Pediatric First Aid, CPR, and Emergency Response

Why Pediatric First Aid and CPR Matter in Early Childhood Settings

Preschool teachers are often the first—and sometimes only—adult present when a child has a medical emergency. A blocked airway, a cardiac event, or a severe allergic reaction can become life-threatening within minutes. Holding a current, accredited pediatric first aid and CPR certification is not optional: it is required for the Child Development Associate (CDA) credential and for most state childcare licenses. More importantly, it gives you the skills to act with confidence when seconds count.

Accredited Certification: What It Means

An "accredited" course is one recognized by a nationally accepted health authority. The American Red Cross Pediatric First Aid CPR AED course and the American Heart Association (AHA) Heartsaver Pediatric First Aid CPR AED course are two widely accepted options. Both include hands-on mannequin practice and end with a certification card that documents your competency. Check your state's childcare licensing rules to confirm which certifications are accepted, because requirements vary. Certification cards have expiration dates; you must renew before yours lapses to stay in compliance.

Infant CPR: The Sequence

Infant CPR applies to babies under approximately one year of age. Follow the published sequence from your certifying body. In general terms:

1. Check the scene for safety before approaching.

2. Check responsiveness by tapping the infant's foot and shouting.

3. Call or send someone to call 9-1-1 and retrieve an AED.

4. Begin chest compressions: place two fingers on the center of the chest, just below the nipple line. Push down about 1.5 inches at a rate of 100–120 compressions per minute.

5. Open the airway with a gentle head-tilt/chin-lift (avoid over-tilting an infant's head).

6. Give rescue breaths: cover the infant's mouth and nose and give small puffs just enough to see the chest rise.

7. Continue the compression-to-ventilation ratio specified by your certifying body (commonly 30:2 for a single rescuer).

8. Use the AED as soon as it is available, using pediatric-sized pads if provided.

Child CPR: Key Differences

Child CPR applies from approximately one year of age through puberty. Key differences from infant CPR include:

• Use the heel of one or two hands on the center of the chest.
• Push down about 2 inches (no more than 2.4 inches).
• Cover only the mouth for rescue breaths (pinch the nose closed).
• The compression rate and ratio remain the same as for adults in most protocols.

In a two-rescuer scenario, one person performs compressions while the other manages the airway and delivers rescue breaths. Rescuers should switch roles approximately every two minutes to prevent fatigue and maintain compression quality.

Choking Response

Infant choking (under 1 year): Hold the infant face-down along your forearm, support the head, and deliver five firm back blows between the shoulder blades with the heel of your hand. Then flip the infant face-up and give five chest thrusts using two fingers on the center of the chest. Repeat until the object is expelled or the infant becomes unresponsive. Never perform blind finger sweeps.

Child choking (1 year and older, conscious): Perform abdominal thrusts (Heimlich maneuver). Stand behind the child, make a fist above the navel and below the breastbone, cover it with your other hand, and deliver firm upward-and-inward thrusts. Repeat until the object clears or the child becomes unresponsive. If the child becomes unresponsive, begin CPR and look in the mouth before giving rescue breaths—remove any visible object.

Basic First Aid for Common Early-Childhood Emergencies

• Cuts and scrapes: Apply direct pressure with a clean gloved hand or sterile gauze, clean the wound when bleeding stops, and cover with an appropriate bandage.
• Allergic reactions / anaphylaxis: Know which children have epinephrine auto-injectors prescribed, follow the facility's allergy-alert plan, call 9-1-1 for any sign of anaphylaxis, and administer the auto-injector per the prescriber's instructions if you are authorized to do so under your state's rules.
• Febrile seizures: Do not restrain the child. Clear the area of hard objects, time the seizure, place the child on their side after convulsions stop, and call 9-1-1 if the seizure lasts more than five minutes or if this is the child's first seizure.
• Head injuries: Observe for loss of consciousness, unequal pupils, or persistent vomiting; notify parents and call 9-1-1 for any serious signs.

Emergency Preparedness in the Preschool Room

Every licensed preschool must have a written emergency plan. A well-organized room includes:

• Posted emergency numbers (9-1-1, Poison Control, facility director, nearest hospital) at every phone and exit.
• A clear evacuation route posted at each exit, with a designated outdoor assembly point.
• A stocked first-aid kit in a known, accessible location (not locked away from staff).
• An allergy-alert binder with each child's photo, known allergens, and action plan.
• Defined staff roles: who calls 9-1-1, who performs first aid, who supervises the remaining children, and who meets emergency responders at the door.

Safety Reminders for This Lab

• Always wear disposable gloves and a face shield during mannequin practice to protect against cross-contamination.
• Sanitize mannequins with the provided wipes between each student's turn, following the manufacturer's instructions.
• The AED trainer used in this lab is a non-shocking training device; do not use a real AED on a mannequin.
• Never practice choking-response thrusts on a live person; use only approved training mannequins.
• If you feel dizzy during rescue-breathing practice, stop and rest; hyperventilation is possible.