Not the lightest read for your Tuesday morning, but this is going to be filled with critical updates and information that hopefully you will never have to use.
Before we get into this, we must credit the fantastic team at onlinefirstaid.com and Emma Hammett for the comprehensive updates on this topic. We have condensed the key information, but you can find the full article here.
A big thank you goes to Helen Ferguson, Group Medical Lead of Cognita School Group, for her help in collating this research.
Every five years, the Resuscitation Council UK publishes new paediatric resuscitation and First Aid guidelines. These new guidelines are aligned with those published by a slew of institutions, who back-up their findings with scientific research and clinical evidence.
Note that this article focuses on the changes to recommendations on paediatric resuscitation and first aid, covering individuals aged 0–18 years.
Fortunately, Paediatric emergencies are rare, but they still happen. And with approximately 750-800 cases a year, it’s best to be prepared.
Credit: First Aid for Life
CPR and first-aid training should be family‑centred.
Newborns to 4‑year‑olds are the most likely to have accidents at home. Since during term time we spend more time at school than at home, your classrooms and assemblies become crucial mediums for training, awareness, and information.
Ensuring that parents, caregivers, and the wider community know how to respond in an emergency first‑aid situation can make all the difference. Ideally, everyone should be able to recognise signs of an emergency and administer first aid and CPR.
New research commissioned by the Resuscitation Council UK highlights the critical need for CPR education in schools:
Cardiac arrests and other emergencies don’t discriminate, and receiving CPR and defibrillation early multiplies chances of survival by four. To support this, the guidance recommends:
Mandatory CPR training for schoolchildren, students, and all members of staff in schools, to link up what is called “the survival chain” and improve their likelihood of surviving a cardiac emergency.
It is therefore now recommended that:
Resuscitation training begins at 4 years old and is provided in schools every year.
Importantly, the guidance also highlights:
- The value of using a team approach
- Defining clear roles for each team member
- Training together in simulated scenarios so everyone knows exactly what to do and when.
- Hands‑on mannequin training, incorporating interactive aids, games, and scenario‑based learning, approaches that are especially well‑suited for children.
For infant resuscitation, the new guidelines recommend performing CPR (and chest thrusts for choking) using the two‑thumb encircling hands technique instead of the traditional two‑finger method. Pictured below:
Credit: First Aid for Life
If you attend a Paediatric Basic Life Support or Paediatric First Aid course, you’ll now be taught to start with five rescue breaths and then switch to chest compressions using a 15:2 ratio, meaning 15 compressions followed by 2 breaths once CPR begins.
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AEDs can be used on people of all ages, including infants. Automated external defibrillators are designed to check the heart rhythm and will only deliver a shock if a shockable rhythm (like ventricular fibrillation or pulseless VT) is present. They won’t shock unless it’s needed.
Most infants in cardiac arrest won’t have a shockable rhythm, so the AED may simply analyse and tell you to continue CPR without shocking.
There’s also been a significant update regarding AED pad placement for younger children.
Instead of putting them right in the middle of the chest like adults:
1. The front pad should now go just to the left of centre on the chest.
2. The second pad should be placed in the middle of the child’s back.
The idea is always to position the pads so that the electrical shock passes right through the heart, giving it the best chance of restarting a normal rhythm.
At Medical Tracker, we’ve partnered with St John’s Ambulance, the UK’s leading first‑aid training charity, to expand access to high‑quality CPR and first‑aid education for families, schools, and communities. Through this collaboration, we’re able to bring trusted, expert‑led training resources and engaging learning opportunities directly to schools and communities, helping more people feel confident and ready to act in an emergency.
Now, we know this blog has been information-dense, and there is a lot to take in. This issue is designed to be cherry-picked as needed. Many of the details are crucial to different stakeholders in your community. We have created an additional resource to help you with spotting the signs of paediatric emergencies.
P.S. This may be a great item to include in your next parent newsletter or staff meeting.