2.3. Identify circumstances when children and young people might require urgent medical attention

This guide will help you answer 2.3. Identify circumstances when children and young people might require urgent medical attention.

Recognising when a child or young person needs urgent medical help is a key part of good practice in early years and playwork settings. Quick decisions and fast action can prevent serious harm. Your responsibility is to act immediately if a child shows signs of a serious health problem, injury, or condition that could worsen quickly.

In this guide, we will look closely at the circumstances that mean urgent attention is needed. We will include what to look for and why it matters. Always seek professional medical advice when dealing with emergencies.

Breathing Difficulties

If a child is struggling to breathe, this is always an emergency. The airway may be blocked, or there may be a medical condition affecting their lungs or heart.

Signs to watch for include:

• Wheezing or gasping
• Breathing that is fast and shallow
• Pauses in breathing
• Skin or lips turning blue or pale
• Struggling to speak or cry

In babies and toddlers, breathing difficulty can happen quickly after choking, illness, or allergic reaction. In older children, breathing problems may start suddenly through asthma or injury. You must call emergency services immediately, and, if trained, give first aid to clear the airway or assist breathing.

Severe Choking

Choking can fully block the airway. This can lead to brain damage or death within minutes.

Signs that choking is severe:

• Inability to speak, cry or make any sound
• Hands clutching the throat
• Panic or distress followed by weakness
• Face turning red, then pale or bluish

If you suspect severe choking, act straight away using recognised first aid techniques such as back blows or abdominal thrusts if you are trained. Always call emergency services after giving aid. Even if the object is removed, medical examination is needed.

Seizures or Fits

A seizure or fit is caused by abnormal electrical activity in the brain. It can be linked to epilepsy, high fever, head injury or other health conditions.

Signs include:

• Sudden loss of consciousness
• Uncontrolled jerking movements
• Stiffening of the body
• Eye rolling or staring
• Periods of confusion afterwards

A seizure lasting more than five minutes or repeated seizures without recovery in between needs urgent medical help. If it is the child’s first seizure, treat this as an emergency. Position them safely away from objects that can harm them, and do not put anything in their mouth.

Severe Allergic Reactions (Anaphylaxis)

Some children have allergies to foods, insect stings, or medicines. Anaphylaxis is the most serious allergic reaction and can be life-threatening.

Signs can include:

• Swelling of the face, lips or throat
• Difficulty breathing
• Rash or hives across the body
• Feeling faint or collapse

Action steps:

• Call emergency services at once
• Use an auto-injector such as an Epipen if the child has one prescribed, and you are trained
• Keep the child lying down and calm until help arrives

Anaphylaxis requires immediate medical care even if symptoms improve after medication.

Heavy Bleeding

Heavy bleeding can quickly cause shock. This can happen after an accident, a fall, or other injury.

Signs include:

• Blood flowing rapidly from a wound
• Blood soaking clothing or dressings
• Child becoming pale, dizzy or weak

Control bleeding with firm pressure using a clean cloth or dressing. If possible, raise the injured area above heart level. Always call emergency services, especially if bleeding is not stopping, is from a large wound, or if the child becomes unresponsive.

Suspected Head Injury

Head injuries can be dangerous because they may lead to bleeding or swelling inside the skull.

Signs requiring urgent action include:

• Loss of consciousness at any time
• Confusion or strange behaviour
• Persistent headache or vomiting
• Drowsiness or difficulty staying awake
• Seizure or problems with movement

Do not allow the child to go to sleep before being examined except if medically directed. Keep them still and calm. Treat any head injury with caution, especially if caused by a fall, hit, or accident.

Burns and Scalds

Serious burns and scalds can cause shock and risk infection. Young children are at greater risk because their skin is thinner.

Signs of serious burns include:

• Large or deep burn
• Burn affecting face, hands, feet, or genitals
• Burn caused by chemicals or electricity
• White, charred or leathery skin

For all severe burns, call emergency services. While waiting, cool the burn with running lukewarm water for at least ten minutes. Do not use ice, creams, or press hard on the area. Cover with clean non-fluffy material.

Signs of Shock

Shock happens when the body is not getting enough blood to vital organs. It can be caused by major bleeding, burns, allergic reactions, or infections.

Signs to watch for:

• Pale grey or clammy skin
• Weak rapid pulse
• Fast shallow breathing
• Confusion or collapse

If you suspect shock, call emergency services. Keep the child lying down with their legs raised unless this causes pain or difficulty in breathing. Loosen tight clothing and keep them warm.

High Fever in Babies and Young Children

High fever can be a sign of infection. In very young children, fever can lead to fits or serious illness quickly.

Seek urgent medical help if:

• The child is under three months and has a temperature above 38°C
• A child between three and six months has a temperature above 39°C
• The fever is lasting and does not respond to treatment
• There are other signs such as rash, trouble breathing, persistent vomiting, drowsiness, or seizures

Fevers with rash that does not fade when pressed is an emergency as it may be linked to meningitis.

Suspected Meningitis

Meningitis affects the protective layers around the brain and spinal cord. It can be life-threatening and needs urgent hospital care.

Signs include:

• Severe headache or stiff neck
• Fever with a rash that does not fade when pressed with a glass
• Sensitivity to light
• Vomiting
• Drowsiness or confusion

In babies and very young children, signs can include irritability, refusal to feed, seizures, and bulging soft spot on the head. Call emergency services without delay.

Poisoning

Children can be poisoned by swallowing, breathing in, or skin contact with harmful substances.

Urgent help is needed if:

• The child has swallowed a cleaning product, medicine, plant, or other poison
• They are drowsy, confused, or unconscious
• Breathing is affected
• There is persistent vomiting or seizures

Do not make the child vomit unless advised by medical staff. Call emergency services and take the container or description of the substance to show them.

Broken Bones and Serious Sprains

Broken bones can cause severe pain and loss of movement. Larger fractures or those affecting leg bones can lead to shock.

Signs include:

• Obvious bone deformity
• Swelling and bruising
• Difficulty using the affected limb
• Visible bone or open wound

Call for medical help straight away if you suspect a serious fracture. Keep the injured limb supported and still.

Sudden Unexplained Collapse

A child or young person who collapses without warning should be treated as an emergency. Causes can include heart problems, seizure, serious allergic reaction, poisoning, or trauma.

If the child is unresponsive, check for breathing and pulse. Begin CPR if trained and call emergency services straight away. Quick action here can save a life.

Severe Stomach Pain

Sudden or worsening stomach pain may be linked to appendicitis, bowel problems, or other serious illness.

Seek urgent help if:

• Pain is severe and lasts
• There is vomiting, especially if green or bloody
• The stomach is hard, swollen, or tender to touch
• Fever is present

Pain in the lower right side is often linked to appendicitis, which is an emergency.

Electrical Injuries

Electric shocks can cause burns, irregular heart rhythm, or internal injuries.

Signs needing urgent help:

• Burn marks at entry and exit points on skin
• Loss of consciousness
• Confusion or irregular heartbeat
• Muscle pain or cramps

Call emergency services and keep the child still. Do not touch the child until the electrical source is turned off.

Hypothermia

Prolonged exposure to cold can cause hypothermia, where body temperature drops too low.

Signs include:

• Shivering
• Confusion or slurred speech
• Drowsiness
• Pale cold skin

Move the child to a warm place and call for medical help. Warm the body gradually using blankets. Do not place them in hot water or near direct heat sources as this can cause shock.

Hyperthermia (Heatstroke)

Heatstroke happens when the body overheats and cannot cool down.

Signs include:

• Hot dry skin
• High temperature
• Confusion
• Headache and vomiting

Call emergency services. Move the child to a cooler place and use cool water or fans to reduce temperature. Do not give very cold drinks or ice on the skin.

Final Thoughts

Being aware of these circumstances will help you act quickly when a child or young person becomes seriously ill or injured. Recognising the signs of urgent medical need can be the difference between recovery and serious harm.

In any doubt, treat the situation as urgent and seek medical help straight away. Children can deteriorate very quickly and may not be able to explain how they feel. Your role is to observe, act, and get them the care they need without delay.