If you work with babies or young children in England, "paediatric first aid" is not an optional extra — it is written into the rules that govern early years settings. But unlike most workplace training, it is not a single national exam, and the requirements around who needs it, how long it lasts and what it must cover trip up a lot of nursery staff and childminders. Here is what the EYFS actually requires.
What is paediatric first aid, and why is it different from normal first aid?
Paediatric first aid (PFA) is first aid specifically for babies and children, and the technique differs from adult first aid in several important ways — chest compression depth, rescue-breath ratios and choking response are all different for a baby than for an adult. It is a statutory requirement of the Early Years Foundation Stage (EYFS) framework, the Department for Education's rulebook for early years providers in England.
- Who needs it Nursery staff, childminders, nannies, early years teachers
- Certificate lasts Three years
- Emergency course At least 6 hours face-to-face (EYFS Annex A)
- Full course At least 12 hours, with the emergency elements face-to-face (EYFS Annex A)
- Regulated qualification Level 3 Award in Paediatric First Aid (RQF), 12 guided learning hours
- Assessment Multiple-choice examination plus practical demonstration, pass/fail
Who actually has to hold it
The EYFS requires at least one person with a current full paediatric first aid certificate to be on the premises and available whenever children are present, and on every outing — and says a full-certificate holder should be in the room while children eat.
- Nursery and pre-school staff who gained a level 2 or level 3 early years qualification since 30 June 2016 need the certificate within three months of starting work to count in the statutory staff:child ratios.
- Childminders must hold a current certificate to register with Ofsted, and keep it current while registered.
- Reception classes and school nurseries follow the same EYFS requirement.
Get ready for the knowledge paper before your course. PassNova's paediatric first aid practice covers CPR, choking, seizures, anaphylaxis, burns and every EYFS-relevant topic, free and with every answer explained.
Emergency vs full paediatric first aid
EYFS Annex A sets minimum course lengths for two levels of training, and only one of them satisfies the requirement to have a paediatric first aider on the premises:
- Emergency PFA — at least 6 hours face-to-face, covering assessing an emergency, the unresponsive baby or child, CPR, seizures, choking, and bleeding and shock.
- Full PFA — at least 12 hours (the emergency elements delivered face-to-face), adding anaphylaxis, electric shock, burns, fractures, head and spinal injuries, poisoning, foreign bodies and eye injuries, bites and stings, heat and cold, medical conditions such as asthma, allergic reactions, diabetes, meningitis and febrile convulsions, and the first aider's own responsibilities.
Only the full course satisfies the EYFS requirement to have a qualified paediatric first aider present. The regulated route is the Level 3 Award in Paediatric First Aid (RQF) — 12 guided learning hours, delivered by an Ofqual-recognised awarding organisation and assessed by a multiple-choice examination plus a practical demonstration, graded pass or fail. Settings can also use a Voluntary Aid Society or a trade-body-approved trainer.
What the knowledge paper actually tests
Expect questions across the full range of paediatric emergencies: the primary survey and the unresponsive baby or child, CPR and AED use, choking, seizures and febrile convulsions, meningitis, bleeding and shock, anaphylaxis and adrenaline auto-injectors, asthma attacks, diabetic emergencies, burns and scalds, electric shock, poisoning, fractures and head/neck/back injuries, foreign bodies, bites and stings, heat and cold — plus the paediatric first aider's own duties, such as maintaining the first aid box, keeping accident records, telling parents the same day, and notifying Ofsted of a serious accident within 14 days.
Baby CPR is not the same as adult CPR
This trips people up in the practical assessment as often as the knowledge paper. Following Resuscitation Council UK's 2025 Paediatric Life Support Guidelines (published 27 October 2025):
- Call 999 on speakerphone first
- Give five initial rescue breaths
- Then compressions at a ratio of 15:2 if you are trained in paediatric life support (30:2 if you are only adult-trained)
- Compress at 100–120 times a minute, to at least one third of the chest depth
- Use the two-thumb encircling technique for a baby
- For choking, give back blows then chest thrusts for a baby — abdominal thrusts are only used from one year old
If your course materials or a refresher you have seen elsewhere still describe the 2021 sequence, check with the trainer which version is actually being assessed — the 2025 update is what current qualifications are built around.
How to prepare
- Learn the sequences until they are automatic — five rescue breaths, then 15:2, then the compression technique for the age group in front of you. Hesitating to recall the ratio costs real seconds in an actual emergency.
- Do not skip the "boring" admin content. Accident records, the 14-day Ofsted notification window and first aid box maintenance come up in the knowledge paper as often as the clinical scenarios.
- Practise scenario-style questions, not just fact recall. Most paediatric first aid papers describe a situation and ask what you would do next, which rewards understanding the sequence over memorising isolated facts.
- Check your renewal date. The certificate lasts three years — mark it early, since letting it lapse can mean you no longer count in ratios until it is renewed.
Frequently asked questions
How long does a paediatric first aid certificate last?
Three years. The EYFS requires renewal every three years to keep counting in ratios, and recommends considering annual refreshers in between so the skills stay current.
Do childminders need paediatric first aid?
Yes. Childminders must hold a current paediatric first aid certificate to register with Ofsted and to keep that registration.
What is the difference between the emergency and full course?
The emergency course is a minimum of 6 hours and covers the core emergencies — CPR, seizures, choking, bleeding and shock. The full course is a minimum of 12 hours and adds anaphylaxis, burns, fractures, poisoning, medical conditions and more. Only the full course satisfies the EYFS requirement for a paediatric first aider on the premises.
Is baby CPR different from adult CPR?
Yes. Resuscitation Council UK's 2025 guidelines start with five rescue breaths for a baby, then compressions at 100–120 a minute using a two-thumb technique, at a 15:2 ratio if you are paediatric-trained. Choking in a baby is treated with back blows and chest thrusts, not abdominal thrusts, which are only used from one year old.
One point of clarity: PassNova is a practice and revision site, not a training provider — the regulated Level 3 Award is delivered and assessed by an approved trainer, including the practical manikin work this article cannot cover. Details here come from the EYFS statutory framework, Resuscitation Council UK and the Ofqual register, checked in September 2026; always confirm current requirements on the EYFS framework page.