Criterion HS218#

All practicable steps are taken to get immediate medical assistance for a child who is seriously injured or becomes seriously ill, and to notify a parent of what has happened.

Documentation required#

1. A record of all injuries, illnesses and incidents that occur at the service. Records include:
   • the child's name
   • the date, time and description of the injury, illness or incident
   • actions taken and by whom and
   • evidence that parents have been informed.
2. A procedure outlining the service's response to injury, illness and incidents, including the review and implementation of practices as required.

Guidance#

How to show you are complying  #

Injuries, illnesses and incidents are a part of early childhood experiences, most of the time providing basic first aid and keeping parents informed of the event and what actions you have taken will be sufficient. However, if a child becomes seriously injured or ill, you will also need to act quickly to get medical help.

Serious injury 

Serious injury is not defined by a fixed list, but typically refers to any injury that:

• requires resuscitation
• leads to hospital admission for more than 24 hours
• involves a broken bone or suspected fracture
• causes dislocation of a major joint (for example shoulder, knee, hip, or elbow)
• results in loss of consciousness
• triggers severe breathing difficulties, including asphyxia
• penetrates the eye or causes a chemical or hot metal burn to the eye
• involves a head injury, especially if the child loses consciousness or becomes disoriented
• causes burns
• leads to excessive or uncontrollable bleeding
• leaves the child unresponsive or struggling to speak
• causes convulsions, seizures, or fainting.

Serious illness 

Serious illness isn’t defined by a fixed list, but includes any condition that:

• produces a prolonged high fever, particularly if accompanied by a rash
• triggers an anaphylactic reaction
• results from ingesting toxic substances or foreign objects.

Seek medical assistance

You must seek medical assistance in some circumstances.

If a child is seriously ill or injured while in your care, you must make sure that child gets immediate medical assistance.

It is better to seek medical assistance if you are unsure about the seriousness of an injury or illness than to wait and see. In these circumstances, it is best to call 111.  

Seeking medical advice such as phoning Healthline or Plunketline would not be considered seeking immediate medical assistance.

Notify parents

Services must notify parents if a child is seriously ill or injured.

If a child is seriously ill or injured, you must notify parents as soon as possible. Ideally this would be a phone call to the parent/caregiver directly. You should provide detailed information about what happened, when it occurred, and the actions you have taken in response. To make sure you can reach parents quickly in an emergency, keep enrolment records up to date with current contact details.

Keep records

You must keep written or digital records.

You must keep a record of all incidents, injuries and illnesses that happen at the service,
even if a parent or visitor tells you about it later. Your records must include:

• the child's name
• the date, time and description of the injury, illness or incident
• actions taken and by whom; and
• evidence that parents have been informed.

For any injury/incident that is notifiable under the Health and Safety at Work Act 2015 (HSWA), you must keep the records for 5 years from the date of the incident.

Recording all injuries, illnesses and incidents is important. This is because:

• the record of injury, incident or illness will be of assistance to paramedics or the child’s doctor if further assessment of the child’s health is required
• an injury, illness or incident that might be considered minor initially, can sometimes become more serious after a period of time
• records can help you see patterns or trends that can indicate changes are needed to prevent harm.

Procedure outlining the service’s response

You need a procedure outlining how your service will respond to injury, illness and incidents, including how you review and improve your practices when you identified changes are needed.  

Notify relevant agencies when required

Some injuries, illnesses, or accidents must be reported under specific legislation. You must understand and comply with these broader notification obligations.

There may be injuries and illnesses you consider serious in the context of notification that may not require seeking immediate medical assistance. For example, if there were contagious gastrointestinal illnesses, you would contact parents or caregivers to take the child home rather than call 111.

See HS227 for more information on when to notify agencies