Injuries and emergencies can happen in the childcare setting, even when you least expect it. Many injuries are minor, such as cuts, scrapes, bruises, and splinters.

However, serious injuries can occur as well, such as head injuries, broken bones, severe cuts, knocked-out teeth, poisoning, burns, choking, and drowning. Children also can experience medical emergencies such as severe allergic reactions to insect bites or food, and asthma attacks.

While most injuries in childcare settings involve children, caregivers and other adults present are at risk as well. Planning, first aid training, and a proper first aid kit are necessary to protect the children in your care as well as you, other caregivers, and parents.

Plan, Prevent, and Prepare

The National Health and Safety Performance Standards state that childcare programs should have written plans for reporting and handling situations requiring urgent medical care or other incidents that threaten the health, safety, and well-being of the children, staff, or volunteers. In addition, the childcare facility should include policies and procedures concerning staff training on this plan.

Injury prevention is the first line of defense. Most injuries can be prevented by creating and maintaining safer play areas, establishing safety rules, following individual children’s health care plans, and supervising children properly.

However, when injuries do occur, being prepared to respond effectively can help both caregivers and children stay calm and facilitate the proper care of all involved. Being prepared to respond effectively to injury-related incidents includes first aid training and having a well-stocked first aid kit readily available.

First Aid Training

The American Academy of Pediatrics (AAP) asserts that all caregivers and teachers should have pediatric first aid training. For potentially serious injuries or emergencies, immediately call for emergency assistance.

At least one caregiver who is present at the scene should have training for life-threatening emergencies such as severe bleeding, breathing difficulties, poisoning, or head injury. This can make a tremendous difference while waiting for paramedics or other trained emergency help to arrive.

Contact your local American Red Cross for more details about CPR/first aid training opportunities in your area.

First Aid Kit: The Basics

Childcare programs should have a well-stocked first aid kit readily accessible at all times, including during outdoor play, field trips, and transportation. A single kit may be sufficient for home-based or small childcare programs although an extra kit might be kept in the kitchen.

Larger centers may require additional kits (e.g., one located in each area of the facility). Store additional kits in the kitchen and main office.

For outside play, a first aid kit should be nearby. This can be kept outside away from children in a waterproof container or carried outside by the caregiver.

First aid kits should be kept in a safe area away from children but be easily accessible by caregivers. All caregivers should be aware of the location of the first aid kits as well as what items are included.

First aid kits should be periodically checked to make sure that all needed items are included. If, for example, an early care and education professional uses the last adhesive in the kit, there should be a procedure in place to make sure they are replaced. A complete list of items that should be included in the first aid kit can be found from a number of places (see resources).

In addition, a mini-first aid kit can be useful for outside activities that take place near the facility. Supplies can be transported in a small, clearly marked case or fanny pack, and carried or worn by a staff member.

Items for the mini-kit include:

• Disposable non-porous gloves
• Pre-moistened cloths and hand sanitizer (if soap and water are not available)
• Adhesive bandages (assorted sizes)
• Sterile gauze pads, flexible roller gauze, and bandage tape
• Scissors and tweezers
• Plastic bags that seal (assorted sizes)
• Instant cold pack and a cloth or gauze to protect skin from a cold pack
• Pen/pencil and notepad
• Telephone numbers for emergency contacts (including Poison Control Center 800-222-1222)
• A cell phone with emergency numbers already programmed

Children with Special Health Needs

Childcare programs often enroll children who have allergies, asthma, diabetes, or other chronic medical conditions. Caregivers should be prepared to care for the unique and emergency medical needs of these children.

Every child with a chronic medical condition should have a written action plan detailing the child’s diagnosis, routine measures to maintain health and prevent complications, warning signs of an emergency, and emergency procedures to follow (including medication directions and whom to contact).

Keep a copy of the action plans in the emergency/first aid kit as well as in the childcare facility.

Keep a labeled supply of emergency medication in a separate first aid kit (e.g., injectable epinephrine for severe allergies or a metered dose inhaler for asthma), and be sure that the kit is always available. Check medications regularly for expiration dates.

All caregivers who work with children with special health needs should be trained in each child’s special care action plan and know how to access and use the plan as well as the first aid kit.

Injuries often can be prevented in the childcare setting. However, when injuries or medical emergencies do occur, it is crucial to have a plan and be ready to respond with a well-stocked, readily accessible first aid kit. Both caregivers and children will benefit from this important aspect of safety and preparedness.

Marilyn Massey-Stokes, EdD, CHES, FASHA, IC®
Associate Professor, Department of Health Studies, Texas Woman’s University

Internet Resources

First Aid Basics, American Red Cross, www.redcross.org

First Aid & CPR, Healthy Kids, www.healthykids.us/chapters/firstaid_pf.htm   

First Aid Kit List, www.childhealthonline.org

Pediatric First Aid for Caregivers and Teachers, American Academy of Pediatrics, www.pedfactsonline.com