FIRST AID POLICY

Contents

Introduction
Staff Training
First Aid Equipment
Record Keeping
Notifying Parents
Notifying Ofsted
Transporting children to hospital
Assessing A Casualty
Managing Illnesses
Managing Incidents
Managing Injuries

Introduction

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

Illness	What is it	What to look for	What to do
Asthma	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 Wheezing Coughing Distress 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
Diabetes	Long term condition Individuals do not produce enough insulin to regulate book sugar levels	Weakness Fainting Hunger Confusion Irrational behaviour Sweating Cold clammy skin Rapid pulse/palpitations Trembling 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
Sepsis	Body responds to infection, reduces blood supply to vital organs, multiple organ failure, death	Fever, low temperature Fast breathing Seizure Mottled skin, cold to touch Rash which doesn’t change when touched Lethargic Dry nappies Not feeding May vomit	Call 999/112 Cuddle in a blanket Monitor response levels
Meningitis	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 Headache Neck stiffness Vomiting 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

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
Choking	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 Repeat 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.
Seizure	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
Fainting	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	Collapse 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
Eyes	Foreign object in the eye	Blurred vision Discomfort 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
Ears	Foreign object in the ear	Discomfort	Do not remove a foreign object lodged in ear. Take to hospital to remover Insect can be gently flooded out with tepid water
Nose	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

Injuries

What is it

What to look for

What to do

Wounds

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.

Burns

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

Pain

Tenderness

Shock

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

Distortion

Swelling

Bruising

RICE procedure

Rest the injured part

Ice pack or cold compress for 10 minutes

Comfortable support should be applied

Elevate the injury

Fractures

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

Pain

Swelling

Unnatural range of movement

Immobility

Grating noise or feeling

Deformity

Loss of strength

Shock

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

Dislocation

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

Nausea

Weakness to a limb

Speech difficulties

Dizziness

Seizures

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

Vomiting

Double vision

Seizure

Previous brain surgery

Policy date September 2021

Date for review September 2023

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