Notes:
Situations in which at least one staff member must be certified in CPR include:

• when children are involved in swimming and wading, and


• when at least one child is known to have a specific special health need, as determined by that child's doctor, that makes the child more likely to require CPR.

If your child has a health need that may require CPR, check with the caregiver to make sure staff that are supervising your child have up-to-date pediatric CPR certification.

Many states require that all caregivers have up-to-date CPR training in addition to pediatric first aid training but some states may only require the first aid training.

• 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.

• 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.

• 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.

Healthy Kids, Healthy Care is based on Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, 2nd Edition, 2002, (American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care)

STANDARD 1.009 PRESERVICE AND ONGOING STAFF TRAINING
STANDARD 1.026 FIRST AID TRAINING FOR STAFF
STANDARD 2.038 EMERGENCY SUPPLIES FOR FIELD TRIPS
STANDARD 3.048 EMERGENCY PROCEDURES
STANDARD 5.093 FIRST AID KITS
STANDARD 5.237 EMERGENCY EQUIPMENT AND INFORMATION DURING TRANSPORT
STANDARD 8.022 WRITTEN PLAN AND TRAINING FOR HANDLING URGENT MEDICAL CARE OR THREATENING INCIDENTS
STANDARD 8.062 RECORDS OF INJURY