Role of the Paediatric First Aider & EYFS Requirements

A practitioner who gained her level 3 early years qualification in 2022 starts work at a nursery. Under the EYFS, when must she hold a paediatric first aid certificate to be counted in the staff:child ratios, and how often must it be renewed?

• AWithin three months of starting work, and renewed every three years✓
• BWithin one month of starting work, and renewed every five years
• CWithin six months of starting work, and renewed every two years
• DBefore her first day with children, and renewed every twelve months thereafter

Answer: Staff who obtained a level 2 or level 3 qualification since 30 June 2016 must gain a PFA qualification within three months of starting to be counted in the ratios, and the certificate must be renewed every three years to keep counting. Shorter or longer windows and yearly or five-yearly renewals are not what the framework sets, although providers are encouraged to consider an annual refresher within the three-year period.

A nursery's only paediatric first aider is due to accompany the pre-school room on a trip to the library while the baby room stays open. What does the EYFS require?

• AThe trip must be cancelled, because a first aider may never leave the premises during opening hours
• BThe first aider may go on the trip as long as the baby room has a mobile phone and the first aid box
• CThe first aider must stay behind, because outings only need an adult who knows how to call 999
• DAnother person with a current full PFA certificate must stay on the premises with the babies✓

Answer: At least one person holding a current full PFA certificate must be on the premises and available whenever children are present, and one must also accompany children on outings, so both groups need cover. A phone and a first aid box do not replace a qualified person, outings are not exempt from the requirement, and cancelling is unnecessary if a second certificate holder covers the premises.

When deciding how many paediatric first aiders are needed, what does the EYFS say a provider should take into account?

• AThe Ofsted inspection grade, the size of the garden and the rate of staff turnover
• BThe age of the oldest child, the opening hours and the local ambulance response time
• CThe number of parents on the committee, the annual budget and the distance to hospital
• DThe number of children, the number of staff and the layout of the premises✓

Answer: The framework asks providers to consider the number of children, the number of staff and the layout of the premises so that a paediatric first aider can respond quickly to an emergency. Inspection grades, budgets, committee membership and ambulance response times are not the factors the EYFS names for this decision.

A newly appointed level 3 practitioner has a disability that prevents him from gaining a paediatric first aid certificate. How does the EYFS treat his position in the staff:child ratios?

• AHe must be moved to a role with no direct contact with children, and the provider must notify Ofsted within 14 days
• BHe can be counted only as an unqualified member of staff, and must be directly supervised by a first aider at all times
• CHe cannot be counted at any level until a doctor confirms in writing that the disability no longer prevents him qualifying
• DHe can still be counted if he is otherwise competent, and should attend the training and obtain written evidence that he attended✓

Answer: The framework lets the provider make an exception where a disability prevents a member of staff from gaining the certificate: they can still be counted in the ratios if otherwise competent, and where possible should attend the training and get written evidence of attendance. Excluding them from the ratios, downgrading them to unqualified, or removing them from contact with children are not what the EYFS requires, and no Ofsted notification is involved.

What does the EYFS say a provider should do with staff paediatric first aid certificates?

• ADisplay them or make them available to parents and carers✓
• BUpload them to the Ofsted portal at each annual self-evaluation
• CKeep them confidential in the individual staff personnel files
• DSend a copy of each one to the local authority every year

Answer: Providers should display staff PFA certificates, or a list of staff holding a current certificate, or make them available to parents and carers on request. Filing them away confidentially defeats that purpose, and there is no requirement to send them to the local authority or upload them to Ofsted.

At what point must a childminder hold a paediatric first aid certificate?

• AOnly if they employ an assistant, and then for as long as the assistant works
• BBefore registering, and at all times while they remain registered✓
• CWithin three months of registering, and then only while caring for babies
• DOnly once they care for a child under one, and then for as long as they do

Answer: Childminders must hold a PFA certificate in order to register and must keep it for the whole time they are registered. There is no three-month grace period for childminders, and the duty does not depend on the age of the children or on whether an assistant is employed.

Lunchtime is about to start in a nursery's toddler room. Which arrangement meets the EYFS safer eating guidance?

• AA member of staff with a food hygiene certificate is in the room while the children eat
• BA member of staff with a valid full PFA certificate is in the room while the children eat✓
• CA member of staff with a first aid at work certificate is in the room while the children eat
• DA member of staff with an emergency PFA certificate is in the room while the children eat

Answer: While children are eating there should always be a member of staff in the room with a valid full paediatric first aid certificate, because choking can happen suddenly. The six-hour emergency course, an adult first aid at work certificate and a food hygiene certificate do not satisfy this requirement.

A two-year-old grazes her knee in the garden at 10 a.m. and is given first aid. By when must her parents be told about the accident and the treatment?

• AAt the next parents' meeting, or within one month at the latest
• BWithin 24 hours, but only if the graze needed a hospital visit
• CThe same day, or as soon as reasonably practicable afterwards✓
• DWithin 14 days, in writing, on the setting's accident form

Answer: Parents or carers must be informed of any accident or injury, and of any first aid given, on the same day or as soon as reasonably practicable afterwards, and the provider must also keep a written record. The 14-day period relates to notifying Ofsted of serious incidents, not parents, and a delay until a later meeting or a hospital-only rule would breach the requirement.

Which statement about a setting's first aid box is correct?

• AIt must be kept in the kitchen and hold children's paracetamol, for high temperatures
• BIt must always be accessible and hold items suitable for children, with no medicines inside✓
• CIt must be checked by Ofsted at inspection and hold items set by the local authority, with no additions
• DIt must be locked in the office and hold the HSE's mandatory items, with nothing extra added

Answer: The EYFS requires a first aid box with appropriate items for use on children to be accessible at all times, and its contents should follow the setting's own needs assessment rather than a mandatory list, which the HSE does not publish. The HSE recommends that tablets and medicines are not kept in the box, locking it away defeats its purpose, and neither Ofsted nor the local authority sets its contents.

A child breaks his arm falling from climbing equipment at nursery and is taken to hospital. Within what time must the registered provider notify Ofsted?

• AAs soon as reasonably practicable and in any event within 7 days
• BAs soon as reasonably practicable and in any event within 14 days✓
• CAs soon as reasonably practicable and in any event within 28 days
• DAs soon as reasonably practicable and in any event within 24 hours

Answer: Registered providers must notify Ofsted, or their childminder agency, of any serious accident, illness or injury to, or death of, a child in their care, and the action taken, as soon as reasonably practicable and at the latest within 14 days; failing to do so without reasonable excuse is an offence. Local child protection agencies must also be told of a serious accident, injury or death, and their advice followed. Shorter and longer deadlines are simply not the period the framework sets.

A training company offers an emergency paediatric first aid course delivered as a four-hour live webinar, with a workbook to complete at home and no manikins. Why does this fail the EYFS Annex A criteria?

• AThe emergency elements can be taught online, but only by a registered nurse and only with a written examination lasting at least one hour
• BThe emergency elements need a trainer physically present for at least twelve hours excluding breaks, with an adult manikin shared between trainees
• CThe emergency elements need at least eight hours of self-study, with a video recording of each trainee practising submitted for marking
• DThe emergency elements need a trainer physically present for at least six hours excluding breaks, with baby and junior manikins for every trainee✓

Answer: Annex A requires the emergency PFA elements to be delivered face-to-face with the trainer physically present, online platforms being excluded, for a minimum of six hours excluding breaks, using baby and junior manikins so that every trainee practises, and competence must be assessed before a certificate is issued. Twelve hours is the minimum for the full course rather than the emergency one, an adult manikin does not cover babies and children, and self-study or recorded practice does not meet the face-to-face rule. Providers should also consider an annual refresher within the three-year certificate period.

A nursery manager is choosing where to send staff for paediatric first aid training. Which of these is one of the routes the EYFS names for identifying a competent provider?

• AA local secondary school's PE department
• BA private nursery chain's in-house trainer
• CA pharmacy that offers health checks
• DAn Ofqual-regulated awarding organisation✓

Answer: The framework leaves providers responsible for choosing a competent trainer and points to three routes: a member of a trade body with an approval and monitoring scheme, the Voluntary Aid Societies, or a trainer accredited by an Ofqual-regulated awarding organisation, with HSE guidance GEIS3 on choosing a provider. A school PE department, an in-house trainer or a pharmacy are not among the routes named.

How is the Level 3 Award in Paediatric First Aid (RQF) assessed and graded, according to the Ofqual register?

• AAn online quiz and a reflective account, graded as a percentage score
• BA multiple-choice examination and a practical demonstration, graded pass or fail✓
• CA written essay and an oral interview, graded from distinction down to pass
• DA portfolio of workplace evidence and a supervisor observation, graded from A to E

Answer: The Level 3 Award carries 12 guided learning hours against 6 for the Emergency award, and it is assessed by a multiple-choice examination plus a practical demonstration and graded simply pass or fail. Essays, portfolios, reflective accounts and percentage or lettered grades are not part of the qualification.

A parent asks the nursery to give her four-year-old a medicine that contains aspirin during the day. Under the EYFS, when may staff do this?

• AOnly if a pharmacist has recommended it, with verbal parental permission and a note in the daily diary
• BOnly if a doctor has prescribed it, with written parental permission and a written record of each dose given✓
• COnly if the manager agrees, with written parental permission and the parent present when each dose is given
• DOnly if the child is over five, with written parental permission and the dose written on the bottle

Answer: Prescription medicines may normally be given if prescribed by a doctor, dentist, nurse or pharmacist, but a medicine containing aspirin may be given only if a doctor has prescribed it, and every medicine needs written parental permission, a written record each time it is given and the parents informed the same day or as soon as reasonably practicable. A pharmacist's recommendation, verbal consent, the child's age or the manager's agreement do not meet the rule for aspirin.

A child has a bleeding graze on his elbow. What should you do before you touch the wound?

• AWash the child's hands with antibacterial soap and hot water
• BPut on a plastic apron and tie back the child's hair
• CPut on disposable gloves and cover any cuts on your own hands✓
• DRinse your hands in the sink and dry them on the nearest towel

Answer: Disposable gloves and covered cuts on your own hands protect both you and the child from infection passed through blood. Washing the child's hands, rinsing your own without gloves, or putting on an apron do not give that barrier protection.

Which description best sums up the role of a paediatric first aider when a child is seriously hurt?

• AContact the child's GP, obtain a prescription and administer the treatment the GP advises
• BGive first aid, reassure the child, hand over to the ambulance crew and record what happened✓
• CDiagnose the illness, decide on the medicine needed and treat the child until they recover
• DTake the child to A&E in a staff member's own car, wait with them and update the parents by text

Answer: A first aider gives immediate care to preserve life and prevent the condition worsening, keeps the child calm, hands over to the ambulance service, records the accident and the treatment, and makes sure the parents are informed. Diagnosing conditions, prescribing or obtaining medicines and providing ongoing treatment are for medical professionals, and transporting a seriously injured child yourself rather than calling 999 is unsafe.