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Responding to Injuries

Despite your best efforts to keep children safe, injuries can happen. You must be prepared to respond quickly when a child or staff member gets hurt. This lesson will help you recognize different events that can cause injuries in child development and school-age programs, and you will learn how to keep children safe by getting them medical attention.

  • Teach staff members how to respond when a child or colleague is injured.
  • Assist during emergencies when a child is injured.
  • Ensure staff training requirements and requirements for first-aid kits are met.



It is very important that you take a course in first-aid and cardiopulmonary resuscitation (CPR). This lesson does not replace that course. This lesson only provides a brief introduction to keeping children safe when they are injured.

Collect each staff member’s responses to their Explore activity. Compare their responses to the suggested answers. Discuss any differences with them. Use what you learn to shape training for the staff member.

Discuss the staff members’ first aid and CPR certifications. If they are not yet certified, make a plan for achieving and maintaining certification.

Additionally, make sure staff members follow procedures in the rest of this course to prevent injuries. Make sure dangerous and toxic items are out of children’s reach. In the event of emergencies, make sure staff members:

Prevent injuries: Follow procedures outlined in other lessons in this course. Make sure dangerous and toxic items are out of children's reach.

Are prepared: Have a well-stocked first-aid kit. Make sure your first-aid and CPR training are always current.

Respond quickly: Use what they learned in their first-aid courses.

  • Stay calm.
  • Survey the scene. Look around and find out what is wrong. Decide whether it is safe to approach. Ask questions and examine the child head-to-toe for injuries.
  • Take action. Decide whether injuries are life threatening: Is the child conscious? Is the child breathing? If the child is not breathing, perform CPR as needed. If the injury is not life threatening, check the child head-to-toe. Look for all injuries. Ask the child questions and continue to check breathing and heart rate. Perform any basic first-aid that is needed. Do not move the child unless his or her life is at risk.
  • Make the calls. Decide whether to call 911 or local EMS. Call the child's family.
  • Ride along. Be prepared to ride with the child in the ambulance. Know what documents and contact information you need to bring with you.
  • Document. Report the injury using the forms provided by your workplace (and required by your state or program). Make sure the family also signs the incident report.

Identifying and Responding to Concussions in Child and Youth Settings

As children are growing and learning, accidents are bound to occur. But what happens when a child suffers a significant head injury? What if they are too young to communicate how they feel as a result? With increasing research about the long-term effects of traumatic brain injuries, it is important for caregivers to understand how to properly identify and respond to head injuries in young children. As a training & curriculum specialist, use the following information regarding head injuries, as well as what you already know about responding to injuries, to ensure staff members are prepared to identify and respond to possible concussions in children and youth.

Childhood concussions are common. They can affect a child’s ability to think, learn, and interact with the world around them. According to Dr. Sam Torbati of Cedars-Sinai Hospital (2021), a concussion is “a mild, temporary form of brain injury that can result after a forceful blow to the head or jolt to the body which causes the brain to bounce against the skull.” Concussions are often thought to be the result of sports injuries, however, the most common reasons for a concussion in younger children are falls or collisions with objects such a ball, peer, table, or wall. The following are a few scenarios in which a concussion could occur:

  • 11-month-old Sammy is learning to stand independently and take a few steps. He is rolling a ball on the floor and crawling after it. The ball stops under the snack table and Sammy crawls to get it. Instead of crawling away, he tries to stand up to walk and hits his head on the edge of the table.
  • Katie is building a tower using large wooden blocks. She reaches to place two blocks on the very top but drops one. When she bends over to pick it up, she bumps into the structure by accident, and it falls over on top of her. She immediately shouts, “Ouch! My head!”
  • Chad and Jason are playing tag outside after school. Jason is not paying attention to where he is running and collides with Chad running toward him. The two children run into one another and hit their heads.

Symptoms of a concussion can appear immediately following the injury or up to a few days afterwards. For this reason, it is important for caregivers to carefully observe the child and track their symptoms over the course of several days. Below are common symptoms to note:

Common Symptoms of Concussion by Age

Infants & Toddlers
  • Frequent vomiting
  • Excessive crying (especially when moving head)
  • Significant changes in sleep patterns
  • Changes in appetite
  • Decreased interaction
Preschoolers & School Age
  • Vomiting
  • Headache
  • Dizziness/ balance problems
  • Changes in vision
  • Sensitivity to light or sound
  • Difficulty concentrating
  • Memory loss/ slowed response time
  • Changes in mood
  • Significant changes in sleep patterns
  • Changes in appetite

Regardless of the perceived severity of the head injury, caregivers should take the following actions (as outlined above) after a blow to the head occurs. Consider where you can best support staff members in the event of a head injury.

  1. Stay calm: We know that young children’s actions and feelings are affected by their caregivers’ responses. When you remain calm, the child can focus on calming themselves if they are upset.
  2. Take action: staff member should use their knowledge of the typical appearance and behavior of the child. If anything seems out of the ordinary, or any of the symptoms listed in the table above are present, seek appropriate medical care. Once the situation has been evaluated, provide appropriate first aid (stop any bleeding, clean any cuts or scrapes, apply bandages or cold compress). It might be helpful for the staff member to receive a second opinion from you regarding the child’s behavior and appearance.
  3. Notify: Whenever a child suffers a head injury, providers should contact the child’s family to notify them of what occurred and the status of the child. If immediate medical attention is needed, you may be asked to contact the family or Emergency Medical Services (911).
  4. Document: Ensure the correct incident reporting form used by your program or Service is completed by the staff member caring for the child at the time of the injury. This is an important step as symptoms of a concussion may not appear for a few days. Refer to your program or Service specific guidelines for additional required documentation.

Concussion symptoms in infants and younger toddlers are especially important to note as children under 2 years of age are at a higher risk for more serious brain injuries. If excessive vomiting occurs in younger children, seek medical attention right away. Additional symptoms that warrant an emergency visit to a doctor or hospital (in all ages) include worsened headache, increased confusion, inability to stay awake, slurred speech, weakness, seizures, and loss of consciousness.

As evident in the information above, symptoms of a concussion will look different for every child. The recovery time will look different as well. Regardless of how the injury occurred or presented in a child, monitoring and rest is important for all ages to properly recover from a concussion. For older children, modifications to their learning environment and school workload may be necessary. Support staff members making appropriate modifications to their environment, curriculum, or schedule. If mild symptoms persist for longer than a week or signs of a regression in the child’s development are observed, encourage staff members to talk with the child’s family about contacting their pediatrician for follow-up care.


As a trainer and coach, you will likely need to assist in an emergency. Be prepared to assist with first aid and CPR. You must have current training. You should also be prepared to help supervise other children, provide coverage if a staff member rides in an ambulance, or contact families as needed.


Staff members have differing comfort levels with injuries and illnesses. Regardless of their comfort, it is critical that staff members are able to keep children safe during serious situations. Watch to see how staff members respond in stressful situations. Do they remain calm? Are first-aid kits available at all times? Are first-aid kits well stocked? Are emergency medications stored in designated locations? Do staff members remember to use safety precautions when handling blood or other body fluids?


It is important to think about what you would do during stressful situations. Read the Responding to Injuries activity. Complete the answers and talk about them with a coworker. Then, compare your answers to the suggested responses.


Make sure you are prepared for injuries and other emergencies. Review the First Aid Checklist and use it to make sure the program’s first aid kit is well stocked.

Consider using the Injuries Best Practices Checklist to observe and document competencies that specifically address responding to injuries. As you observe and reflect on a staff member’s practice, indicate how often the staff member performs the following actions using the scale provided. Share your observations with staff and use the information learned from the checklist to identify goals and focus your coaching interactions.


Which of the following is not a life-threatening situation?
Which of the following does not require calling 911 (or the local emergency medical service outside the United States)?
Which one of these statements is true?
References & Resources

American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. (2020). Caring for our children: National health and safety performance standards; Guidelines for early care and education programs. (4th ed.). American Academy of Pediatrics.

American Red Cross. (2012). American Red Cross homepage. 

Cedars-Sinai Staff. (2021, July 29). Concussion symptoms in children: What to know. Cedars-Sinai Hospital.

Centers for Disease Control and Prevention. Caring for your child’s concussion. (2018).

Cleveland Clinic. (2020, May 5). 10 things parents should know about children and concussions.

Halstead, M.E., McAvoy, K., Devore, C.D., Carl, R., Lee, M., Logan, K., Council on Sports Medicine and Fitness; Council on School Health; Brenner, J., Demorest, R.A., Weiss Kelly, A.K., Koutures, C.G., LaBella, C.R., LaBotz, M., Loud, K.J., Moffatt, K.A., Brooks, M.A., Martin, S.S., & Guinn-Jones, M. (2013). Returning to learning following a concussion. American Academy of Pediatrics, 132(5) 948-957.

Kids Health. Concussions. (2019, February).

National Association for the Education of Young Children. (2018). NAEYC early learning program accreditation standard and assessment items. National Association for the Education of Young Children.

Podolak, O. (2020, June 18). The natural history of concussion in infants and children under age 5. Children’s Hospital of Philadelphia.

Podolak, O.E., Chaudhary, S., Haarbauer-Krupa, J., Metzger, K.B., Curry, A.E., Kessler, R.S., Pfeiffer, M.R., Breiding, M.J., Master, C.L., & Arbogast, K.B. (2021). Characteristics of diagnosed concussions in children aged 0 to 4 years presenting to a large pediatric healthcare network. Retrieved March 10, 2022, from

UNC Health. (2018, April 23). Spotting concussions in babies and toddlers.