As first aid trainers, we know that clarity and confidence are essential in delivering life-saving skills. Yet, navigating the guidelines around paediatric CPR, age classifications, and defibrillator use can sometimes be challenging, especially when different organisations define “children” and “adults” in slightly different ways. Here, we’ll unpack the latest thinking on age classifications, explore practical techniques in CPR, and outline how our Good First Aid Guide focuses on inclusivity and adaptability to support both first aiders and casualties in diverse community settings.
Understanding Age Classifications: RCUK, VAS, and the Good First Aid Guide
Resuscitation Council UK (RCUK) Paediatric Guidelines
The Resuscitation Council UK (RCUK) defines “children” as those between ages 1 and 18 in its Paediatric Basic Life Support (PBLS) guidelines. However, it’s important to remember that these PBLS guidelines are intended for healthcare providers with a duty to respond, who may have additional training and resources. This age range often causes confusion when applied in community first aid settings, where a responder’s priority is to ensure basic life support rather than complex age-based distinctions.
Voluntary Aid Services (VAS) and Good First Aid Guide
The Voluntary Aid Services (VAS) guidelines and our Good First Aid Guide provide a more streamlined approach. Rather than specifying an upper age limit, they categorise casualties as infants (under 1 year) and children (1 year and over). This flexible classification is particularly useful in community settings, where first aiders may not have the time or information to determine age accurately in emergencies. The Good First Aid Guide’s approach allows first aiders to focus on effective CPR techniques, adapting to the casualty’s size and needs without being bound by age restrictions.
Historical Use of “Onset of Puberty” as an Age Marker
Until around 2010, RCUK used “onset of puberty” as the marker for determining when to use paediatric versus adult CPR techniques. This method simplified decision-making by focusing on physical signs rather than age, which can be ambiguous in emergencies. The shift to defining children as ages 1–18 in RCUK’s healthcare-oriented PBLS guidelines aligns with clinical standards but can add complexity for first aiders without a clinical background.
Focusing on Practical Technique: Depth, Flexibility, and Inclusivity
The Good First Aid Guide prioritises practical technique over rigid age classifications. For instance, it advises first aiders to “use one or two hands for a child over one year as needed to achieve an adequate depth of compression (at least one-third of the chest depth).” This allows flexibility for first aiders to respond based on the size and needs of the casualty rather than age, which is especially helpful since some adults may be smaller than adolescents and vice versa.
Additionally, this approach promotes inclusivity by considering individuals of varying physical builds, including those with dwarfism or restricted growth conditions.
Dwarfism, or restricted growth, describes a range of conditions resulting in shorter stature, with some preferring the term “restricted growth” as more encompassing.
These conditions can lead to adults who are physically “child-sized,” making flexibility in CPR techniques crucial to providing safe, appropriate care in emergency situations. This adaptable technique empowers first aiders to make quick, effective decisions to deliver the right depth of compressions based on the casualty’s unique characteristics.
Paediatric Defibrillation: Aligning with RCUK and VAS
For defibrillation, the Good First Aid Guide aligns with RCUK and VAS by recommending paediatric pads or mode for children aged 1–8 when available. If paediatric pads aren’t accessible, standard adult pads can be used. This straightforward guidance avoids age-related confusion, particularly in urgent situations where time is critical.
Community-Based First Aid Recommendations: Empowering First Aiders
In community settings, for individuals who are not healthcare providers, the standard recommendation remains to use the adult Basic Life Support (BLS) technique. If the first aider is trained and confident, the Good First Aid Guide allows for adding modifications such as paediatric adjustments (e.g., 5 rescue breaths initially) to better support infants and young children. This provides a balance between maintaining simplicity for general responders and offering those with additional training the flexibility to apply more tailored approaches.
Moving Forward: Practical, Inclusive, and Flexible Training
We’re keen to keep enhancing courses to reflect these principles of practicality, flexibility, and inclusivity. By focusing on effective CPR techniques—achieving the correct compression depth and responding to the casualty’s size rather than age—our trainers and first aiders can deliver care that’s safe, effective, and adaptable for diverse communities.
Update to LO7: Child and Baby Basic Life Support
You will see on future copies of the course directive that the following changes have been made to LO7:
Objective Clarification: LO7 now emphasizes the importance of adapting adult Basic Life Support (BLS) techniques for infants and children, with a focus on achieving the correct compression depth and providing effective rescue breaths based on size rather than strict age classifications.
Inclusive and Flexible Approach: The learning objective incorporates an inclusive approach, allowing adjustments for varying body sizes, including individuals with restricted growth conditions.
Instructor Guidance: A guided discussion will include positioning options for infant resuscitation (e.g., using a waist-height surface for compressions), supporting control and effectiveness.
Let’s continue empowering our delegates to feel confident in making these quick, life-saving adjustments.
Thank you to all our dedicated trainers who help make first aid accessible and inclusive for everyone!
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