First Aid & Medical Emergencies

Course 06 – First Aid & Medical Emergencies

Introduction

Children are naturally active.

During play, sport, educational visits and everyday activities they may experience accidents, injuries or sudden illness.

Most incidents are minor.

Occasionally, however, staff may be required to respond to life-threatening emergencies where calm decision-making is critical.

This course provides the knowledge required to respond safely and confidently while working within DASC procedures.

It complements practical first aid training but does not replace accredited first aid qualifications.

Learning Outcomes

After completing this course you will be able to:

• understand the principles of first aid;
• respond safely to common injuries;
• recognise medical emergencies;
• understand the role of the qualified first aider;
• summon emergency assistance appropriately;
• administer first aid within your level of competence;
• record accidents correctly;
• communicate effectively with parents and emergency services.

What Is First Aid?

First aid is the immediate assistance provided to someone who has been injured or becomes suddenly ill before professional medical help arrives.

The aims of first aid are to:

• preserve life;
• prevent the condition worsening;
• promote recovery;
• protect the casualty from further harm.

Every action should place the welfare of the injured person first.

The Role of DASC Staff

Not every member of staff will hold a paediatric first aid qualification.

However, every member of staff should know how to:

• remain calm;
• make the area safe;
• summon help;
• reassure the casualty;
• contact the qualified first aider;
• call 999 where necessary;
• support emergency responders.

Prompt action can significantly improve outcomes.

The Primary Survey (DR ABC)

When responding to a medical emergency, staff should follow a structured assessment rather than reacting instinctively.

The Primary Survey helps identify life-threatening conditions quickly and ensures that the most urgent problems are dealt with first.

Remember:

D – Danger

R – Response

A – Airway

B – Breathing

C – Circulation / CPR

Following the same sequence every time helps staff remain calm under pressure.

D – Danger

Before helping anyone, check whether the area is safe.

Consider:

• traffic
• electrical hazards
• fire
• broken glass
• chemicals
• aggressive behaviour
• unsafe equipment

Never place yourself or others in unnecessary danger.

If the area remains unsafe:

• move away if possible;
• call the emergency services;
• wait until it is safe to approach.

You cannot help effectively if you also become injured.

R – Response

Once the area is safe, check whether the casualty responds.

Speak clearly.

For example:

"Can you hear me?"

"Open your eyes."

If appropriate, gently tap the shoulder.

Never shake a child.

Observe whether the casualty:

• speaks;
• opens their eyes;
• moves purposefully;
• responds to pain.

A lack of response indicates a potentially life-threatening emergency.

A – Airway

An unconscious person may have a blocked airway.

Check whether the airway is open.

If appropriate:

• carefully tilt the head;
• lift the chin;
• remove visible obstructions only if easily accessible.

Never blindly place fingers into a person's mouth.

Maintaining an open airway allows breathing to be assessed accurately.

B – Breathing

Look.

Listen.

Feel.

Spend no longer than 10 seconds checking for normal breathing.

Look for:

• chest movement;
• regular breathing;
• normal colour.

Listen for breathing sounds.

Feel for breath on your cheek.

Occasional gasps are not normal breathing.

C – Circulation and CPR

If the casualty is not breathing normally:

• call 999 immediately;
• send someone to fetch the qualified first aider;
• begin CPR if trained;
• ask for an AED if one is available.

Continue until:

• emergency services arrive;
• the casualty begins breathing normally;
• you are physically unable to continue;
• another trained person takes over.

Calling 999

When calling emergency services remain calm.

Be prepared to provide:

• your name;
• DASC name;
• full address;
• telephone number;
• nature of the emergency;
• age of the casualty;
• whether they are breathing;
• any immediate dangers.

Do not end the call until instructed.

Follow all advice given by the call handler.

Reassuring Children

Medical emergencies can be frightening for other children.

Staff should:

• remain calm;
• move children away where appropriate;
• provide simple reassurance;
• avoid causing panic;
• maintain supervision.

Children should not witness unnecessary distress.

One member of staff should support the casualty while others supervise the remaining children.

Practice Scenario – Child Collapses

Practice Scenario – Unresponsive Adult

Manager Coaching Notes

Managers should ensure that staff:

• know the DR ABC sequence;
• know who the qualified first aiders are;
• know where first aid kits are located;
• understand emergency communication procedures;
• participate in emergency drills.

Regular refresher discussions improve confidence during genuine emergencies.

CPR Awareness

Cardiopulmonary Resuscitation (CPR) is an emergency procedure used when a casualty has stopped breathing normally and their heart has stopped pumping blood effectively.

Early CPR helps maintain the flow of oxygen to the brain and other vital organs until professional medical help arrives.

Only staff who have received appropriate practical training should perform CPR.

However, every member of staff should understand:

• when CPR may be required;
• how to summon help quickly;
• the importance of early intervention;
• how to support trained colleagues.

When CPR May Be Needed

CPR may be required when a casualty:

• is unresponsive;
• is not breathing normally;
• has no obvious signs of circulation.

Examples include:

• sudden cardiac arrest;
• drowning;
• severe choking;
• traumatic injury;
• electrocution.

Always follow the DR ABC assessment before deciding whether CPR may be required.

High-Quality CPR

Qualified first aiders should aim to provide CPR that is:

• immediate;
• continuous;
• effective;
• interrupted only when absolutely necessary.

Good-quality CPR significantly improves survival.

Where several trained adults are present, they should rotate to reduce fatigue.

Automated External Defibrillators (AEDs)

An Automated External Defibrillator (AED) is designed to help restore a normal heart rhythm during certain cardiac emergencies.

AEDs:

• provide spoken instructions;
• analyse the heart rhythm automatically;
• only deliver a shock if appropriate;
• are designed for use by members of the public.

Where an AED is available:

• send someone to collect it immediately;
• switch it on;
• follow the spoken instructions carefully.

Do not delay CPR while waiting for the AED.

Recovery Position

If a casualty is:

• unconscious;
• breathing normally;
• not suspected of having a spinal injury;

they should normally be placed into the recovery position.

The recovery position helps:

• keep the airway open;
• reduce the risk of choking;
• allow fluids to drain safely.

Continue monitoring breathing until emergency services arrive.

Monitoring the Casualty

While waiting for help:

• remain with the casualty;
• continue reassurance if responsive;
• monitor breathing;
• monitor consciousness;
• note any changes;
• prepare to provide information to emergency services.

Never leave an unresponsive casualty alone unless absolutely necessary to obtain help.

Supporting Emergency Services

When emergency responders arrive, provide a clear handover including:

• what happened;
• time the incident occurred;
• DR ABC findings;
• first aid provided;
• medication administered;
• known medical conditions;
• changes observed.

Accurate information supports effective treatment.

Practice Scenario – AED Available

Practice Scenario – Child Breathing Normally

Manager Coaching Notes

Managers should ensure staff know:

• where AEDs are located;
• who holds paediatric first aid qualifications;
• emergency communication procedures;
• recovery position awareness;
• emergency handover procedures.

Emergency preparedness should be refreshed regularly through discussion and practical drills.

Bleeding and Wound Management

Minor cuts and grazes are common within childcare settings.

Most can be managed safely using basic first aid procedures.

However, staff must also recognise when bleeding is severe and requires urgent medical attention.

The priority is always to:

• protect life;
• reduce blood loss;
• prevent infection;
• obtain appropriate medical assistance.

Protect Yourself First

Before treating any bleeding injury:

• assess the area for danger;
• wear disposable gloves;
• use additional PPE if splashing is possible;
• reassure the casualty.

Blood should always be treated as potentially infectious.

Appropriate infection prevention protects both the casualty and the first aider.

Minor Cuts and Grazes

Most minor wounds require only simple treatment.

The correct approach is to:

1. Wash your hands or wear gloves.
2. Clean the wound using clean water where appropriate.
3. Remove visible dirt carefully.
4. Dry surrounding skin.
5. Apply an appropriate sterile dressing.
6. Reassure the child.
7. Record the accident if required.

Children should be praised for remaining calm during treatment.

Nosebleeds

Nosebleeds are common in childhood.

If a child has a nosebleed:

• remain calm;
• sit the child upright;
• encourage them to lean slightly forward;
• pinch the soft part of the nose continuously;
• reassure the child.

Do not encourage the child to tilt their head backwards.

If bleeding continues beyond normal first aid expectations, seek medical advice.

Severe Bleeding

Heavy bleeding is a medical emergency.

Signs may include:

• blood flowing rapidly;
• blood soaking dressings;
• pale skin;
• dizziness;
• confusion;
• reduced responsiveness.

Where severe bleeding occurs:

• apply firm direct pressure;
• call for the qualified first aider;
• dial 999 immediately;
• continue pressure until help arrives.

Never remove dressings that become soaked.

Apply additional dressings over the top if required.

Embedded Objects

Occasionally an object may remain embedded within a wound.

Examples include:

• glass;
• wood;
• metal;
• sharp plastic.

Do not attempt to remove embedded objects.

Instead:

• stabilise the object where possible;
• seek urgent medical assistance;
• prevent further movement.

Removing an embedded object may increase bleeding.

Burns and Scalds

Burns may be caused by:

• hot drinks;
• hot food;
• cooking equipment;
• radiators;
• electrical equipment;
• chemicals;
• sunlight.

Young children are particularly vulnerable to burns and scalds.

Immediate Treatment for Burns

For thermal burns:

• remove the source of heat;
• cool the burn under cool running water for at least 20 minutes where appropriate;
• remove restrictive clothing or jewellery if safe to do so;
• cover the burn with an appropriate sterile non-fluffy dressing.

Do not apply:

• butter;
• toothpaste;
• creams;
• oils;
• ice.

These may worsen the injury.

Chemical Burns

If chemicals contact the skin:

• protect yourself first;
• remove contaminated clothing where safe;
• irrigate the affected area with copious running water;
• seek urgent medical advice.

Always follow COSHH guidance where chemicals are involved.

Electrical Burns

Electrical burns may appear small externally while causing significant internal injury.

If electrical injury is suspected:

• isolate the electrical source first;
• do not touch the casualty until safe;
• call emergency services where appropriate;
• arrange urgent medical assessment.

Practice Scenario – Hot Chocolate Spill

Practice Scenario – Playground Cut

Manager Coaching Notes

Managers should ensure staff understand:

• infection prevention during first aid;
• correct use of PPE;
• treatment of burns and scalds;
• management of severe bleeding;
• accident recording procedures.

First aid confidence improves through regular discussion and refresher training.

Head Injuries

Head injuries are common during childhood.

Most are minor.

However, because it is sometimes difficult to determine the seriousness of a head injury immediately, every head injury should be taken seriously and monitored carefully.

Staff should never dismiss a head injury simply because the child appears well initially.

Common Causes

Head injuries may occur following:

• trips and falls;
• collisions during play;
• sporting activities;
• falling equipment;
• accidental contact with furniture;
• playground incidents.

Many incidents appear minor but still require appropriate observation.

Signs and Symptoms

Following a head injury, monitor for:

• headache;
• dizziness;
• confusion;
• drowsiness;
• vomiting;
• blurred vision;
• loss of balance;
• unusual behaviour;
• memory problems;
• loss of consciousness.

Some symptoms may appear several minutes or hours after the injury.

Continued observation is essential.

Immediate First Aid

If a child receives a minor head injury:

• remain calm;
• reassure the child;
• assess for other injuries;
• apply a cold compress if appropriate;
• monitor closely;
• inform the qualified first aider;
• complete the accident record;
• inform parents.

Observation is often as important as initial treatment.

Loss of Consciousness

Loss of consciousness following a head injury is a medical emergency.

If this occurs:

• call 999 immediately;
• summon the qualified first aider;
• monitor breathing;
• follow the DR ABC approach;
• keep the child still;
• do not allow them to stand or walk.

Protect the airway while awaiting emergency services.

Suspected Neck or Spinal Injury

Head injuries may occasionally occur alongside spinal injuries.

Do not move the casualty unless:

• there is immediate danger;
• remaining where they are is more dangerous.

Keep the casualty still.

Provide reassurance.

Await emergency services.

Movement may worsen spinal injuries.

Concussion Awareness

A concussion is a type of brain injury that may occur following a blow to the head.

Symptoms may include:

• confusion;
• headache;
• dizziness;
• nausea;
• sensitivity to light;
• poor concentration;
• unusual tiredness.

Children with suspected concussion should not return to physical activity until medically assessed and appropriate advice has been followed.

Parent Communication

Parents should always be informed when a child receives a head injury, even where the injury appears minor.

Information should include:

• how the injury occurred;
• treatment provided;
• observations made;
• any symptoms requiring medical review.

Accurate communication supports continuity of care after the child leaves DASC.

Practice Scenario – Playground Collision

Practice Scenario – Fall from Climbing Equipment

Manager Coaching Notes

Managers should ensure staff understand:

• observation following head injuries;
• concussion awareness;
• spinal injury precautions;
• parent notification procedures;
• accident recording requirements.

Head injuries should always be reviewed carefully, regardless of their apparent severity.

Choking

Choking is a life-threatening emergency.

Young children are particularly vulnerable because their airways are smaller than those of adults and they may not chew food thoroughly.

Rapid recognition and prompt action can save a child's life.

Every member of staff should know how to recognise choking and how to summon immediate assistance.

Common Causes

Children may choke on:

• food;
• sweets;
• grapes;
• popcorn;
• nuts;
• small toys;
• coins;
• pen lids;
• craft materials.

Good supervision significantly reduces the likelihood of choking incidents.

Recognising Choking

A child who is choking may:

• clutch their throat;
• be unable to speak;
• be unable to cry;
• struggle to breathe;
• make high-pitched breathing sounds;
• cough weakly or not at all;
• become distressed;
• develop blue lips or skin.

A child who is coughing effectively should be encouraged to continue coughing.

Do not interfere unless the airway becomes severely blocked.

Mild Airway Obstruction

If the child is:

• coughing forcefully;
• able to breathe;
• able to speak or cry,

encourage them to continue coughing.

Remain with the child.

Monitor carefully.

Be prepared to act if the obstruction worsens.

Severe Airway Obstruction

If the child:

• cannot breathe;
• cannot speak;
• cannot cough effectively;
• becomes unconscious,

this is a medical emergency.

Immediately:

• call for the qualified first aider;
• dial 999;
• begin appropriate choking first aid if trained.

Time is critical.

If the Child Becomes Unconscious

If the child becomes unconscious:

• call 999 immediately;
• begin the DR ABC assessment;
• commence CPR if trained and indicated;
• continue until emergency services arrive or another trained responder takes over.

Follow guidance from the emergency call handler where appropriate.

Preventing Choking

Many choking incidents are preventable.

Staff should:

• supervise children while eating;
• encourage children to sit while eating;
• discourage running with food;
• ensure food is cut appropriately;
• monitor younger children closely;
• remove small objects from areas used by young children.

Children should be encouraged to eat slowly and chew food thoroughly.

Choking Hazards During Activities

Not all choking hazards involve food.

Staff should monitor activities involving:

• beads;
• buttons;
• marbles;
• small construction pieces;
• balloons;
• loose craft materials.

Activities should always be age appropriate.

Risk assessments should consider the developmental stage of the children participating.

Practice Scenario – Snack Time

Practice Scenario – Running While Eating

Manager Coaching Notes

Managers should ensure staff understand:

• choking prevention;
• snack-time supervision;
• emergency procedures;
• age-appropriate food preparation;
• emergency communication arrangements.

Regular refresher discussions improve confidence during genuine emergencies.

Asthma

Asthma is one of the most common long-term medical conditions affecting children.

Many children attending DASC may have asthma, and some may require medication during club sessions or educational visits.

Most asthma attacks can be managed successfully when recognised early and treated promptly.

However, severe asthma attacks can become life-threatening if not managed appropriately.

Understanding Asthma

Asthma affects the airways within the lungs.

During an asthma attack, the airways become narrower due to:

• tightening of the airway muscles;
• swelling of the airway lining;
• increased mucus production.

This makes breathing more difficult.

Children with asthma should be able to participate fully in activities, provided appropriate support and medication are available.

Common Asthma Triggers

Triggers vary between children.

Common triggers include:

• exercise;
• pollen;
• dust;
• viral infections;
• cold weather;
• smoke;
• strong smells;
• animal fur;
• emotional stress.

Children's individual healthcare plans should identify known triggers wherever possible.

Recognising an Asthma Attack

Early signs may include:

• coughing;
• wheezing;
• shortness of breath;
• chest tightness;
• difficulty speaking in full sentences;
• appearing anxious;
• unusual tiredness during activity.

Prompt recognition allows treatment to begin before symptoms worsen.

Severe Asthma Symptoms

Seek urgent medical assistance if the child:

• struggles to breathe;
• cannot complete sentences;
• has blue lips or fingernails;
• becomes unusually drowsy;
• shows little improvement after using their reliever inhaler;
• becomes exhausted from breathing.

Call 999 immediately if severe symptoms are present.

Reliever Inhalers

Many children carry a blue reliever inhaler.

The inhaler relaxes the airway muscles, helping the child breathe more easily.

Staff should only assist with medication in accordance with:

• the child's healthcare plan;
• DASC's medication procedures;
• appropriate training;
• parental consent where required.

Children should have rapid access to their prescribed emergency medication.

During an Asthma Attack

If a child develops asthma symptoms:

• remain calm;
• reassure the child;
• encourage them to sit upright;
• assist with their prescribed inhaler if authorised;
• loosen tight clothing if appropriate;
• monitor their breathing;
• stay with the child.

Never encourage the child to lie flat.

Sitting upright usually makes breathing easier.

Calling Emergency Services

Dial 999 immediately if:

• the child becomes severely breathless;
• the inhaler has little or no effect;
• symptoms worsen rapidly;
• the child becomes exhausted;
• you are seriously concerned.

Continue reassuring the child while waiting for emergency services.

Follow the advice given by the emergency call handler.

Physical Activity

Exercise is beneficial for children with asthma.

Children should not routinely be excluded from physical activities.

However, staff should:

• understand individual healthcare plans;
• ensure inhalers are accessible;
• monitor symptoms;
• allow rest if needed.

Children should never feel embarrassed about using prescribed medication.

Practice Scenario – PE Activity

Practice Scenario – Forgotten Inhaler

Manager Coaching Notes

Managers should ensure:

• healthcare plans remain current;
• inhalers are readily accessible;
• medication consent forms are up to date;
• staff understand asthma procedures;
• educational visits include medical planning.

Regular reviews help ensure children with asthma remain safe while participating fully in club activities.

Anaphylaxis and Severe Allergic Reactions

Anaphylaxis is a severe, life-threatening allergic reaction.

It can develop rapidly and requires immediate emergency treatment.

Some children attending DASC may have known severe allergies and carry emergency medication such as an adrenaline auto-injector (AAI), commonly known by brand names such as EpiPen®, Jext® or Emerade®.

Every member of staff should know how to recognise anaphylaxis and how to obtain help immediately.

Common Allergens

Common triggers include:

• peanuts;
• tree nuts;
• milk;
• eggs;
• fish;
• shellfish;
• sesame;
• insect stings;
• certain medications;
• latex.

Each child's healthcare plan should identify their known allergens and emergency treatment arrangements.

Recognising Anaphylaxis

Symptoms may develop within minutes.

Possible signs include:

• swelling of the lips, tongue or throat;
• difficulty breathing;
• noisy breathing or wheezing;
• persistent coughing;
• difficulty swallowing;
• widespread rash or hives;
• pale or clammy skin;
• dizziness;
• collapse;
• loss of consciousness.

Symptoms may worsen quickly.

Immediate action is essential.

Mild Allergic Reactions

Some children may experience milder symptoms such as:

• itchy skin;
• mild rash;
• watery eyes;
• sneezing.

Although these symptoms may not immediately indicate anaphylaxis, staff should monitor the child carefully as reactions can progress.

When in doubt, seek advice from the qualified first aider and follow the child's healthcare plan.

Adrenaline Auto-Injectors (AAIs)

Children at risk of anaphylaxis may carry an adrenaline auto-injector.

Staff should only administer medication:

• if authorised;
• in accordance with training;
• following the child's healthcare plan;
• in line with DASC procedures.

Adrenaline should never be withheld if anaphylaxis is suspected and staff have been trained and authorised to administer it.

Immediate Actions

If anaphylaxis is suspected:

• remain calm;
• call for the qualified first aider;
• administer the prescribed adrenaline auto-injector if authorised and trained;
• dial 999 immediately;
• reassure the child;
• monitor breathing continuously;
• prepare for deterioration.

Do not leave the child alone.

Positioning the Child

The child's position depends upon their symptoms.

Generally:

• keep the child lying flat if possible;
• raise the legs if appropriate;
• if breathing is difficult, allow the child to sit up slightly if advised by their healthcare plan or emergency services;
• if unconscious but breathing normally, use the recovery position where appropriate.

Avoid sudden standing or walking.

Food Allergies

Food allergies require careful management.

Staff should:

• understand children's allergy plans;
• supervise meal and snack times;
• avoid cross-contamination;
• check food labels carefully;
• ensure all staff are aware of severe allergies.

Children should never share food unless this is clearly permitted.

Educational Visits

Before leaving the setting:

• confirm emergency medication is available;
• check expiry dates;
• identify trained staff;
• carry emergency contact details;
• review healthcare plans.

Medication should remain immediately accessible throughout the visit.

Practice Scenario – Peanut Exposure

Practice Scenario – School Trip

Manager Coaching Notes

Managers should regularly review:

• healthcare plans;
• allergy registers;
• medication expiry dates;
• staff training;
• emergency procedures;
• educational visit planning.

Effective allergy management depends upon preparation rather than reaction.

Diabetes

Some children attending DASC may have diabetes.

With appropriate planning and support, children with diabetes should be able to participate fully in all club activities.

Staff should understand the child's individual healthcare plan and know how to respond if the child's blood glucose becomes too high or too low.

Children should never be excluded from activities because they have diabetes.

What is Diabetes?

Diabetes is a condition that affects the body's ability to regulate blood glucose (blood sugar).

Some children produce little or no insulin and require insulin treatment.

Others may require different medical management depending on their diagnosis.

Healthcare plans should always be followed.

Hypoglycaemia (Low Blood Glucose)

Hypoglycaemia, often called a "hypo," occurs when blood glucose falls too low.

It can develop quickly and requires prompt treatment.

Common causes include:

• delayed meals;
• increased physical activity;
• too much insulin;
• illness.

Recognising a Hypo

Signs may include:

• sweating;
• shaking;
• pale skin;
• hunger;
• irritability;
• confusion;
• unusual behaviour;
• poor concentration;
• dizziness;
• tiredness.

If untreated, the child may become unconscious.

Responding to a Hypo

If the child is conscious and able to swallow:

• remain calm;
• follow the child's healthcare plan;
• provide fast-acting sugar if authorised;
• monitor the child's condition;
• inform the qualified first aider where appropriate.

Never force food or drink into someone who is unconscious.

Severe Hypoglycaemia

If the child:

• becomes unconscious;
• has a seizure;
• cannot swallow safely;

call 999 immediately.

Place the child in the recovery position if appropriate and breathing normally.

Do not give food or drink.

Monitor breathing continuously until emergency services arrive.

Hyperglycaemia (High Blood Glucose)

Hyperglycaemia develops when blood glucose becomes too high.

Symptoms usually develop more gradually.

Signs may include:

• excessive thirst;
• frequent urination;
• tiredness;
• blurred vision;
• stomach pain;
• nausea.

Follow the child's healthcare plan and seek medical advice where appropriate.

Physical Activity

Exercise is encouraged for children with diabetes.

Staff should:

• know the child's healthcare plan;
• recognise symptoms of low blood glucose;
• ensure snacks are available if required;
• allow rest where appropriate;
• monitor the child during prolonged activity.

Participation should be supported rather than restricted.

Medication

Some children may require insulin or blood glucose monitoring during DASC sessions.

Only authorised and appropriately trained staff should assist with medication.

Always:

• follow the healthcare plan;
• record medication where required;
• maintain confidentiality;
• seek advice whenever unsure.

Educational Visits

Before educational visits:

• review healthcare plans;
• ensure medication accompanies the child;
• carry emergency contact details;
• identify trained staff;
• plan meal and snack timings;
• carry suitable emergency supplies.

Good planning helps children participate confidently and safely.

Practice Scenario – Sports Activity

Practice Scenario – Educational Visit

Manager Coaching Notes

Managers should ensure:

• healthcare plans remain current;
• medication is accessible;
• staff receive appropriate training;
• educational visits include medical planning;
• communication with parents remains effective.

Children with diabetes should feel fully included while receiving the support they need.

Epilepsy and Seizures

Some children attending DASC may have epilepsy or another condition that causes seizures.

Most seizures stop naturally within a few minutes.

The role of staff is to protect the child from injury, monitor the seizure and obtain appropriate medical assistance where required.

Remaining calm helps protect both the child and those around them.

Understanding Epilepsy

Epilepsy is a neurological condition that causes repeated seizures.

Not every seizure is the same.

Different children may experience different types of seizures, and each child's Individual Healthcare Plan should be followed.

Staff should never assume that every seizure requires identical management.

Recognising a Seizure

A seizure may involve one or more of the following:

• sudden collapse;
• loss of consciousness;
• stiffening of the body;
• rhythmic jerking movements;
• staring into space;
• confusion;
• unusual repetitive movements;
• temporary loss of awareness.

Some children remain awake during certain types of seizure.

Others may become completely unconscious.

What To Do During a Seizure

If a child has a seizure:

• remain calm;
• note the time the seizure begins;
• protect the child from injury;
• remove nearby hazards;
• cushion the head if possible;
• loosen tight clothing around the neck;
• allow the seizure to finish naturally.

Stay with the child throughout the seizure.

What Not To Do

During a seizure, never:

• restrain the child's movements;
• place anything in their mouth;
• attempt to give food or drink;
• move the child unnecessarily unless they are in immediate danger.

These actions may increase the risk of injury.

After the Seizure

Once the seizure has stopped:

• check breathing;
• follow the DR ABC approach if necessary;
• place the child in the recovery position if appropriate;
• reassure the child as they regain awareness;
• allow them time to recover;
• monitor continuously.

Many children feel tired or confused following a seizure.

Recovery should not be rushed.

When to Call 999

Call 999 immediately if:

• this is the child's first known seizure;
• the seizure lasts longer than five minutes (or as specified in the child's healthcare plan);
• repeated seizures occur without recovery;
• the child has difficulty breathing afterwards;
• serious injury has occurred;
• you are uncertain about the child's condition.

Always follow the Individual Healthcare Plan where one exists.

Febrile Seizures

Some younger children experience seizures caused by a rapid rise in body temperature during illness.

These are known as febrile seizures.

Although frightening, many febrile seizures stop within a few minutes.

Staff should:

• protect the child from injury;
• monitor breathing;
• seek urgent medical assessment;
• inform parents immediately.

Never attempt to cool the child rapidly using cold water or ice.

Recording the Seizure

Following any seizure, record:

• date and time;
• duration;
• observations;
• injuries;
• first aid provided;
• medication administered (if applicable);
• emergency services involvement;
• parent notification.

Accurate records support ongoing medical care.

Practice Scenario – Classroom Seizure

Practice Scenario – Recovery Phase

Manager Coaching Notes

Managers should ensure:

• Individual Healthcare Plans are reviewed regularly;
• staff know which children have epilepsy;
• emergency medication arrangements are understood;
• seizure records are completed accurately;
• educational visits include appropriate medical planning.

Preparation supports safe inclusion.

Medication Administration

Some children attending DASC require medication during club sessions to enable them to participate safely and fully.

Medication should only ever be administered in accordance with:

• DASC's Administration of Medication Policy;
• the child's Individual Healthcare Plan where applicable;
• written parental consent;
• staff training and authorisation.

Medication management is both a health and safeguarding responsibility.

Principles of Safe Medication

Whenever medication is administered, staff should ensure:

• the correct child receives the medication;
• the correct medication is given;
• the correct dose is administered;
• the correct route is used;
• the correct time is followed;
• the medication is recorded accurately.

These are commonly known as the Six Rights of Medication Administration.

Before Administering Medication

Before giving any medication, staff should check:

• the child's identity;
• written parental consent;
• the medication label;
• expiry date;
• dosage instructions;
• storage requirements;
• the child's healthcare plan where applicable.

Medication should never be given based on memory or verbal instructions alone.

Storage of Medication

Medication should be:

• stored securely;
• kept in its original container;
• clearly labelled with the child's name;
• stored according to manufacturer instructions;
• inaccessible to children;
• checked regularly for expiry dates.

Emergency medication should remain quickly accessible to authorised staff.

Controlled Medication

Some prescribed medicines require additional security and recording.

Managers should ensure:

• secure storage;
• restricted access;
• accurate stock records;
• witnessed administration where required.

Local procedures should always be followed.

Administering Medication

When administering medication:

1. Wash or sanitise your hands.
2. Check the medication carefully.
3. Confirm the child's identity.
4. Explain what you are doing.
5. Administer the medication calmly.
6. Observe the child afterwards.
7. Complete the medication record immediately.

Never leave medication unattended.

Refusing Medication

Children may sometimes refuse medication.

If this occurs:

• remain calm;
• never force medication;
• reassure the child;
• inform the manager;
• contact parents where appropriate;
• record the refusal.

The child's healthcare plan should guide decision-making.

Medication Errors

Examples include:

• wrong child;
• wrong medication;
• wrong dose;
• wrong time;
• omitted dose;
• incorrect recording.

If a medication error occurs:

• ensure the child's immediate safety;
• inform the manager immediately;
• seek medical advice where appropriate;
• contact parents;
• record the incident;
• review procedures to prevent recurrence.

Mistakes should always be reported promptly.

Educational Visits

Before leaving the setting:

• check medication accompanies the child;
• confirm expiry dates;
• identify trained staff;
• carry healthcare plans;
• ensure emergency medication remains accessible.

Medication should never be packed where it cannot be accessed quickly during an emergency.

Practice Scenario – Forgotten Dose

Practice Scenario – Child Refuses Medication

Manager Coaching Notes

Managers should regularly review:

• medication records;
• parental consent forms;
• healthcare plans;
• medication expiry dates;
• staff training;
• storage arrangements;
• audit trails.

Robust medication systems protect children and provide reassurance to families.

Communicating During Medical Emergencies

Clear communication is essential during any medical emergency.

Children, parents, colleagues and emergency services all rely on staff providing calm, accurate and timely information.

Good communication reduces confusion, supports effective treatment and reassures everyone involved.

Staying Calm

Children often copy the behaviour of trusted adults.

During an emergency:

• speak slowly;
• use a calm voice;
• give simple instructions;
• avoid shouting;
• reassure children regularly.

Remaining calm helps everyone think more clearly.

Calling Emergency Services

When calling 999, be prepared to provide:

• the address of Dagenham After School Club or the visit location;
• your name and role;
• the telephone number you are calling from;
• the child's approximate age;
• what has happened;
• whether the child is conscious;
• whether the child is breathing;
• any known medical conditions;
• what first aid has already been provided.

Listen carefully to the call handler and follow every instruction.

Do not end the call until told to do so.

Communicating with Parents

Parents should be informed promptly whenever:

• emergency services have been called;
• a significant injury has occurred;
• emergency medication has been administered;
• a child has been taken to hospital;
• further medical assessment is recommended.

Communication should always be:

• factual;
• honest;
• calm;
• respectful.

Avoid speculation or making medical diagnoses.

Handover to Emergency Services

When emergency responders arrive, provide a structured handover.

Include:

• the child's name;
• age;
• what happened;
• time the incident occurred;
• observations made;
• first aid provided;
• medication administered;
• known allergies;
• existing medical conditions;
• changes since the incident began.

Accurate handovers support continuity of care.

Supporting Other Children

Medical emergencies can be upsetting for children who witness them.

Where possible:

• move children away from the incident;
• continue normal routines where appropriate;
• provide reassurance;
• answer questions honestly using age-appropriate language;
• avoid discussing confidential information.

Children should feel safe and supported.

Confidentiality

Medical information is confidential.

Staff should only share information with:

• emergency services;
• parents or carers;
• healthcare professionals;
• authorised managers;
• staff with a legitimate need to know.

Medical emergencies should never become topics of informal conversation or social media discussion.

Documentation

Following every significant medical incident:

• complete accident records;
• complete medication records where appropriate;
• record times accurately;
• document observations factually;
• record emergency service involvement;
• note parent communication;
• submit documentation promptly.

Good documentation supports safeguarding, legal compliance and future medical care.

Debriefing After an Incident

Medical emergencies can be affecting staff emotionally.

Following significant incidents, managers should arrange a structured debrief.

Discussion may include:

• what happened;
• what went well;
• lessons learned;
• support required;
• updates to procedures;
• additional training needs.

The purpose of a debrief is learning and staff wellbeing—not blame.

Practice Scenario – Ambulance Called

Practice Scenario – Curious Children

Manager Coaching Notes

Managers should review after every significant medical incident:

• communication;
• emergency response;
• documentation;
• equipment used;
• staff confidence;
• emotional wellbeing;
• training requirements.

Every emergency provides an opportunity to strengthen future practice.

First Aid During Educational Visits

Children should receive the same high standard of first aid whether they are at DASC or attending an educational visit.

Leaving the premises introduces additional risks and requires careful planning to ensure that medical emergencies can be managed safely.

Preparation before departure is one of the most important elements of effective first aid provision.

Before Leaving the Setting

The visit leader should ensure:

• an appropriate first aid kit is available;
• a qualified paediatric first aider is attending where required;
• emergency contact details are available;
• children's healthcare plans accompany the group;
• prescribed medication is packed;
• medication expiry dates have been checked;
• emergency services can be contacted if required.

Medical preparation should form part of every educational visit risk assessment.

Carrying First Aid Equipment

The first aid kit should remain:

• easily accessible;
• protected from damage;
• carried by an identified member of staff;
• checked before and after each visit.

The contents should reflect:

• the activity;
• number of children;
• travel arrangements;
• location.

Missing equipment should be replaced immediately after returning to the setting.

Emergency Medication

Emergency medication must accompany the child at all times.

Examples include:

• reliever inhalers;
• adrenaline auto-injectors;
• diabetic medication;
• emergency seizure medication where appropriate.

Medication should never travel separately from the child.

Staff must know:

• where medication is kept;
• who is carrying it;
• how it should be administered;
• when emergency services should be contacted.

Remote Locations

Some visits take place in locations where emergency services may take longer to arrive.

Examples include:

• country parks;
• forests;
• beaches;
• farms;
• outdoor activity centres.

Additional planning may include:

• identifying the nearest hospital;
• confirming mobile phone signal;
• sharing exact location details;
• carrying emergency maps or grid references.

Preparation reduces delays during emergencies.

Transport Emergencies

If a medical emergency occurs during transport:

• stop safely where appropriate;
• assess the situation;
• call emergency services if required;
• supervise the remaining children;
• inform the visit leader;
• contact parents in accordance with DASC procedures.

Children should never be left unattended during an emergency.

Weather-Related Illness

Educational visits increase the likelihood of weather-related illness.

Staff should monitor for:

Hot Weather

• dehydration;
• sunburn;
• heat exhaustion.

Provide:

• drinking water;
• regular rest breaks;
• shaded areas;
• sunscreen where appropriate.

Cold Weather

Monitor for:

• shivering;
• cold extremities;
• reduced concentration;
• signs of hypothermia.

Children should wear suitable clothing and remain warm and dry.

Lost Child During a Medical Emergency

If one child requires emergency first aid while another child becomes separated from the group:

• immediately allocate staff responsibilities;
• ensure the injured child receives appropriate care;
• activate the lost child procedure;
• maintain supervision of the remaining children;
• inform emergency services if required.

Clear leadership prevents confusion.

Practice Scenario – Asthma Attack at the Park

Practice Scenario – Minor Injury on a Coach

Manager Coaching Notes

Managers should ensure educational visits include:

• first aid planning;
• medication checks;
• emergency communication arrangements;
• healthcare plans;
• trained staff;
• emergency contact information;
• post-visit incident reviews.

Well-planned visits allow children to explore confidently while remaining protected.

Decision Trees and Quick Reference Guides

Medical emergencies can be stressful.

Using simple decision-making tools helps staff remain calm and follow DASC procedures consistently.

The following decision trees should be used alongside practical training, Individual Healthcare Plans and the advice of emergency services.

Decision Tree – Medical Emergency

flowchart TD

A["Child becomes ill or injured"]

A --> B{"Is the area safe?"}

B -->|No| C["Make area safe if possible and call for help"]

B -->|Yes| D["Carry out DR ABC assessment"]

D --> E{"Life-threatening emergency?"}

E -->|Yes| F["Call 999 immediately"]

F --> G["Summon Qualified First Aider"]

G --> H["Provide first aid within level of competence"]

E -->|No| I["Treat minor injury or illness"]

I --> J["Monitor child"]

J --> K["Record incident and inform parents"]

Decision Tree – Head Injury

flowchart TD

A["Child receives head injury"]

A --> B{"Loss of consciousness?"}

B -->|Yes| C["Call 999 immediately"]

B -->|No| D["Assess injury"]

D --> E["Monitor child"]

E --> F["Inform Qualified First Aider"]

F --> G["Inform Parents"]

G --> H["Record Accident"]

Decision Tree – Asthma Attack

flowchart TD

A["Child develops breathing difficulties"]

A --> B["Keep child calm and sitting upright"]

B --> C["Assist with prescribed inhaler if authorised"]

C --> D{"Symptoms improving?"}

D -->|Yes| E["Continue monitoring"]

D -->|No| F["Call 999"]

F --> G["Monitor continuously until help arrives"]

Decision Tree – Anaphylaxis

flowchart TD

A["Suspected severe allergic reaction"]

A --> B["Call Qualified First Aider"]

B --> C["Administer Adrenaline Auto-Injector if authorised"]

C --> D["Dial 999"]

D --> E["Monitor breathing"]

E --> F["Stay with child until emergency services arrive"]

Decision Tree – Seizure

flowchart TD

A["Child having seizure"]

A --> B["Protect from injury"]

B --> C["Time seizure"]

C --> D{"Seizure continues beyond healthcare plan or over 5 minutes?"}

D -->|Yes| E["Call 999"]

D -->|No| F["Monitor recovery"]

F --> G["Recovery Position if appropriate"]

G --> H["Record Incident"]

Quick Reference Guide

Always

✔ Stay calm.

✔ Follow DR ABC.

✔ Protect yourself first.

✔ Call for the qualified first aider early.

✔ Dial 999 whenever serious concerns exist.

✔ Follow Individual Healthcare Plans.

✔ Monitor the casualty continuously.

✔ Reassure children.

✔ Complete documentation promptly.

✔ Inform parents appropriately.

Never

✘ Ignore breathing difficulties.

✘ Leave an unresponsive casualty alone.

✘ Force medication.

✘ Place anything into the mouth of someone having a seizure.

✘ Delay calling 999 because you are uncertain.

✘ Give food or drink to an unconscious casualty.

✘ Administer medication without authorisation.

✘ Speculate when communicating with parents.

✘ Share confidential medical information inappropriately.

✘ Forget to record the incident.

End of Course Assessment

Instructions

Complete the assessment below.

A pass mark of 80% is required.

Competency Declaration

Related DASC Policies

References

Course Completion

Congratulations.

You have completed Course 06 – First Aid & Medical Emergencies.

First aid is one of the most important responsibilities within childcare. Children depend on adults who remain calm, think clearly and act quickly when emergencies occur.

By understanding emergency procedures, recognising serious illness and injury, following healthcare plans and working effectively as a team, you help ensure every child receives the safest possible care.

Remember:

Stay calm. Assess. Act. Record. Review.

Every prompt, professional response has the potential to protect a child's health—and in some situations, to save a life.