What is the correct CPR ratio for a 2-year-old child?

For a child aged 1 year to puberty, the correct CPR ratio is 5 initial rescue breaths followed by cycles of 15 chest compressions and 2 breaths. Compressions should be performed at a rate of 100-120 per minute, with a depth of about 5 cm (one-third of the chest depth). Use one or two hands as needed to achieve the correct depth.

How do I treat a child who is having a severe allergic reaction?

If a child shows signs of anaphylaxis (difficulty breathing, swelling, hives, or collapse), immediately administer an adrenaline auto-injector (e.g., EpiPen) into the outer thigh. Call 999 and state 'anaphylaxis'. Lay the child on their back with legs raised if they are conscious, or place them in the recovery position if unconscious. Monitor breathing and be prepared to start CPR if they stop breathing.

What should I do if an infant is choking and becomes unconscious?

If an infant becomes unconscious while choking, call 999 immediately. Start CPR with 5 rescue breaths (check for obstruction after each breath), then perform 30 chest compressions (using two fingers, one-third chest depth). After 30 compressions, look in the mouth for the object and remove it if visible. Continue cycles of 30 compressions and 2 breaths until help arrives.

Do I need to use an AED on a child under 1 year old?

For infants under 1 year, manual defibrillation is preferred, but if unavailable, an AED with paediatric pads (or a paediatric mode) can be used. Place one pad on the front of the chest and one on the back, or as per the manufacturer's instructions. If paediatric pads are not available, adult pads can be used but ensure they do not touch each other.

How do I put a child in the recovery position?

For a child over 1 year, kneel beside them, place the arm nearest to you at a right angle to their body, and bring the other arm across their chest. Roll them onto their side by pulling the far knee towards you, ensuring the airway is open by tilting the head back slightly. For an infant, hold them in your arms with their head tilted downwards to keep the airway open and monitor breathing.

What is the difference between paediatric first aid and adult first aid?

Paediatric first aid focuses on the anatomical and physiological differences in infants and children, such as smaller airways, faster breathing rates, and different CPR ratios. It also covers conditions more common in children, like febrile convulsions, croup, and choking on small objects. The approach to resuscitation, choking management, and use of AEDs is adapted for younger ages.

Emergency Paediatric First Aid

PEARSON EDUCATION LTD

vocational

Emergency Paediatric First Aid equips learners with the essential skills and knowledge to respond promptly and effectively to life-threatening situations involving infants and children. This subtopic covers the immediate care required for an unresponsive casualty, choking, severe bleeding, shock, and minor injuries, emphasizing the paediatric first-aider's duty to preserve life, prevent deterioration, and promote recovery until professional medical assistance arrives. Practical application includes conducting a scene safety assessment, performing CPR, managing airway obstructions, controlling blood loss, and recognizing the early signs of shock in a paediatric context.

Learning Outcomes

Assessment Guidance

Key Skills

Key Terms

Assessment Criteria

Assessment criteria

Pearson BTEC Level 3 Award in Paediatric First Aid

Topic Overview

The Pearson BTEC Level 3 Award in Paediatric First Aid is a vocationally-related qualification designed for individuals working with children, such as early years practitioners, childminders, and nursery staff. It covers essential life-saving skills and knowledge required to manage emergencies in infants and children, including resuscitation, choking, bleeding, and anaphylaxis. This qualification meets the requirements of the Early Years Foundation Stage (EYFS) statutory framework, making it mandatory for many childcare roles in the UK.

This topic is critical because children have unique anatomical and physiological differences that affect how first aid is administered. For example, infants have smaller airways, faster metabolic rates, and different resuscitation ratios compared to adults. The course emphasizes practical skills, such as performing CPR on a child manikin and using an AED with paediatric pads, alongside theoretical understanding of emergency protocols. Mastery of this content ensures students can confidently respond to incidents like febrile convulsions, head injuries, and allergic reactions, potentially saving lives in childcare settings.

Within the broader Nursing & Healthcare curriculum, paediatric first aid complements modules on child development, health promotion, and safeguarding. It provides a foundation for further study in paediatric nursing, paramedic science, or early years education. The qualification is assessed through a combination of practical demonstrations and multiple-choice examinations, requiring students to apply knowledge in realistic scenarios. Understanding this material not only prepares students for assessment but also equips them with transferable skills for professional practice.

Key Concepts

Core ideas you must understand for this topic

→The paediatric resuscitation protocol: For infants (under 1 year) and children (1 year to puberty), the correct ratio is 5 initial rescue breaths followed by 15 chest compressions and 2 breaths, at a rate of 100-120 compressions per minute. Compressions should be one-third the depth of the chest (approximately 4 cm for infants, 5 cm for children).
→Management of choking: For infants, use back blows (5) and chest thrusts (5); for children over 1 year, use back blows and abdominal thrusts (Heimlich manoeuvre). Never use blind finger sweeps.
→Recognition and treatment of anaphylaxis: Signs include difficulty breathing, swelling of the face/lips, and rash. Immediate treatment is an adrenaline auto-injector (e.g., EpiPen) into the outer thigh, followed by calling 999.
→Control of severe bleeding: Apply direct pressure with a sterile dressing, elevate the limb if possible, and call for emergency help. Use a tourniquet only as a last resort if bleeding is life-threatening and pressure fails.
→Recovery position for infants and children: For infants, hold them in your arms with head tilted down; for children, roll them onto their side with the airway open and monitor breathing.

Learning Objectives

What you need to know and understand

1. Understand the role and responsibilities of the paediatric first-aider2. Be able to assess an emergency situation safely3. Be able to provide first aid for an infant and a child who are unresponsive4. Be able to provide first aid for an infant and a child who are choking5. Be able to provide first aid to an infant and a child with external bleeding6. Know how to provide first aid to an infant or a child who is suffering from shock7. Know how to provide first aid to an infant or a child with bites, stings and minor injuries

Assessment Criteria

Key criteria assessors look for in your portfolio

Award credit for clearly articulating the paediatric first-aider’s responsibilities: ensuring safety, assessing the situation, providing appropriate care, documenting incidents, and maintaining confidentiality.
Assessor must observe a thorough scene assessment: checking for hazards, identifying the mechanism of injury, and ensuring personal safety before approaching the casualty.
For unresponsive infant/child with normal breathing, credit is given for correctly positioning in the recovery position, maintaining an open airway, and monitoring breathing continuously.
Demonstrate correct resuscitation sequence: 5 initial rescue breaths for infants/children, followed by 30 compressions to 2 breaths; adjust hand placement and compression depth for age.
Award credit for showing effective back blows and chest thrusts for an infant, or back blows and abdominal thrusts for a child, with correct force and positioning.
For external bleeding, expect direct pressure applied firmly with a clean dressing, elevation of the injured part, and appropriate use of bandages without restricting circulation.
Marking point: accurately identify signs of shock (pale, cold, clammy skin; rapid, weak pulse; rapid, shallow breathing) and implement appropriate positioning (lying down, legs raised if no fractures).
Credit knowledge of when to call emergency services immediately, such as in cases of unresponsiveness not resolved quickly, severe bleeding not stopping, or signs of shock.

Assessment Guidance

Guidance for achieving higher grades

💡In practical assessments, verbalise every step as you perform it, explaining your actions and decisions to demonstrate underpinning knowledge.
💡Always prioritise scene safety first; begin every scenario by stating that you are checking for danger and making the area safe before you approach.
💡Memorise the key differences between infant and child first aid techniques, particularly CPR ratios, choking procedures, and the recovery position.
💡Use the primary survey acronym DRABC (Danger, Response, Airway, Breathing, Circulation) to structure your initial assessment and show a systematic approach.
💡For written questions, link practical actions to their clinical rationale; for example, explain why you give rescue breaths first in paediatric resuscitation (because cardiac arrest is usually due to hypoxia).
💡When demonstrating bleeding control, remember to apply direct pressure with a clean dressing and bandage it in place, then check circulation beyond the bandage.
💡In practical assessments, demonstrate clear communication with bystanders (e.g., 'You call 999, you get the AED') and explain each step as you perform it. Examiners award marks for both correct technique and verbal reasoning.
💡Memorise the specific numbers: 5 initial breaths, 15 compressions, 2 breaths, 100-120 compressions per minute, 1/3 chest depth. These are frequently tested in multiple-choice questions.
💡For written exams, use the acronyms DRABC (Danger, Response, Airway, Breathing, Circulation) and SAMPLE (Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, Events leading up to incident) to structure answers on emergency management.

Common Mistakes

Common errors to avoid in your coursework

Failing to differentiate between infant (under 1 year) and child (1 year to puberty) protocols, e.g., using the same CPR compression depth or choking manoeuvre for both.
Incorrectly performing abdominal thrusts on an infant, which can cause internal injury; only chest thrusts and back blows are appropriate for infants.
Neglecting to call 999/112 early enough, especially when dealing with an initially unresponsive casualty who does not regain consciousness quickly.
Applying a tourniquet or improvised constricting band to control bleeding, which is contraindicated in standard first aid; direct pressure is the appropriate method.
Confusing febrile convulsions with an unresponsive state and initiating CPR unnecessarily; the child should be protected from injury and placed in the recovery position once the seizure stops.
Omitting to check the casualty’s airway and breathing before performing chest compressions, leading to inappropriate CPR on a person who is breathing.
Assuming that minor bites and stings do not require medical attention; for example, tick bites may need careful removal and monitoring for Lyme disease symptoms.
Misconception: The same CPR ratio applies to infants and adults. Correction: Infants and children require 5 initial rescue breaths before compressions, whereas adults start with compressions only (30:2 ratio). The compression depth and hand placement also differ.
Misconception: You should put something in a choking child's mouth to remove the object. Correction: Blind finger sweeps can push the object deeper. Only perform a finger sweep if you can see the object clearly.
Misconception: An AED should not be used on children under 8 years old. Correction: AEDs can be used on children over 1 year with paediatric pads or a paediatric mode. For infants under 1 year, manual defibrillation is preferred, but if unavailable, an AED with paediatric pads can be used.

Frequently Asked Questions

Common questions students ask about this topic

Before You Start

Prior knowledge that will help with this topic

•Basic understanding of human anatomy and physiology, particularly the respiratory and circulatory systems in children.
•Familiarity with general first aid principles, such as the primary survey and calling emergency services.
•Knowledge of safeguarding and health and safety regulations in childcare settings, as per the EYFS framework.

Key Terminology

Essential terms to know

1. Understand the role and responsibilities of the paediatric first-aider2. Be able to assess an emergency situation safely3. Be able to provide first aid for an infant and a child who are unresponsive4. Be able to provide first aid for an infant and a child who are choking5. Be able to provide first aid to an infant and a child with external bleeding6. Know how to provide first aid to an infant or a child who is suffering from shock7. Know how to provide first aid to an infant or a child with bites, stings and minor injuries

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Emergency Paediatric First Aid

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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