Paediatric first aid is taught in short courses and is among the more useful things a parent can learn, and this article is a description of the topics rather than a substitute for training.
Why training matters
Reading about a technique and performing it under stress are different things.
Which is why practical courses with manikins exist, and why recall and confidence decline measurably without refreshers.
Courses are widely available, generally short, and frequently free through health services or voluntary organisations.
Choking
The distinction between mild and severe obstruction determines the response.
A child who can cough effectively should be encouraged to cough rather than interfered with.
A child who cannot cough, cry or breathe requires immediate intervention, and the technique differs between infants and older children.
Which is precisely the sort of thing that requires demonstration and practice rather than description.
Emergency services should be called for severe obstruction.
Resuscitation
Paediatric technique differs from adult in the ratio, the depth and the initial rescue breaths, reflecting that cardiac arrest in children is usually secondary to breathing problems.
Which is why paediatric-specific training exists.
Emergency call handlers provide instructions over the phone, which improves outcomes substantially, and calling immediately is the first action.
Burns and scalds
Cooling with running cool water for a sustained period, which guidance specifies and which is longer than most people apply.
Removing clothing and jewellery unless stuck to the skin.
Covering with cling film or a clean non-fluffy material.
Not applying creams, ice or any traditional remedy, several of which cause additional damage.
And seeking medical assessment, since burns in children are assessed differently from adults.
Bleeding
Direct pressure on the wound, maintained.
Which is the primary measure, and elevating the limb assists.
Anything embedded should not be removed, since it may be limiting bleeding.
Head injury
Common in children and generally minor, with specific features warranting urgent assessment.
Loss of consciousness, repeated vomiting, unusual drowsiness or difficulty waking, seizure, fluid from ears or nose, and increasing confusion all warrant emergency assessment.
Which are the features clinical guidance specifies, and any doubt warrants seeking advice.
Poisoning and ingestion
Not inducing vomiting, which is no longer recommended and can cause additional harm.
Taking the container or a sample to the hospital.
And calling emergency services or a poisons information service immediately.
Button batteries and magnets are specific emergencies requiring immediate attention even if the child seems well.
Anaphylaxis
Adrenaline auto-injector used immediately if prescribed, followed by emergency services.
Which should be given early rather than held back, and a second dose may be needed.
Anyone with an at-risk child should have training, and schools and carers should know where the device is and how to use it.
The practical step
Booking a paediatric first aid course.
Which is the actual recommendation, since none of the above is a substitute for having practised it.
Fever and seizures
A febrile seizure requires protecting the child from injury, not restraining them, and placing them on their side afterwards.
Emergency help should be called for a first seizure, a prolonged one, or if the child does not recover normally.
Which is specific guidance that a course covers properly.
Drowning
Rescue without endangering yourself, then resuscitation with initial rescue breaths, since the cause is oxygen deprivation.
Which is why the paediatric sequence differs from the adult one, and why any child rescued from water requires medical assessment even if apparently recovered.
The kit
A basic first aid kit at home and in the car.
Emergency numbers accessible.
Any prescribed emergency medication in date and accessible.
And knowledge of where the nearest emergency department is.
Refreshers
Skills decay measurably within months without practice, which is why periodic refresher training is recommended.
Sepsis
A time-critical condition that can develop from any infection, and recognition is what determines outcome.
Health services publish specific signs to look for in children, which generally include mottled or blue skin, extreme lethargy, difficulty breathing, a rash that does not fade, not passing urine, and a very high or very low temperature.
Which warrants immediate emergency assessment, and asking directly whether sepsis is a possibility is encouraged by health services.
Meningitis
The non-blanching rash is a late sign, which means waiting for it is dangerous.
Earlier signs include severe headache, dislike of bright light, neck stiffness, unusual drowsiness and, in infants, a bulging fontanelle and unusual cry.
Which requires emergency assessment without delay.
Where to learn
Voluntary first aid organisations, health services and community groups all run paediatric courses, frequently short and inexpensive.
Staying calm
Children take cues from adults, and a calm adult produces a calmer child, which makes assessment and treatment easier.
Which is genuinely difficult and is one of the things practice provides.
Rehearsing what you would do, mentally, also helps when it is needed.
Confidence comes from having done it before, even in practice.