Paediatric first aid is an important part of keeping babies and young children safe in nurseries, preschools, childminding settings and other early years environments.
Unlike general workplace first aid, early years providers in England must also meet specific requirements under the Early Years Foundation Stage (EYFS) statutory framework. These rules cover paediatric first aid training, staff availability, outings, first aid equipment and the recording of accidents and treatment.
This guide explains the main requirements in clear terms and helps early years providers understand the difference between general workplace first aid duties and the additional rules that apply when caring for children from birth to five.
Important: this guide applies to England. Scotland, Wales and Northern Ireland have separate early years frameworks and requirements.
Early years providers in England must follow the EYFS statutory framework. This includes nurseries, preschools, childminders, reception classes and other registered early years providers.
One of the most important requirements is that at least one person with a current full paediatric first aid certificate must be:
The number of trained people needed in practice may be higher than one. Providers should consider the number of children, number of staff, size and layout of the premises, working patterns and how quickly a trained person could respond to an emergency.
The EYFS applies to registered early years provision in England, including:
This is different from general school first aid provision. If you are looking at provision across a wider school environment, see our First Aid in Schools and Educational Settings guide.
The EYFS distinguishes between a full paediatric first aid course and an emergency paediatric first aid course.
| Training | Typical role under EYFS | Does it satisfy the main on-site PFA requirement? |
|---|---|---|
| Full Paediatric First Aid | Comprehensive paediatric first aid training meeting the EYFS Annex A criteria. | Yes, provided the certificate is current. |
| Emergency Paediatric First Aid | Shorter emergency-focused training that can be relevant to staff qualification and ratio requirements in certain circumstances. | No. The person required to be available on the premises and on outings must hold a full PFA certificate. |
The EYFS does not set one universal staffing number such as “one paediatric first aider for every ten children”.
The minimum requirement is that a person with a current full PFA certificate is available whenever children are present, but providers must consider whether that minimum is sufficient for their individual setting.
Factors to consider include:
A setting with one trained person on paper may therefore need several trained staff to ensure suitable cover throughout the working day.
This risk-based approach is similar to wider workplace provision. See our HSE First Aid Needs Assessment Explained guide for more detail.
Childminders must also meet the EYFS paediatric first aid requirements that apply to their provider type.
A childminder should hold a current paediatric first aid certificate. Any assistant who may be left in sole charge of children for any period should also hold an appropriate current paediatric first aid certificate.
Childminders should also consider how first aid would be provided when:
Safer eating is now an important part of the EYFS requirements.
While children are eating, there should always be a member of staff in the room who holds a valid full paediatric first aid certificate consistent with the EYFS criteria.
This requirement is particularly important because choking and allergic reactions can develop quickly in young children.
Providers should also ensure that staff understand each child's:
For more information about emergency response to choking, see our First Aid for Choking in Adults, Children and Babies guide.
For severe allergic reactions, see our First Aid for Allergic Reactions and Anaphylaxis guide.
Yes. Paediatric first aid training must be renewed every three years.
Providers should monitor certificate expiry dates and arrange renewal before a certificate expires. Waiting until the final few days can create a staffing problem if the setting no longer has sufficient qualified cover.
A practical training record could include:
Providers should select a competent training provider and make sure the course meets the relevant EYFS paediatric first aid criteria.
Additional rules apply to certain staff who hold level 2 or level 3 early years qualifications.
Staff who obtained a relevant level 2 or level 3 qualification on or after 30 June 2016 must have either a full paediatric first aid certificate or an emergency paediatric first aid certificate within three months of starting work if they are to be included in the required staff-to-child ratios at level 2 or level 3.
This requirement should not be confused with the separate rule requiring a person with a full PFA certificate to be available whenever children are present.
Early years providers should ensure that a first aid box is always accessible and contains appropriate items for use with children.
There is no single statutory contents list that is suitable for every setting. The contents should reflect the risks, number of children, activities and environment.
A nursery or early years setting may need to consider provision for:
First aid kits should be accessible to staff but stored appropriately so that young children cannot freely access their contents.
For a broader explanation of what to consider when selecting equipment, see our School First Aid Kits Guide.
You can also view our range of first aid kits when reviewing your setting's first aid provision.
Medicines and first aid equipment should be managed separately.
Early years settings have specific rules covering the administration of medicines, parental permission and record keeping. A standard first aid kit should not be treated as general medicine storage.
Providers should have clear procedures for medicines and ensure staff understand the difference between administering medication under an agreed care arrangement and providing immediate first aid.
The requirement for paediatric first aid does not stop when children leave the premises.
A person with a current full paediatric first aid certificate should accompany children on outings.
Before an outing, providers should consider:
A suitable travelling first aid kit may be necessary depending on the activity and risk assessment.
Our First Aid for School Trips guide covers many of the practical considerations that also apply to early years outings.
Early years providers should keep written records of accidents, injuries and first aid treatment.
Parents or carers should be informed of an accident or injury involving their child and any first aid treatment given on the same day, or as soon as reasonably practicable.
A useful incident record would normally identify:
Serious incidents may also need to be reported to Ofsted or the relevant childminder agency, and separate RIDDOR duties can apply in certain circumstances.
For a wider explanation of accident records, see our Accident Reporting and First Aid Records guide.
Registered providers must notify Ofsted, or the childminder agency with which they are registered, of certain serious accidents, illnesses, injuries or deaths involving a child in their care.
Where notification is required, it should be made as soon as reasonably practicable and within the applicable statutory timeframe.
Providers should not assume that every minor first aid incident is reportable. Internal accident recording, parent notification, Ofsted notification and RIDDOR reporting are separate processes with different thresholds.
A general first aid arrangement may not be enough for every child.
Providers should consider known conditions and individual needs when planning emergency arrangements. Examples can include:
Relevant staff should know where emergency medication is stored, who is authorised or trained to assist, and what action should be taken in an emergency.
No. The EYFS does not state that every member of staff must hold a full PFA certificate.
However, relying on only one trained person can be difficult in practice because providers must maintain adequate cover during:
Providers should therefore determine the number of trained staff needed to maintain effective cover rather than treating one certificate as automatically sufficient.
Common problems include:
| Check | What to confirm |
|---|---|
| Full PFA cover | A person with a current full PFA certificate is available whenever children are present. |
| Outings | A suitably qualified person accompanies children off-site. |
| Eating | A member of staff with a valid full PFA certificate is in the room while children are eating. |
| Certificate dates | Expiry dates are monitored and renewal is arranged before the three-year validity period ends. |
| First aid equipment | An accessible and appropriately stocked first aid box is available. |
| Staffing cover | Breaks, absence, shifts and building layout do not leave children without suitable cover. |
| Medical needs | Known allergies and other individual health requirements are incorporated into emergency arrangements. |
| Records | Accidents, injuries and first aid treatment are recorded and parents or carers are informed appropriately. |
Paediatric first aid in early years settings is more than simply keeping a first aid box on the premises.
Providers in England must combine suitable equipment with trained people, reliable staffing cover, appropriate arrangements for outings and meal times, clear records and consideration of each child's needs.
The most effective approach is to treat paediatric first aid as an ongoing part of safeguarding and risk management. Training dates, staffing arrangements, equipment and emergency procedures should all be reviewed regularly so that the setting remains prepared when circumstances change.
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