1. Survey the scene: Is the scene safe? Are the other children safe? What happened? How many children are injured? Are there bystanders who can help?
2. Do a primary survey for life-threatening conditions: Is the child conscious and responsive? (A-B-C) Is the airway open? Is the child breathing? Is circulation normal? If no breathing or pulse, start CPR.
3. Phone the emergency medical services (911) system for help if... the child does not respond, the child has a life-threatening condition, or the injury appears serious (e.g., severe bleeding or pain).
4. Do a secondary survey for specific injuries:
- Talk with the child: Ask what happened and what hurts. Provide comfort. Explain that you will check his body for other injuries. Ask him to stay as still as possible and tell you where it hurts.
- Do a head-to-toe check: Head, scalp, face, ears, eyes, nose, mouth, neck, collar bones, chest, abdomen, arms, hands, legs (ask child to wiggle fingers and toes).
5. Do first aid, as needed:
- Stop bleeding.
- Immobilize injured bones, muscles and tendons.
- Remove poisons, splinters, small objects.
- Clean and bandage wounds.
6. Call the parent: Explain what happened, what you did, and how the child is. Explain whether the parent will need to pick the child up, take her to the doctor, or meet the ambulance at the hospital. Be sure to have the emergency consent forms.
7. Talk with the other children:
- Have another adult supervise the children while you care for the injured child.
- Reassure the children that first-aid is being given to the injured child and emergency help is on the way.
- Explain that you will talk with them about what happened as soon as possible. Later, answer children's questions about the incident and the injured child, and discuss how future injuries might be prevented.
8. Complete the Injury Report form:
- Give a copy to the parent.
- Keep a copy for the records.
Adapted with permission from: The American Red Cross Child Care Course: Health & Safety Units, 1990. All Rights Reserved in all Countries.