Paediatric First Aid: Navigating UK & Ireland Childcare Regulations

Ensuring Child Safety: Paediatric First Aid Requirements in UK and Ireland Childcare

Childcare settings across the UK and Ireland bear a significant responsibility for the safety and well-being of the children in their care. A cornerstone of this responsibility is robust paediatric first aid provision. Regulatory bodies in both regions mandate specific requirements to ensure that staff are adequately trained to respond to emergencies involving infants and children. This article outlines the current regulations and key considerations for schools, nurseries, and other childcare providers.

UK Regulations: EYFS, Ofsted, and HSE Guidelines

In England, the primary regulatory framework for early years settings is the Early Years Foundation Stage (EYFS) framework, enforced by Ofsted. The EYFS mandates that at least one person with a current paediatric first aid (PFA) certificate must be on the premises and available at all times when children are present, including on outings.

Key aspects of the UK regulations include:

• Qualified Staff: At least one person with a full 12-hour PFA certificate must be present and available at all times children are on the premises and during outings. From September 2025, anyone counted in the staff-to-child ratio, including students, apprentices, and volunteers, must hold a valid PFA certificate.
• New Staff Requirements: All staff who obtained a Level 2 or Level 3 childcare qualification on or after 30 June 2016 must also have either a full PFA or an emergency PFA certificate within three months of starting work to be included in the required staff-to-child ratios.
• Mealtime Supervision: A new statutory requirement from September 2025 dictates that at least one PFA-qualified staff member must be present in the room during mealtimes to address emergencies like choking.
• Training Renewal: PFA certificates must be renewed every three years to ensure skills and knowledge remain current.
• Course Content: PFA courses must cover a comprehensive range of topics, including assessing emergency situations, dealing with unresponsive infants or children, CPR and defibrillation (for infants and children), choking, seizures, asthma, allergic reactions (including anaphylaxis), meningitis, head, neck and back injuries, fractures, poisoning, burns and scalds, electric shock, bleeding and shock, and more.
• Training Providers: Training must be undertaken through a reputable provider whose courses meet the requirements of the EYFS, with practical, hands-on training being crucial. Blended learning, combining online theory with practical assessment, is accepted for the 12-hour PFA course.
• HSE and Schools: While the Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate first-aid arrangements for their employees, the HSE strongly recommends that schools include non-employees, such as pupils and visitors, in their first-aid provision. Schools are also encouraged to teach basic first aid to students as part of the national curriculum.

Irish Regulations: Tusla and the Child Care Act

In the Republic of Ireland, the regulation of early years services falls under the remit of Tusla, the Child and Family Agency. The Child Care Act 1991 (Early Years Services) Regulations 2016 specifically require that a registered provider ensures a person trained in first aid for children is, at all times, immediately available to children attending the pre-school service.

Key aspects of the Irish regulations include:

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• First Aid Responder (FAR): Tusla recognises the First Aid Responder (FAR) Education and Training Standard, established by the Pre-Hospital Emergency Care Council (PHECC), as the course that meets this regulatory requirement.
• Availability: At least one FAR-trained person must be immediately available to children at all times.
• Refresher Training: FAR certificates are valid for two years, and participants must complete a refresher course before their certificate expires to remain qualified.
• Risk Assessment: The number of people trained in first aid for children should be based on the service's risk assessment, considering factors like the size of the service and identified hazards.
• Course Content: Effective paediatric first aid instruction in Ireland should cover infant and child CPR, choking emergencies, allergic reactions and anaphylaxis, asthma emergencies, seizures, bleeding and wounds, burns and scalds, and recovery position techniques.
• HSA and Workplaces: The Health and Safety Authority (HSA) in Ireland governs First Aid at Work regulations for all workplaces, including schools. Employers must conduct a risk assessment to determine their first aid needs. While not explicitly mandating paediatric-specific first aid for all school staff beyond the FAR for early years settings, HSA guidance encourages considering the specific risks associated with children.

Resuscitation Council UK (RCUK) Guidelines

The Resuscitation Council UK (RCUK) regularly updates its guidelines for paediatric resuscitation and first aid based on the latest scientific evidence. The 2025 Guidelines include significant updates, particularly for paediatric resuscitation. Key recommendations emphasise early and repeated resuscitation education, starting from age 4-6, with annual refreshers throughout school years.

Important changes in the 2025 RCUK guidelines include:

• Calling Emergency Services: The new guidance advises calling 999 (or 112 in Ireland) immediately for any unresponsive person before assessing breathing.
• Paediatric CPR Ratio: For those trained in paediatric first aid, the recommended CPR ratio is 15 compressions to 2 rescue breaths, following 5 initial rescue breaths. For those trained only in adult CPR or untrained bystanders, the ratio is 30 compressions to 2 rescue breaths.
• CPR on a Bed: New evidence suggests it's better to start CPR immediately on a bed than delay moving the casualty, advising to remove pillows and kneel beside the bed to improve compression depth.
• AED Use: AEDs can be used on any age, including infants. Adult AEDs may be used if paediatric pads are unavailable.

These regulations and guidelines underscore the critical importance of specialised paediatric first aid training for all individuals working with children. Staying up-to-date with the latest requirements and best practices is essential for ensuring the highest standards of child safety. For comprehensive training solutions tailored to these requirements, consider Abertay Training at https://www.abertaytraining.co.uk.