What is the most important thing about First Aid for children that most people overlook?

In the UK, first aid provision for children is crucial to ensure their safety and meet legal requirements. The Early Years Foundation Stage (EYFS) requires at least one person with a full Paediatric First Aid (PFA) certificate to be on-site and present during outings with children under five. Additionally, newly qualified staff with a Level 2 or Level 3 Early Years qualification, awarded after 30 June 2016, must have a full or emergency PFA certificate within three months of starting their role. Without it, they cannot be counted in EYFS staff-to-child ratios as qualified staff.

The Health and Safety (First Aid) Regulations 1981 also require employers to provide appropriate first aid for their staff. While these regulations mainly focus on employees, schools, nurseries, and child-focused venues are encouraged to consider the needs of children and visitors. Unfortunately, many settings fail to provide sufficient first aid, partly due to vague guidelines on what is “adequate” for children aged 0–18.

What happens when First Aid Provision falls short?

Failing to provide proper first aid can lead to serious consequences, including legal issues, financial loss, and reputational damage. Most tragically, it can cost lives. Millie’s Trust, for example, was created after the heartbreaking death of Millie Thompson in 2012 from choking. Her story highlights the need for better training and first aid provision.

First Aid at Work (FAW) qualifications are designed for adults and workplace hazards but are not always suitable for emergencies involving children. Children have unique physical and behavioural needs that require specialised training. For example:

• Children are more likely to experience choking, febrile seizures, or falls, while adults are more likely to face cardiac issues or work-related injuries.
• Paediatric emergencies often involve breathing difficulties, while adult emergencies are usually heart-related.

These differences are reflected in the guidelines for Paediatric Basic Life Support (BLS):

Paediatric First Aid focuses on these differences. For example, knowing how to respond to a choking toddler or give appropriate CPR can save lives. Without this training, staff may act incorrectly, putting children at greater risk.

Bridging the gaps in First Aid

While EYFS guidelines are clear for early years providers, other child-focused settings—like sports clubs, play centres, and family-friendly venues—often have inconsistent first aid provision. This lack of regulation means some children may not receive the help they need during emergencies.

Older children face different risks than younger ones. Young children often get into accidents due to curiosity, while teens face risks related to sports, independence, and peer pressure. To bridge these gaps, all child-focused environments should ensure staff are properly trained, equipment is up to standard, and guidelines are followed.

Taking responsibility as a community

Providing good first aid is more than a legal obligation—it’s a shared responsibility. Organisations like Millie’s Trust and training providers, such as GEM Compliance Training, work to raise awareness and improve standards. GEM encourages following the Resuscitation Council UK’s 2021 guidelines for Paediatric BLS, which are based on international research and best practices. These guidelines ensure that first aid methods are specific to children’s needs.

Child-focused settings must also equip staff with age-appropriate tools, like paediatric AED pads, and conduct regular risk assessments to identify potential dangers. Training and preparedness help create safer environments for children to thrive.

Striking a balance between safety and compliance

Meeting first aid standards means combining legal compliance with practical preparation. EYFS ensures children under five have trained staff who can handle specific risks like choking or seizures. For older children, risks change and require staff to be trained for issues like sports injuries or risk-taking behaviours.

First Aid at Work qualifications are essential for adult-focused workplaces, but for children, Paediatric First Aid is critical. Ensuring that staff are properly trained and equipped, and regularly practising emergency responses, helps create safer spaces for children and gives staff the confidence to act quickly when needed.

Conclusion

First aid for children requires more than basic training. For under-fives, EYFS rules mandate PFA certification to address their unique needs. Older children face different risks that require tailored training and preparation. By prioritising proper training, equipping facilities, and addressing the needs of children of all ages, we can ensure they are safe in any setting. Creating safer spaces is not just about compliance—it’s about protecting young lives and providing peace of mind for everyone involved.

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