimum course duration of 12 Hrs.
- Also the EYFS state that the training provider must be approved by the local authority whereas the childcare register extends this by adding: the HSE or QCA, or provided by a reputable body, such as the Red Cross, St John Ambulance or St Andrew Ambulance.
- These are only applicable in England.
- Scotland authority: Care Commission - Tel:01382207100
- Northern Ireland authority: Local Health & Social Services - Tel:02891279279
- Wales authority: ESTYN - Tel:0144382207100