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• What should first aid training include?

Caregivers should have training on the following elements:


• Management of a blocked airway for children including infants.


• Rescue breathing for children including infants (the process of breathing air into the lungs of a person who has stopped breathing).


• Overview of the Emergency Medical Services (EMS) in their area.


• How to access EMS services.


• Ensuring safety at the scene of the injury/emergency.


• Handling blood and body fluids. (See Cleaning and Sanitizing Section)


• Recognition and how to first respond to the following:


• Scrapes and cuts.
• Bleeding, including nosebleeds.
• Burns.
• Fainting.
• Poisoning.
• Puncture wounds, including splinters.
• Insect, animal, and human bites.
• Shock.
• Convulsions or nonconvulsive seizures.
• Bone and muscle injuries (such as sprains, fractures).
• Dental and mouth injuries.
• Head injuries.
• Allergic reactions, including information about when auto-injected epinephrine might be required.
• Eye injuries.
• Loss of consciousness.
• Electric shock.
• Drowning.
• Heat-related injuries, including heat exhaustion/heat stroke.
• Cold injuries.
• Correct ways to move and position an injured or ill person.
• Illness-related emergencies (such as stiff neck, unexplainable confusion, sudden onset of blood red or purple rash, severe pain, temperature of 105 degrees F or higher, or looking/acting severely ill).
• Organizing and implementing a plan to handle an emergency for any child with a special health care need.
• Meeting the needs of the other children in the group while managing emergencies in a child care setting.

• First aid kits
• Contents - First aid kits should include the following:


• Disposable nonporous gloves.
• Scissors.
• Tweezers.
• A non-glass thermometer to measure a child's temperature.
• Bandage tape.
• Sterile gauze pads.
• Flexible roller gauze.
• Triangular bandages.
• Safety pins.
• Sterile eye bandage.
• Pen/pencil and note pad.
• Cold pack.
• Current American Academy of Pediatrics (AAP) standard first aid chart (http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=2246 - There is a fee for this document) or a similar first aid guide.
• Coins for use in a pay phone.
• Water.
• Small plastic or metal splints.
• Liquid soap.
• Adhesive strip bandages, plastic bags for cloths, gauze, and other materials used in handling blood.
• Any emergency medication needed for a child with special needs.
• List of emergency phone numbers, parents' home and work phone numbers, and the Poison Control Center phone number.




Note: Syrup of Ipecac was recommended for first aid kits prior to 2004. Because of recent research, it is no longer considered the best practice to include it in first aid kits. Instead caregivers should call their Poison Control Center or 911 for instructions when they think a child may have taken a poison. See http://nrckids.org/CFOC/updates.htm.


Check with your caregiver to see if they know of this change regarding Syrup of Ipecac. Also, some state child care licensing agencies may not have changed this regulation yet and they may still require your caregiver to include Syrup of Ipecac in their kits.


• Location: Where should first aid kits be located and how many should there be?


• At least one first aid kit should be readily available wherever children are in care, including one for field trips and outings away from the facility and one to remain at the facility if all the children do not attend the field trip.



• A first aid kit should be in each vehicle that is used to transport children to and from a child care program.


• Other first aid kit issues


• Are first aid kits out of reach of children?



• Are first aid kits restocked each time after they are used?



• Are contents checked at least monthly to insure all items are included?


Note: Since it may be impractical to keep fresh medicines for children with special health needs (asthma, etc) in the portable kit for trips, a neon colored or bold note should be placed on the outside of the kit. This will remind the caregiver what medicines she/he needs to take and where they are located. This is also a safeguard when there is a substitute or the need for an emergency evacuation.

• First Aid Policies
• Does the program have a policy that all caregivers that supervise children, including substitutes, are required to have up-to-date pediatric first aid training?



• Is there a policy that all first aid kits are regularly checked for fully stocked contents?



• Is there a policy that parents are informed through written record when first aid is administered to a child?



For a sample report form see, Appendix Y Incident Report Form from Caring for Our Children, 2nd Ed.

• Sample questions to ask a caregiver on first aid procedures:
• Question: "If my child started choking, what would you do?"



Answer: "If they could cough, I'd let them, while I grab the phone to call 911 if needed. If their cough gets weak or their lips start to turn blue, I'd start the Heimlich Maneuver." http://www.heimlichinstitute.org/page.php?id=34

Answer if your child is an infant:
"If he could cough, I'd let him, while I carry him to the phone to call 911 if needed. If their cough gets weak or their lips start to turn blue, I'd start back blows and chest thrusts."

Note: Infants who have been treated for choking should always be examined by a doctor.


• Question "How would you treat a bump, a bloody nose or a small cut?"



Answers should include:

• Bumps (that don't break the skin): cold pack and TLC.



• Bloody nose: Put on gloves, have the child lean forward, stop bleeding with gentle pinching for 10 minutes (Note: leaning the head back is no longer used - it can cause the child to swallow or choke on blood).



• Small cut: Wash my hands with soap and water; put on gloves, wash the wound with soap and water, stop bleeding with pressure and elevation, cover with sterile dressing or an adhesive bandage (band aid); TLC.