First‑Aid Playbook for Nannies: Your Quick Reference Guide

It’s many nannies’ nightmare – and for most, something that will never happen: an emergency when working with a child. The best approach is to come prepared, so that if something happens,your response can be appropriate and lightning-fast. 

a toy ambulance in an article about CPR and first aid for nannies

We’ve put together this streamlined guide to help you act quickly and decisively no matter what comes your way. Read through it now, then keep it on hand if anything should happen in the future. 

Step one: Know the 3 Cs — Check • Call • Care

Start here.

  1. Check the scene and the child for safety and obvious injuries.

  2. Call 911 immediately for life‑threatening conditions.

  3. Care for the child until help or a parent arrives, or until you can get to emergency care.

Call 911, Urgent Care, or Parent?

If an emergency occurs, you’ll need to call the parent at some point – but they may not be your first call. Here’s how to decide:

Situation

Not breathing/choking, severe bleeding, seizure >5 min

Possible broken bone, deep cut needing stitches

Mild fever, scraped knee, small burn

911

X

Urgent care

X

Parent

X (after 911)

X

X

Rule of thumb: If you are unsure, call 911 first. A false alarm is always better than a missed crisis.

Post & Share Emergency Contacts

It’s also helpful at the start of any job (temporary or long-term) to confirm emergency contacts. Put the parents number in your phone, and make sure there is a paper sheet on the fridge with:

  • Parents’ numbers & pediatrician

  • Local urgent‑care address

  • Poison Control 1‑800‑222‑1222

Some families also have a preferred hospital in case of emergencies. Update this if the family moves or switches doctors, and snap a picture of the list on your phone so you have it when you’re out.

What to Do Right Now in 5 Top Emergencies 

1  Choking (Infant & Child)

Techniques differ depending on the age/size of the child. Familiarize yourself ahead of time with what’s appropriate for the kids in your care. Do not put your finger inside the child’s mouth to dislodge the item, as this can push it further down the airway.

  • Use LifeVac if parents have one, and familiarize yourself ahead of time with how to use it to suck out an obstruction from the airways

  • Call 911 if airway isn’t cleared after two cycles or child becomes unresponsive.

For infants:

  • Turn the baby over on its stomach along your leg, hold the head steady with one hand, then administer: 5 back blows between shoulder blades with the heel of your other hand;

  • Turn the child around on its back and administer 5 quick chest thrusts using two fingers on the middle of the breastbone.

For children 1 and up:

  • Stand behind the child and wrap your arms around the child's waist, making a fist with one hand and grabbing it with the other, just below the chest, slightly above the bellybutton.

  • Press into the abdomen and upwards, with quick pushes until the item is dislodged.

Pro tip: A CPR Course will let you practice on infant and child dummies to get the actions right

2  Severe & Minor Bleeding/Cuts

  1. Severe: 

    1. Apply firm pressure with clean cloth; 

    2. Add layers – never remove soaked pad; 

    3. Elevate limb; 

    4. Call 911 if bleeding spurts or soaks through

  2. Small cuts: 

    1. Rinse, 

    2. Dry, 

    3. Apply antibiotic ointment, 

    4. Bandage; 

    5. Alert parents at end of shift

3  Burns & Scalds

  • Cool under running water for 20 min; do not use ice or freezing water

  • Cover loosely with sterile, non‑fluffy dressing or leave open

  • Seek urgent care for blisters bigger than a quarter or burns on face, hands, genitals.

  • Severe burns (third degree, where the skin turns white, gray, or black) need emergency medical care; remove any loose clothing but nothing that is stuck to the skin; remove diapers if hot liquid is in them; rinse in cool water but take care not to subject the skin to prolonged cold to avoid freezing

For small babies who burn their hands lightly, letting them play in a bowl of cool water may be easier. If a child at any point loses consciousness, call 911.

4  Allergic Reaction / Anaphylaxis

  • Signs: wheeze, hives, swelling, vomiting and nausea, swollen tongue or difficulty swallowing, difficulty breathing

  • Use prescribed epinephrine if available immediately, then call 911; lay child flat with legs raised unless breathing is difficult.

Children with known, severe allergies often have epinephrine (either as EpiPen or nasal spray) which must be administered as soon as possible. A CPR class will let you practice using an EpiPen. 

If the symptoms disappear after one EpiPen dose, contact the parents. New guidelines say the child doesn’t necessarily have to go to the ER if you have another EpiPen on hand, are near an emergency department, and can monitor the child, but many parents will still choose to take their child to medical care.

5  Head Injuries & Concussion

Children fall all the time, and rarely does it lead to head injuries or concussions. However, when they do happen, there can be some long-lasting effects, so if you see signs of a concussion they should always be evaluated by a healthcare professional. Concussions are most common as a result of playing contact sports. 

  • For mild bumps, apply ice pack for 10 min; keep child awake for initial hour to observe

  • Watch the child for signs of concussion: vomiting, dizziness, unequal pupils – and call 911 if you see any

  • If a child under 1 year gets a blow to the head and doesn’t immediately cry, call 911

CPR at a Glance

CPR can be a lifesaving technique when used right. We at Smart Sitting recommend all nannies to be CPR Certified and do require it for caregivers working with infants. A Red Cross or AHA pediatric CPR course gives hands‑on practice and the latest guidelines.

Use CPR only if the child or infant is unresponsive and not breathing (or only gasping). Every second counts, so move fast:

  1. Check & Call – Tap the shoulder/foot, shout at the child, look for normal breathing ≤ 10 sec. If no response or breathing, send someone to call 911; if you’re alone, call 911 on speaker.

  2. Lay the child on a firm, flat surface.

    Start CPR at a rate of 30 seconds chest compressions to 2 breaths (as per the most recent guidelines).

  3. Chest Compressions (30 sec)

    • Child (≈1–12 yrs): Place the heel of one hand (or both for larger child) on the center of the chest; push 2 inches deep at 100–120 compressions/min.

    • Infant (< 1 yr): Use two fingers or both thumbs just below the nipple line in the center of the chest; push 1½ inches deep at the same rate.

      (👆Our long-time CPR trainer partner, Jason, gives us the tip to sing the BeeGees “Staying Alive” while performing compressions, since it’s just the right speed)

  4. Breaths (2x) – Tilt head slightly (neutral for infant), lift chin, pinch child’s nose; give 2 gentle breaths (1 sec each) watching for chest rise.

  5. Repeat Cycles – Continue 30 compressions::2 breaths non‑stop until the child breathes, an AED is ready, or EMS takes over.

If you are alone and your phone is out of reach: After 2 minutes (about 5 cycles), carry the child to call 911, then resume CPR.

Build Your Own Mini First Aid Kit

Most families will have a first aid kit at home. Make sure you know where they keep their kits. You can also build a mini first aid kit for yourself and keep it with you at all times.

In a quart‑size zip bag, pack:

  • Vinyl gloves, CPR face shield

  • 4″ gauze roll, assorted band‑aids, large sterile pad

  • Adhesive tape, antibiotic ointment, alcohol wipes

  • Instant cold pack, small burn gel, tweezers

  • Laminated emergency‑contact card

Debrief After Emergency

Any emergency where a child is involved can feel harrowing – even if you stay cool and collected in the moment, knowing just what to do. After the emergency is over (the child is stable, you’ve handed over responsibility to the parents, etc.), make sure to give yourself a chance to breathe and process what happened. It’s okay if you’re in shock, if you need to call it a day, if you don’t quite know what to do now. 

There’s no room in the moment for all those feelings, but there is afterwards. Lean on a friend or family member, give yourself a break, and then check back in with the parents. You’ve just handled a parent’s biggest fear like a pro, that’s what super nannies (ahem, Smart Sitters) are made of.

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Cajsa Landin