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How to save a choking child – how to recognise and help

Choking can be one of the most terrifying situations you can find yourself in – even more so with children, do you know what to do?

Recognition

Choking is characterised by the sudden onset of respiratory distress associated with coughing and gagging. Suspect choking if:

  • The onset is very sudden
  • There are no other signs of illness
  • There are clues to alert the rescuer, for example a history of eating or playing with small items immediately prior to the onset of symptoms

Ineffective cough:

Unable to speak

Quiet or silent cough

Unable to breathe

Cyanosis

Decreasing level of consciousness

Effective cough:

Crying or verbal response to questions

Loud cough

Able to take a breath before coughing

Fully responsive

Refer to Hospital:

Victims who have had abdominal or chest thrusts

Victims you are worried or unsure about

What to do:

For a child aged 1- 18:

  1. Encourage the child to cough
  2. Administer up to 5 back slaps
  3. Perform up to 5 abdominal thrusts

For a baby aged 0-1: 

  1. Administer up to 5 back slaps
  2. Check the mouth to remove any obvious obstructions
  3. Perform up to 5 chest thrusts

Back Slaps

Child aged over one year – bend the child well forward and give up to five blows between the shoulder blades using the heel of your hand. Check the mouth.

Baby/infant less than one year – lay the baby face down along your thigh and support the head. Give up to five blows between the shoulder blades using the heel of your hand.

Abdominal and Chest Thrusts

Child aged over one year – perform abdominal thrusts. Put your arms around the child’s upper abdomen and bend them well forwards. Place your fist between the navel and the bottom of the breastbone and grasp it with your other hand. Pull inwards and upwards sharply up to five times. Stop if the obstruction clears, if not check the mouth and carry on.

Baby/infant less than one year – perform chest thrusts using two fingers in the middle of their chest. Never perform abdominal thrusts on this age group.

Once you’ve done one cycle of back slaps and thrusts if the obstruction has not cleared go for help/call 999. If you have someone with you don’t delay in calling for help

Anaphylaxis – an awareness

Do you know how to recognise anaphylactic shock and how to help?

Anaphylaxis is a severe allergic reaction that affects the breathing and blood pressure of the casualty – and is therefore a life threatening condition. It can develop very quickly in people who are susceptible to it.

Signs and symptoms:

  • Red, blotchy skin
  • Tingling in the mouth
  • Swelling – initially localised (tongue and mouth) and then more widespread (throat and under the arms)
  • Puffiness around the eyes
  • Difficulty in breathing – tight chest, wheezing

These casualties need immediate medical aid. The drug that is used to treat anaphylaxis is called Epinephrine. This is a life saving procedure that needs to be instigated at the earliest opportunity.

Treatment:

  • Airway, Breathing and Circulation – the A.B.C’s
  • Rest and reassure
  • Loosen tight clothing
  • Steady and support in a position that allows them to breath more easily – normally sitting upright
  • Help the casualty to administer their auto-injector
  • Be prepared to resuscitate
  • Seek urgent medical help

Heart attack and cardiac arrest what’s the difference?

Heart attack and cardiac arrest what’s the difference? This sheds some light on their differences, their signs and symptoms and treatments.

Heart Attack

A heart attack occurs when a portion of the heart muscle is deprived of oxygen and dies.

Signs and symptoms:

Sudden crushing, vice like central chest pain that may radiate to the jaw, left and right arm
Some casualties may also describe the pain as indigestion or as though a heavy weight was placed on their chest
Cold, clammy skin – ashen in colour
Rapid pulse, sometimes irregular
Shortness of breath
Feeling faint or collapse
Nausea and/or vomiting
Impending sense of doom

Treatment:

Airway, Breathing and Circulation
Put the patient at ease
Minimise the work of the heart
Position – half sitting, head and shoulders raised, knees bent (the W position)
Loosen tight clothing
If available offer 300mg of Aspirin – if over the age of 16 and able to consent
Seek urgent medical help
Monitor
Be prepared to resuscitate

Cardiac Arrest

Describes any sudden “stoppage” of the heart
Possible causes include:
Heart attack • Electric shock
Blood loss • Drug overdose
Suffocation • Hypothermia
Recognition:
Unresponsive and the absence of normal breathing

Treatment:

Commence C.P.R.
Seek urgent medical help

What First Aid training should Nursery staff have?

First Aid News

Guidance on what First Aid training should Nursery staff have

We detail below the pertinent sections of the EYFS – while the guidance says at least 1 person – in reality (and in our experience) Nurseries typically train all staff at this level.
The relevant title we offer is Full Peadiaitric First Aid – this is a 2 day course when delivered face to face, as below this can be delivered via blended learning (one day classroom and part online).

Here’s the excerpt – source https://www.gov.uk/government/publications/early-years-foundation-stage-framework–2

At least one person who has a current paediatric first aid (PFA) certificate must
be on the premises and available at all times when children are present and must
accompany children on outings. The certificate must be for a full course consistent
with the criteria set out in Annex A:

Annex A: Criteria for effective Paediatric First Aid
(PFA) training

    1. Training is designed for workers caring for young children in the absence of their
      parents and is appropriate to the age of the children being cared for.

    1. Following training, an assessment of competence leads to the award of a certificate.

    1. The certificate must be renewed every three years.

    1. Adequate resuscitation and other equipment including baby and junior models must
      be provided, so that all trainees are able to practice and demonstrate techniques.

    1. The emergency PFA course should be undertaken face-to-face and last for a
      minimum of 6 hours (excluding breaks) and cover the following areas:

    1. Be able to assess an emergency situation and prioritise what action to take

    1. Help a baby/child who is unresponsive and breathing normally.

    1. Help a baby/child who is unresponsive and not breathing normally.

    1. Help a baby/child who is having a seizure.

    1. Help a baby/child who is choking.

    1. Help a baby/child who is bleeding.

    1. Help a baby/child who is suffering from shock caused by severe blood loss
      (hypovolemic shock).

    1. The full PFA course should last for a minimum of 12 hours (excluding breaks) and
      cover the elements listed below in addition to the areas set out in paragraph 5 (the
      emergency PFA training elements outlined in paragraph 5 should be delivered
      face-to-face).

    1. Help a baby/child who is suffering from anaphylactic shock.

    1. Help a baby/child who has had an electric shock.

    1. Help a baby/child who has burns or scalds.

    1. Help a baby/child who has a suspected fracture.

    1. Help a baby/child with head, neck or back injuries.

    1. Help a baby/child who is suspected of being poisoned.

    1. Help a baby/child with a foreign body in eyes, ears or nose.

    1. Help a baby/child with an eye injury.

    1. Help a baby/child with a bite or sting.

    1. Help a baby/child who is suffering from the effects of extreme heat or cold.

    1. Help a baby/child having: a diabetic emergency; an asthma attack; an allergic
      reaction; meningitis; and/or febrile convulsions.
      50 Face-to-face means trainers are physically present with their trainees. This excludes the use of online
      platforms.

PFA training must be renewed every three years and be relevant for people caring for young children and babies.

Providers should take into account the number of children, staff, and layout of
premises to ensure that a paediatric first aider is able to respond to emergencies
quickly.
All staff who obtained a level 2 and/or level 3 qualification since 30 June 2016
must obtain a PFA qualification within three months of starting work in order to be
included in the required staff:child ratios at level 2 or level 3 in an early years
setting. To continue to be included in the ratio requirement the certificate must be
renewed every 3 years.
Providers should display (or make available to parents) staff PFA certificates or a
list of staff who have a current PFA certificate.

Can Schools hold a “Spare” emergency Salbutamol inhaler?

Can Schools hold a “Spare” emergency Salbutamol inhaler? YES!

The emergency salbutamol inhaler should only be used by children, for whom written
parental consent for use of the emergency inhaler has been given, who have either been
diagnosed with asthma and prescribed an inhaler, or who have been prescribed an
inhaler as reliever medication.
The inhaler can be used if the pupil’s prescribed inhaler is not available (for example, because it
is broken, or empty).
This change applies to all primary and secondary schools in the UK. Schools are not required to
hold an inhaler – this is a discretionary power enabling schools to do this if they wish. Schools
which choose to keep an emergency inhaler should establish a policy or protocol for the use of
the emergency inhaler based on this guidance.
Keeping an inhaler for emergency use will have many benefits. It could prevent an unnecessary
and traumatic trip to hospital for a child, and potentially save their life. Parents are likely to have
greater peace of mind about sending their child to school. Having a protocol that sets out how
and when the inhaler should be used will also protect staff by ensuring they know what to do in
the event of a child having an asthma attack.

Source: https://www.gov.uk/government/publications/emergency-asthma-inhalers-for-use-in-schools

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What fire training should businesses provide their employees?

What fire training should businesses provide their employees?

In the UK, businesses are required to provide adequate fire safety training to their employees to ensure they can respond effectively in the event of a fire emergency. The specific fire training required may vary depending on factors such as the size and nature of the business, the level of risk, and the type of premises. However, some general guidelines and requirements apply to most businesses:

  1. Basic Fire Safety Training: All employees should receive basic fire awareness training to understand the nature of fire, how fires start and spread, the importance of fire prevention measures, and what to do in the event of a fire alarm.
  2. Evacuation Procedures: Employees should be familiar with the evacuation procedures specific to their workplace, including the location of fire exits, assembly points, and evacuation routes. They should know how to raise the alarm, evacuate the building safely, and assist others if necessary.
  3. Fire Marshal or Fire Warden Training: Larger businesses or premises with higher risks may designate certain employees as fire marshals or fire wardens. These individuals receive additional training in fire safety and emergency procedures and may be responsible for assisting with evacuations, conducting fire drills, and coordinating with emergency services.
  4. Use of Firefighting Equipment: Employees who are designated to use firefighting equipment, such as fire extinguishers or fire blankets, should receive training on how to operate them safely and effectively.
  5. Regular Fire Drills: Businesses should conduct regular fire drills to ensure that employees are familiar with emergency procedures and can evacuate the premises quickly and safely. These drills should be conducted at least annually, and the results should be documented for review and improvement.
  6. Record-Keeping: Businesses should maintain records of fire safety training, fire drills, and any actions taken to improve fire safety measures. These records may be requested during inspections by fire safety authorities.

It’s important for businesses to assess their specific fire risks and tailor their fire safety training and procedures accordingly. They should also stay up-to-date with any changes in fire safety regulations or guidance issued by relevant authorities.

We offer a range of classroom, virtual and online training options to help employers meet their Fire Safety responsibilities.

Are you worried about using your First Aid skills outside of your working environment?

Are you worried about using your First Aid skills outside of your working environment?

We are occasionally asked if those who have had first aid training are vulnerable legally if they use their first aid skills in a public setting – away from work.

Our response is

“Use your first aid skills within the scope of which you have been trained”.

There are “Acts” that give First Aiders confidence to use their skills for the purpose of preserving life, here’s one :

The Social Action, Responsibility and Heroism Act 2015 (SARAH Act) was introduced in the UK with the aim of providing additional reassurance to individuals who engage in certain types of voluntary activities, including acts of heroism, by outlining the factors courts should consider when determining negligence claims

While the SARAH Act does not specifically mention first aid or medical assistance, it does cover a broad range of voluntary activities and acts of heroism. The Act states that courts, when determining negligence claims, should consider whether the person acted heroically to prevent or mitigate harm or damage, whether the person demonstrated a responsible approach towards protecting the safety or interests of others, and whether the person was acting for the benefit of society or any of its members.

While the SARAH Act does not provide blanket immunity or specific protection for those delivering first aid, it underscores the importance of considering the context and intentions of individuals who engage in voluntary activities or acts of heroism when assessing negligence claims.

What first Aid Training does a Secondary School need?

What first Aid Training does a Secondary School need?

The starting point for all schools is to conduct a First Aid needs assessment – the HSE and the DfE give great advice on how to do this. We can of course help, its not as daunting as it sounds , it’s just about considering the size of the school, the number of employees, considering pupils and their possible medical conditions and any visitors to site. It’s also best to consider proximity to emergency services or likely response times and the history of any previous medical emergencies.

While regulations do not require employers to provide first aid for anyone other than their own employees, it is strongly recommended that all schools and colleges consider the needs of non-employees such as pupils, students and visitors when making provision for first aid.

In the majority of cases this drives secondary schools to look at 3 different titles with us, these are:

Emergency First Aid at Work for Schools (EFAW for Schools).

This one day course is suitable for all school staff , the content meets the HSE required syllabus for Emergency First Aid at Work but as the title suggests we acknowledge the requirement to tailor to both employees and pupils and add in relevant content accordingly. Most schools will train as many team members as possible on this title.

The second title is First Aid at Work, this 3 day course gives team members greater opportunity to get comfortable with the practical elements of CPR and choking, the syllabus is largely the same as the EFAW for schools but there is depth of knowledge and more time for scenarios – there are also more formal practical assessments.

The third title is Outdoor First Aid – This two day course is suitable for teachers and DofE assessors, The course includes both theory and practical sessions, in a relaxed atmosphere, aimed to boost a delegate’s confidence.

The content has been developed ( by the Institute for Outdoor Learning) to ensure that Teachers can accompany children off site on trips where the environmental factors and the nature/remoteness of the activities will require a specific first aid syllabus to be covered. Alongside the core first aid subjects there is special attention to subjects such as:

Recognition and management of drowning
Insulation and shelter
Age awareness for vital signs/CPR/bleeding
Ongoing monitoring and casualty care whilst awaiting help
Hypo/hyperthermia
Dehydration,
Stabilising/insulating/monitoring over time.

With blended learning (part classroom and part online) now permissible under HSE guidance there are a number of ways for schools to combine courses , avoid repetition and save money with us.

Whether you are looking for training on an inset or Teacher training day, or you are looking for training after school during twilight sessions we can help you find the best, cost effective, compliant training for your school.

Calls for compulsory Bleed Kit training in Schools.

Calls for compulsory Bleed Kit training in Schools.

A community worker close to the families of two teenagers fatally stabbed, has started a petition to make it compulsory for first aid training for stab victims to be taught in secondary schools.

“We want to make it compulsory that all secondary school children have bleed kit training,” she said. “We think it is important that children and young adults have knowledge from a young age of how to use bleed kits. With all that is happening in the world, we think this could save people’s lives. It may also make young children/adults want to join the healthcare sector”

The petition has been set up on the Government’s Parliament website, and Carly hopes national awareness of the call will take it past the 100,000 signature threshold required to get the idea debated in parliament. The deadline is 23 August 2024.

If your school would like to undertake Bleed kit training please call our team, we can add this to an exiting course or offer a standalone catastrophic bleeding training session.

FREC or FPOS?

FREC or FPOS?

We switched to delivering FREC 3 (First Response Emergency Care) once FPOS (First Person on Scene) became a level 4 qualification. Whilst both are similar in content and are both suited to those who may have a duty to respond to a medical emergency, it has been our opinion that the FPOS qualification requires far more written work to achieve the resulting qualification.

The FREC course sits at level 3 and for those who have historically taken FPOS this course is very similar to the “old ” FPOS qualification.

Of course, it’s personal choice! Both are related to pre-hospital emergency care and focus on providing essential first aid and life-saving interventions in the critical moments before professional medical help arrives. Both include assessing the scene, ensuring personal safety, managing airways, controlling bleeding, providing CPR, and immobilizing casualties.

Aid Training’s team are always happy to chat through the specifics of the course.

What First Aid Training does a Primary School need?

What First Aid Training does a Primary School need?

The starting point for all schools is to conduct a First Aid needs assessment – the HSE and the DfE give great advice on how to do this. We can of course help, its not as daunting as it sounds , it’s just about considering the size of the school, the number of employees, considering pupils and their possible medical conditions and any visitors to site. It’s also best to consider proximity to emergency services or likely response times and the history of any previous medical emergencies.

While regulations do not require employers to provide first aid for anyone other than their own employees, it is strongly recommended that all schools and colleges consider the needs of non-employees such as pupils, students and visitors when making provision for first aid.

In the majority of cases this drives primary schools to look at 3 different titles with us, these are:

Full Paediatric First Aid – This 2 day courses is suitable for those looking after reception year pupils in line with the Statutory framework for the early years foundation stage ( EYFS). The guidance highlights that:

“At least one person who has a current paediatric first aid (PFA) certificate must
be on the premises and available at all times when children are present and must
accompany children on outings”.

This will generally mean training several people in reality to allow for absence and coverage across school sites.

The second title is Emergency First Aid at Work for Schools (EFAW for Schools) .

This one day course is suitable for all school staff , the content meets the HSE required syllabus for Emergency First Aid at Work but as the title suggests we acknowledge the requirement to tailor to both employees and pupils and add in relevant content accordingly. Most schools will train as many team members as possible on this title.

The final title is First Aid at Work, this 3 day course gives team members greater opportunity to get comfortable with the practical elements of CPR and choking, the syllabus is largely the same as the EFAW for schools but there is depth of knowledge and more time for scenarios – there are also more formal practical assessments.

With blended learning (part classroom and part online) now permissible under HSE guidance there are a number of ways for schools to combine courses , avoid repetition and save money with us.

Whether you are looking for training on an inset or Teacher training day, or you are looking for training after school during twilight sessions we can help you find the best, cost effective, compliant training for your school.

What are the most common medical emergencies in schools?

What are the most common medical emergencies in schools?

In UK schools, some of the most common medical emergencies include:

  1. Minor injuries: Such as cuts, bruises, and minor burns from accidents during activities or on the playground.
  2. Asthma attacks: Asthma is a common condition among children, and attacks can be triggered by various factors including exercise, allergens, or respiratory infections.
  3. Allergic reactions: Particularly to food allergens, insect stings, or other environmental triggers.
  4. Anaphylaxis: Severe allergic reactions that can be life-threatening and require immediate treatment with epinephrine.
  5. Seizures: Epilepsy or other medical conditions can cause seizures in children, which may require immediate first aid and medical attention.
  6. Sports injuries: Including sprains, strains, fractures, and head injuries during physical education classes or extracurricular activities.
  7. Fainting: This can occur due to various reasons such as dehydration, stress, or underlying medical conditions.
  8. Head injuries: Resulting from falls, collisions, or accidents, which may range from minor bumps to more serious concussions.
  9. Chronic conditions management: Such as diabetes, where students may experience hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) requiring immediate attention.
  10. Breathing difficulties: Apart from asthma, other respiratory conditions or infections can cause breathing difficulties in children.

It’s important for schools to have trained first aiders who are prepared to handle these common emergencies effectively and efficiently, as well as protocols in place for communication with parents and the emergency services.

Extra clarification around “spare” auto-injectors in schools.

First Aid News

Guidance on Spare auto injectors in schools

Clarification has been given around the holding of spare auto-injectors in schools.

Here’s a clarification letter:

Clarification of AAI guidance for schools in relation to Regulation 238 of the Human
Medicines Regulations 2012 (in response to queries received):
The MHRA is aware of some uncertainties in relation to the permitted scope of use of “spare”
adrenaline auto-injectors held by schools.
Under Schedule 17 of the Human Medicines Regulations 2012 (as amended in 2017),
adrenaline auto-injectors can now be supplied to schools, without being issued against a
prescription for a named patient. The intention is for schools to hold such adrenaline autoinjectors
as back-ups for use in an emergency to treat anaphylaxis. The guidance issued at
the time indicated that such “spare” adrenaline auto-injectors could only be administered to
pupils known to be at risk of anaphylaxis, for whom both medical authorisation and written
parental consent for use of the school’s auto-injector(s) had been provided, for example
through an allergy care plan.
The MHRA would like to clarify that, in principle, a legal exemption under Regulation 238
permits a school’s adrenaline auto-injector(s) to be used for the purpose of saving a life, for a
pupil or other person not known by the school to be at risk of anaphylaxis (and thus does not
have medical authorisation/consent in place for the spare device). This might be, for example,
a child presenting for the first time with anaphylaxis due to an unrecognised allergy. The
provision under Regulation 238 should be reserved for exceptional circumstances only, that
could not have been foreseen. The normal expectation would be for those at risk of
anaphylaxis to have been clearly identified by the school in advance, to reduce the risk of
equivocation, and potential delay in adrenaline auto-injector administration, in the event of an anaphylactic emergency. “Spare” adrenaline auto-injectors held by schools are not supplied against a named prescription for an individual patient, which distinguishes them from adrenaline auto-injectors prescribed to individual pupils and that should be accessible to them at all times. The use of a school’s adrenaline auto-injector, rather than using another pupil’s personal auto-injector, to treat an individual not known by the school to be at risk of anaphylaxis ensures that the personally prescribed auto-injector remains available to that pupil. The schools’ guidance makes it clear that the spare auto-injectors held by schools are not intended to replace children’s own adrenaline auto-injectors. They are available for exceptional use as would apply in this circumstance. This clarification will be published from the agency, to ensure that this guidance is available to all.
Yours faithfully
Mr Julian Beach
Deputy Director, Population Health

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Do you need training to use an AED?

Do you need training to use an AED?

You do not need formal training to use an Automated External Defibrillator (AED).

AEDs are designed to be user-friendly, with voice prompts and visual instructions that guide individuals through the process of delivering a shock to someone experiencing sudden cardiac arrest.

However, training is recommended and is a compulsory part of all Emergency First Aid at Work and First Aid at Work courses. Training ensures that users are familiar with the device, understand when and how to use it effectively, and can perform CPR (Cardiopulmonary Resuscitation) in conjunction with AED use.

Training will include:

    1. Recognising the signs of sudden cardiac arrest.

    1. How to alert the emergency medical services.

    1. Performing CPR, including chest compressions and rescue breaths.

    1. Using an AED, including proper placement of electrode pads and interpreting voice prompts.

    1. Safety precautions to take when using an AED.

By completing formal training, individuals gain confidence and competence in responding to cardiac emergencies, which can significantly improve the chances of survival for someone experiencing sudden cardiac arrest.

What First Aid Training should a Nanny have?

What First Aid Training should a Nanny have?

The most commonly recommended first aid training courses for nannies include:

Paediatric First Aid: This course specifically focuses on first aid techniques for infants and children. It covers topics such as CPR (Cardiopulmonary Resuscitation), choking, dealing with burns, cuts, fractures, and other common childhood emergencies. Aid Training’s 6 hour Emergency Paediatric course fulfills this requirement and is suitable for those registering on the voluntary part of the Ofsted Childcare Register.

First Aid for Mental Health: Some nannies may also benefit from training in mental health first aid, which equips individuals with the skills to provide initial support to someone experiencing mental health problems. Aid Training offer a schedule of virtual training courses in this area.

Extra guidance can be found on www.gov.uk