1. Introduction
  2. Staff Training
  3. First Aid Equipment
  4. Record Keeping
  5. Notifying Parents
  6. Notifying Ofsted
  7. Transporting children to hospital
  8. Assessing A Casualty
  9. Managing Illnesses
  10. Managing Incidents
  11. Managing Injuries

At The Crown Nursery we make every effort to ensure all children are safeguarded and well cared for. The health and safety of all is at the centre of our focus in decision‐making and procedures are put in place to ensure accidents and injuries are prevented.

Staff Training

Adequate First Aid provision and procedures are vital in the daily process of caring for the children however, in case accidents occur.  The nursery ensures that at least one Paediatric first aid trained member of staff is present in each room at all times and throughout nursery excursions and trips away from nursery.  These staff members are specifically trained to take action to supply first aid treatment in the event of an accident involving a child or adult. 

All staff attend Paediatric first aid training every three years by an Ofsted approved training company and in house refresher courses are provided in the interim. 

First Aid Equipment

The nursery has two fully equipped first aid kits on site.  One is stored in the nursery kitchen, in a clearly labelled unit.  The other is stored in the nursery office.  Both are checked and restocked regularly by the nursery manager. They are kept out of the reach of children.

Record Keeping

Records of all illnesses, accident and injuries, along with any first aid treatment required are kept and filed in the ‘Accident File’ in the nursery office.   Incident forms should be completed as soon as the accident is dealt with, whilst the details are still clearly remembered. 

Records of non- prescription and/or prescription medication or treatment given to a child, are also kept and filed.

The nursery reviews the accident forms monthly for patterns, e.g. one child having a repeated number of accidents, a particular area in each nursery or a particular time of the day when most accidents happen. Any patterns will be investigated by the nursery manager and all necessary steps to reduce risks are put in place

Notifying Parents

If an injury is classed as “non-serious”, for example a child falls over in the garden and scratches a knee, the parents will be notified when they collect their children at the end of the session.  They will be given an accident form describing the accident and the first aid care provided and will be asked to sign the form.

In the case of a minor head injury a phone call will be made to the parent as soon as possible, after the child has received first aid. 

Parents are notified immediately if a child has a more serious accident or if they suddenly become very unwell.

Notifying Ofsted

The nursery manager will report any accidents of a serious nature to Ofsted and the local authority.

Transporting children to hospital procedure

In the unlikely event of a very serious incident a senior member of staff will call for an ambulance immediately.  A child must never be transported in a staff members own vehicle.

Whilst waiting for the ambulance, senior members of staff will contact the parents/carers and arrange to meet them at the hospital

They will arrange for the most appropriate member of staff to accompany the child taking with them any relevant information such as registration forms, relevant medication sheets, medication and the child’s comforter.

Staff at nursery will be redeployed if necessary to ensure there is adequate staff to care for the remaining children. This may mean temporarily grouping the children together.

Staff will remain calm at all times. Children who witness an incident may well be affected by and may need lots of cuddles and reassurance. Staff may also require additional support following the accident and this is something senior staff will always endeavour to provide.

Assessing A Casualty

When you encounter a casualty, you have to assess them so you can deliver effective, safe and prompt first aid.  There are two procedure you must follow to help you determine what you response should be:

The Primary Survey

This is often referred to as DRABC, which stands for:

Danger; move any potential sources of danger so you can carry out first aid without any risk to you or the casualty.

Response; check to see if the casualty is response.  Call their name, flick sole of an infant’s foot, gently tap the casualty’s shoulders.

Airway; check that airways are open and clear, tilt an infant’s head back gently.

Breathing; once the airway is open listen, look and feel for breathing.  If the casualty is not breathing normally perform CPR immediately.

Circulation; if breathing is normal check for signs of severe bleeding and injury.

The Secondary Survey

After providing the primary survey, you should then find out what else is wrong with the casualty.  This procedure is called the Secondary survey and involves finding out the history, signs, symptoms and physically examining the casualty in a methodical way. Check:

A - Allergies; is the casualty allergic to anything

M - Medication; is the casualty taking any drugs

P - Previous medical conditions eg. asthma, diabetes

L - Last meal; what food or drink did they last have and when

E - Event history; what happened in the lead up to them needing help

Managing Illnesses


What is it

What to look for

What to do


Muscles of air passages spasm and narrow, making it hard to breath.

Can be caused or aggravated by allergy, cold, smoke, weather change, exercise, crying


Difficulty breathing and/or speaking




Blue tinged lips, ear lobes, nail beds

Sit child in comfortable position

Reassure them

Take usual dose of reliver inhaler (may use spacer)

Encourage them to breath slowly and deeply


Call 999/112 if needed



Long term condition Individuals do not produce enough insulin to regulate book sugar levels





Irrational behaviour


Cold clammy skin

Rapid pulse/palpitations


Deteriorating level of response

Sit child

Take glucose gel or sugary drink

Check blood sugar levels

Give more sugar if needed

Call 999/112 if no improvement

Monitor breathing and responses


Body responds to infection, reduces blood supply to vital organs, multiple organ failure, death

Fever, low temperature

Fast breathing


Mottled skin, cold to touch

Rash which doesn’t change when touched


Dry nappies

Not  feeding

May vomit

Call 999/112

Cuddle in a blanket

Monitor response levels


Infection of lining surrounding the brain or spinal cord.

Cause by a virus or bacteria

Very unwell

Flu like symptoms

High temperature

Mottled and very pale skin

Joint and limb pain


Neck stiffness


Sensitive eyes

Rash which doesn’t fade

Call 999/112

Seek urgent medical advice

Treat fever

Look for rash and do the ‘glass test’

Keep cool, monitor breathing, responses and pulse


Managing Incidents


What is it

What to look for

What to do

Nose bleed

Most commonly occurs when tiny blood vessels inside the nostrils are ruptured

Blood trickles from the nose

Sit the casualty down

Tilt their head forward to allow the blood to drain

Pinch soft part of nose

If bleeding continues for longer than 30mins or is severe send to hospital


Obstruction in the airways causes difficulty breathing

Difficulty breathing

Unable to cry or make noise

Holds neck

Change colour

Blueness to the lips

Bulging eyes

Cough or wheeze

Gestures, panic

Over 1 year

Lean casualty forward

5x blows to the back using heal of hand

5x abdominal thrusts


Under 1 year

Lay infant face down on thigh whilst supporting head

Five back blows

Check mouth for obstruction – do not sweep finger blindly

Turn infant over, 5x chest thrusts below breastbone


Call 999/112 if obstruction doesn’t clear

Continue back blows and chest thrusts.


Convulsions often caused by high temperature

Vigorous shaking with an arched back

Possible vomiting

Loss of bowel or bladder control

Red, puffy face and neck

High temperature with hot, flushed skin

May sweat

Let the convulsion happen naturally

Protect infant from hurting themselves by removing items around them, placing cushion under head


Remove some clothing to cool infant


Call 999/112


Place in recovery position, reassure


Reasonable common, caused by the brain not receiving enough blood for a short time.

Caused by standing for a long period, lack of food, emotional stress


Brief loss of response

Pale, cold, clammy skin

Lie casualty down

Raise legs

Open door/window to provide fresh air

Reassure casualty

Sit them up slowly

Allergic reaction

Abnormal sensitivity to a trigger eg. food, chemical, pollen, insect bite.


Anaphylactic shock is a severe allergic reaction.

Red, itchy rash or raised area of skin

Wheezing and difficulty breathing

Abdominal pain

Vomiting and diarrhoea


Swelling of tongue and throat

Impaired breathing

Signs of shock leading to becoming unresponsive

Assess signs and symptoms

Treat with antihistamine

Inform parents


Call 999/112 if needed


Foreign object in the eye

Blurred vision


Eyelids in a spasm

Redness and watering of the eye

Do not rub eye

Examine the eye gently

Wash out foreign objects with clean water


Foreign object in the ear


Do not remove a foreign object lodged in ear.

Take to hospital to remover


Insect can be gently flooded out with tepid water


Foreign object in the nose

Difficult or noisy breathing

Swelling of nose

Smelly or bloodstained discharge

Keep casualty calm

Breath through mouth

Do not remove a foreign object

Take to hospital to remove


Managing Injuries


What is it

What to look for

What to do


A break in the surface of the skin

Open wound; a break in the skin (cuts and grazes) causing bleeding.


Closed wound; a bruise

Wash your hands before and after treating a wound and/or wear gloves.

Clean wound under water or with an alcohol free wipe.

Cover the wound completely with a sterile material eg. plaster, gauze or dressing.


For severe bleeding control the bleeding by applying direct pressure to the wound and call 999/112.


Assess the severity and cause of a burn; size and depth

Skin may be red, pale or waxy, or sometimes charred, blistered and hot

Swollen and weeping

Smell of charred flesh or singed hair




Do not touch the burned area, as risk of infection.

Leave in place any clothing stuck to the burn.

Leave any blisters intact.

Hold burn under cold running water for a minimum of 10 mins or until pain eases.

Cover with clean plastic bag, kitchen film and sterile dressing.

Call 999/112.

Sprains & Strains

Injuries related to sports and physical activities.


Sprains; ligaments around joints are overstretched or torn by sudden movements


Strains; overstretching or tearing muscles

Difficulty moving the affected part

Sever pain and tenderness





RICE procedure


Rest the injured part

Ice pack or cold compress for 10 minutes

Comfortable support should be applied

Elevate the injury


Closed fracture;

skin is unbroken, internal damage can be seen as swelling


Open fracture;

has a wound, the bone may or may not be protruding



Unnatural range of movement


Grating noise or feeling


Loss of strength


Twisting, shortening or bending of a limb


Closed fracture;

Support the injured limb

Immobilise the affected part

Dial 999/112


Open fracture;

Cover the wound with a sterile stressing

Control bleeding without pressing on any protruding bones

Support and immobilise the injured limb

Dial 999/112


Bones are partly or completely pulled out of their normal position

Sever, sickening pain

Unable to move joint

Swelling and bruising

Area may look shorter, bent or deformed

Do not try to put the joint back into place.

Support the joint in a comfortable position with a sling or padding to prevent movement.

Check circulation to extremities.

Dial 999/112

Head injuries

Treat as serious. 

A head injury can result in;

Damage to brain tissue

Damage to blood vessels inside the skill

Fracture to one of the bones in the skull.

Recent blow to head

Wound to the head

Loss of responsiveness

Increased drowsiness

Worsening headache

Confusion/memory loss, Strange behaviour


Weakness to a limb

Speech difficulties



Balance problems

Sight problems

Clear fluid or watery blood leaking from nose or ear

Sit casualty comfortably

Apply a cold compress

Monitor breathing

Monitor level of response


Seek medical help if;

Worsening headache


Double vision


Previous brain surgery



Policy date                     September 2021                                      

Date for review            September 2023