What is the correct CPR ratio for a child?

For both infants (under 1 year) and children (1 year to puberty), the correct CPR ratio is 15 chest compressions to 2 rescue breaths. Compressions should be performed at a rate of 100-120 per minute, with a depth of about 4cm for infants and 5cm for children. For infants, use two fingers in the centre of the chest; for children, use one or two hands depending on their size.

How do I treat a child who is choking?

For infants under 1 year, give up to 5 back blows (between the shoulder blades) followed by up to 5 chest thrusts (on the breastbone). For children over 1 year, give up to 5 back blows then up to 5 abdominal thrusts (inward and upward). Alternate between back blows and thrusts until the object is dislodged or the child becomes unconscious. Never perform a blind finger sweep.

What should I do if a child has an allergic reaction?

If the child shows signs of anaphylaxis (e.g., difficulty breathing, swelling of the face or throat, rash, or collapse), call 999 immediately. If an adrenaline auto-injector (e.g., EpiPen) is available, administer it into the outer mid-thigh. Lay the child on their back and raise their legs if they are in shock. Monitor their breathing and be prepared to perform CPR if they become unconscious.

How do I put an infant in the recovery position?

For an infant (under 1 year), cradle them in your arms with their head tilted slightly downwards to keep the airway open. Support their head and neck with your hand. For a child (over 1 year), use the standard recovery position: place the child on their side, tilt the head back to open the airway, and adjust the top leg to stabilise them. Always monitor breathing until help arrives.

What is the difference between infant and child CPR?

The main differences are in hand placement and compression depth. For infants (under 1 year), use two fingers in the centre of the chest and compress to about 4cm. For children (1 year to puberty), use one or two hands (depending on child size) and compress to about 5cm. The ratio (15:2) and rate (100-120 compressions per minute) are the same for both.

Do I need to remove a child's clothing to perform CPR?

Yes, you should remove or loosen clothing from the chest to ensure you can see the chest rise and fall and to perform compressions effectively. For infants, you may only need to expose the chest area. For children, remove enough clothing to allow proper hand placement and visual assessment of chest movement.

Managing paediatric illness and injury

COUNCIL FOR AWARDS IN CARE, HEALTH AND EDUCATION

vocational

This subtopic focuses on the immediate and appropriate first aid responses required for a range of paediatric illnesses and injuries. Learners develop the ability to assess the situation, prioritise care, and apply safe, evidence-based interventions to stabilise the infant or child until professional medical help arrives, thereby minimising harm and promoting recovery.

Learning Outcomes

Assessment Guidance

Key Skills

Key Terms

Assessment Criteria

Assessment criteria

CACHE Level 2 Award in Paediatric First Aid (QCF)

Topic Overview

The CACHE Level 2 Award in Paediatric First Aid (QCF) equips learners with the essential skills and knowledge to provide emergency first aid to infants and children up to the age of puberty. This qualification is specifically designed for those working in early years settings, childminding, or any role involving the care of children, such as nannies, au pairs, or sports coaches. It covers a range of life-threatening conditions and injuries, including anaphylaxis, asthma attacks, bleeding, burns, choking, fractures, meningitis, poisoning, and seizures, as well as resuscitation techniques tailored for paediatric patients.

This award is a mandatory requirement for many childcare professionals in the UK, as outlined in the Early Years Foundation Stage (EYFS) statutory framework. It ensures that practitioners can respond confidently and competently in an emergency, potentially saving a child's life. The course typically involves both theoretical knowledge and practical assessments, including a demonstration of infant and child cardiopulmonary resuscitation (CPR) using a manikin. Understanding paediatric first aid is not only a regulatory necessity but also a moral imperative for anyone responsible for children's safety.

Within the broader Health & Social Care curriculum, this qualification sits alongside other safeguarding and health promotion units. It emphasises the importance of risk assessment, accident prevention, and the legal responsibilities of carers. Mastery of paediatric first aid also builds confidence in handling emergencies, which is a key skill for progression into roles such as early years educator, paediatric nurse, or child protection officer.

Key Concepts

Core ideas you must understand for this topic

→The primary survey (DRABC: Danger, Response, Airway, Breathing, Circulation) and its application to infants and children, including the recovery position.
→Paediatric CPR: chest compression to ventilation ratio of 15:2 for both infants (using two fingers) and children (using one or two hands), with a compression depth of approximately 4cm for infants and 5cm for children.
→Management of choking: back blows and chest thrusts for infants (under 1 year) and back blows and abdominal thrusts for children (over 1 year).
→Recognition and treatment of anaphylaxis: use of adrenaline auto-injectors (e.g., EpiPen) and the importance of calling 999 immediately.
→Control of severe bleeding: direct pressure, elevation, and use of sterile dressings, with emphasis on avoiding tourniquets unless trained.

Learning Objectives

What you need to know and understand

Demonstrate how to safely immobilise a suspected fracture in an infant and child using appropriate materials.
Evaluate the signs indicating a serious head or spinal injury that require emergency immobilisation and transport.
Apply first aid procedures for foreign objects or caustic substances in the eyes, ears, or nose.
Distinguish between the first aid management of a diabetic emergency and a febrile seizure in a child.
Explain the stepwise cooling and covering process for paediatric burns and scalds.
Prioritise the actions to take when an infant or child has ingested a potentially toxic substance.

Assessment Criteria

Key criteria assessors look for in your portfolio

Award credit for correctly identifying the type of fracture from a given scenario and selecting an appropriate splinting method that limits movement above and below the injury.
Credit demonstration of manual in-line stabilisation when suspecting a cervical spine injury, explaining the rationale.
Look for evidence of flushing the eye with clean water for at least 15 minutes in chemical exposure cases.
Consider correct differentiation between conditions, such as hypoglycaemia versus epilepsy, and appropriate first aid steps for each.
When assessing burns management, expect mention of removing the heat source, cooling under running water for at least 20 minutes, covering with cling film, and seeking medical advice.

Assessment Guidance

Guidance for achieving higher grades

💡In scenario-based questions, always state the priority action first (e.g., check for danger, call 999), then detail the step-by-step care.
💡Remember to differentiate paediatric from adult responses, particularly for CPR hand placement and the anatomy of infants.
💡When describing first aid for any condition, include reassessment and comfort measures to show holistic care.
💡Use the acronym AVPU (Alert, Voice, Pain, Unresponsive) to systematically record levels of consciousness in head or medical emergencies.
💡When answering questions about CPR, always state the correct ratio (15:2) and specify the compression depth and hand placement for infants versus children. Examiners look for precise, age-appropriate details.
💡In scenarios involving anaphylaxis, mention the need to call 999 immediately and administer the auto-injector into the outer mid-thigh, even if you are not sure it's anaphylaxis. This shows you understand the urgency.
💡For questions on the recovery position, explain that for infants you may need to cradle them in your arms with their head tilted slightly downwards, while for children you use the standard recovery position. Demonstrating this distinction earns marks.

Common Mistakes

Common errors to avoid in your coursework

Confusing the management of a sprain with a fracture and failing to immobilise the limb adequately.
Applying ice, butter, or creams directly to a burn, which can worsen tissue damage.
Forgetting to check for other injuries, particularly neck and spine involvement, in a child who has sustained a head injury.
Inducing vomiting after ingestion of a corrosive substance, which can cause further harm.
Misconception: You should tilt a child's head back as far as possible when opening the airway. Correction: Overextension can block the airway in infants due to their floppy epiglottis; use a neutral head position for infants and a slight head tilt for children.
Misconception: If a child is choking, you should perform a finger sweep to remove the object. Correction: Blind finger sweeps can push the object further down; only perform a finger sweep if you can see the object clearly.
Misconception: You should apply a tourniquet to stop severe bleeding. Correction: Tourniquets are rarely used in paediatric first aid and can cause tissue damage; use direct pressure and elevation instead.

Frequently Asked Questions

Common questions students ask about this topic

Before You Start

Prior knowledge that will help with this topic

•Basic understanding of first aid principles, such as the importance of checking for danger and calling for help.
•Familiarity with the differences between infant, child, and adult anatomy, particularly airway and chest size.
•Completion of a general first aid course (e.g., Level 2 Award in First Aid) is helpful but not essential.

Key Terminology

Essential terms to know

Fracture and dislocation immobilisation
Head, neck, and spinal precautions
Ocular, aural, and nasal emergencies
Acute and chronic medical episodes
Environmental exposure injuries
Toxicological and envenomation emergencies

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Managing paediatric illness and injury

Assessment criteria

Topic Overview

Key Concepts

Learning Objectives

Assessment Criteria

Assessment Guidance

Common Mistakes

Frequently Asked Questions

Before You Start

Key Terminology

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