CPR, First Aid & Bloodborne Pathogen Safety

Why These Skills Are Non-Negotiable in Child Care

As a child care provider, you are often the first—and only—adult present when a medical emergency strikes. A choking infant, a child in cardiac arrest, or a severe allergic reaction can become fatal within minutes. The American Heart Association (AHA) and American Red Cross both document that bystander CPR and early defibrillation dramatically improve survival outcomes. Your Heartsaver certification proves you can act correctly under pressure. This lesson builds every skill you need to pass that certification and to protect the children in your care every day.

Infant, Child, and Adult CPR

Cardiopulmonary resuscitation (CPR) keeps oxygenated blood moving to the brain and heart until advanced medical help arrives. The technique varies by age group.

Adult and Child CPR (ages 1 and older):

• Place the heel of one hand (two hands for adults) on the center of the chest, on the lower half of the breastbone.
• Compress at least 2 inches deep for adults; at least 2 inches for children (about one-third the chest depth).
• Push hard, push fast: target 100–120 compressions per minute.
• Allow full chest recoil between compressions—do not lean on the chest.
• Ratio: 30 compressions to 2 rescue breaths (30:2) for a single rescuer. Each breath should last about 1 second and produce visible chest rise.
• Minimize interruptions; keep pauses under 10 seconds.

Infant CPR (under 1 year):

• Use two fingers (or two-thumb encircling technique for two rescuers) on the center of the chest, just below the nipple line.
• Compress about 1.5 inches deep (one-third the chest depth).
• Rate: 100–120 compressions per minute; ratio 30:2 for a single rescuer.
• Cover both the mouth and nose with your mouth for rescue breaths.

AED Operation

An Automated External Defibrillator (AED) analyzes heart rhythm and delivers a shock to restore a normal heartbeat in cases of certain cardiac arrest rhythms. AEDs are designed for untrained bystanders but practice makes you faster and more confident.

1. Power on the AED (open the lid or press the power button—it will talk you through each step).

2. Attach pads to bare, dry skin: one pad below the right collarbone, one on the left side below the armpit. Use pediatric pads or a pediatric key/attenuator for children under approximately 8 years or under approximately 55 pounds; follow your specific device's guidance.

3. Plug in the connector and let the AED analyze rhythm—everyone must stand clear.

4. If a shock is advised, shout "Clear!" visually confirm no one is touching the patient, then press the shock button.

5. Immediately resume CPR starting with compressions; continue until the AED prompts another analysis or EMS takes over.

Priority First Aid Responses

Severe Bleeding: Apply firm, direct pressure with a clean cloth or gauze and maintain it without lifting. Do not remove soaked dressings—add more on top. Call 911 for wounds that do not slow. Keep the child calm and warm; watch for signs of shock (pale, cool, clammy skin; rapid breathing; confusion).

Anaphylaxis (Severe Allergic Reaction): Signs include hives, swelling of lips or throat, difficulty breathing, vomiting, and sudden drop in alertness. Act immediately: use the epinephrine auto-injector (EpiPen® or equivalent trainer in practice) against the outer mid-thigh and hold for the time specified on the device. Call 911 right away—epinephrine buys time, it does not end the emergency. Keep the child lying flat with legs elevated unless they are having trouble breathing. A second dose may be needed if EMS is delayed and a second auto-injector is available; follow your facility's written emergency plan.

Foreign-Body Airway Obstruction (Choking):

• Conscious infant: Give 5 back blows between the shoulder blades with the heel of your hand, then 5 chest thrusts using two fingers on the breastbone. Alternate until the object is expelled or the infant becomes unconscious.
• Conscious child or adult: Give 5 abdominal thrusts (Heimlich maneuver) between the navel and the lower breastbone. For a pregnant or obese person, use chest thrusts.
• Unconscious victim: Begin CPR; look in the mouth before giving breaths and remove any visible object—never perform a blind finger sweep.

Bloodborne Pathogens Safety

OSHA's Bloodborne Pathogens standard requires that workers who may be exposed to blood or other potentially infectious materials follow specific precautions. In child care, you may encounter blood from cuts, nosebleeds, or biting incidents.

Standard Precautions: Treat every body fluid as potentially infectious—every time, for every person.

PPE—donning and doffing:

1. Don (put on): Inspect gloves for tears, then pull them on before contact with any body fluid.

2. Doff (remove): Pinch the outside of one glove near the wrist and peel it off inside-out over your fingers. Hold the removed glove in your gloved hand, slip a bare finger under the cuff of the second glove, and peel it off inside-out so both gloves are contained together. Dispose of both without touching outer surfaces.

3. Wash hands with soap and water immediately after glove removal.

Spill Cleanup: Put on gloves (and eye protection if splash risk exists) before touching the area. Use paper towels to absorb visible material, then apply a facility-approved disinfectant solution (commonly a diluted bleach solution prepared per current public health guidance). Allow appropriate contact time, wipe, and dispose of all materials in a sealed plastic bag. Remove PPE correctly and wash hands.

Documentation

After any first aid event, complete an incident report before the end of your shift. Record the date, time, child's name, what happened, actions taken, who was notified, and your signature. Accurate documentation protects the child, families, your facility, and you.