Child Care Basics: Emergency Preparedness and Incident Response

What “Emergency Preparedness” Means in Child Care

Emergency preparedness is having a clear, practiced plan for what to do in high-stress situations so children stay as safe and calm as possible. In child care settings, emergencies can be medical (injury, choking, allergic reaction), environmental (fire, severe weather), or security-related (lockdown). Preparedness includes: knowing your role in the moment, having supplies ready, communicating quickly to the right people, and recording what happened accurately.

In an emergency, your priorities are consistent: protect life, prevent the situation from getting worse, get appropriate help, and document facts.

Incident Response Flow (Use This for Any Event)

Use this simple flow as your default. Post it where staff can see it and practice it until it feels automatic.

1. Assess: Quickly determine what happened and whether there is immediate danger (breathing, bleeding, consciousness, hazards).
2. Secure the area: Remove other children from danger; eliminate hazards if safe to do so (cords, broken glass, spilled chemicals, traffic flow).
3. Comfort the child: Stay calm, get to the child’s eye level, use a steady voice, and provide reassurance while you act.
4. Contact supervisor / designated lead: Notify the person responsible for coordinating next steps and communication.
5. Get medical help if needed: Provide first aid within your training; call emergency services when indicated; follow medication protocols for emergency meds (e.g., epinephrine) if authorized.
6. Inform family: Share what happened, what you did, and what is needed next (pick-up, medical evaluation, monitoring).
7. Record facts: Document objective details: time, location, what you observed, actions taken, who was notified, and outcomes.
8. Follow-up prevention: After the immediate situation is stable, identify what to change (environment, routines, supervision points, training, equipment checks).

Quick “Stop and Breathe” Reset for Caregivers

If you feel panic rising, take one slow breath before you speak. A calm voice helps children regulate and helps you think clearly. Then start the flow: assess → secure → comfort → contact.

Common Emergencies: Step-by-Step Responses

1) Injuries (Falls, Cuts, Bumps, Possible Fracture)

Goal: Stop bleeding, reduce swelling, prevent shock, and determine if urgent medical care is needed.

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• Assess: Is the child conscious? Breathing normally? Severe bleeding? Head/neck injury signs (vomiting, confusion, worsening headache, unusual sleepiness)? Obvious deformity?
• Secure: Move other children away; keep the injured child still if you suspect head/neck/spine injury.
• Comfort: “I’m right here. You’re safe. I’m going to help you.”
• First aid basics (within training):
  • Bleeding: Apply firm pressure with clean gauze/cloth; elevate if appropriate; add layers—don’t remove soaked gauze.
  • Minor bumps/bruises: Cold pack wrapped in cloth; short intervals; observe.
  • Possible fracture/sprain: Keep the limb still; do not attempt to straighten; support with a splint only if trained and supplies are available; apply cold pack.
  • Head injury concern: Keep the child still and monitored; call for medical guidance per policy; seek emergency care for red flags.
• Notify: Supervisor immediately; call emergency services if severe bleeding, altered consciousness, breathing issues, suspected serious head injury, or severe pain/deformity.
• Inform family: Provide clear facts and next steps (monitoring, pick-up, medical evaluation).
• Document: Time, mechanism (what the child was doing), witnesses, visible injuries, first aid given, and who was notified.

2) Choking Concerns (Food or Object)

Key decision: Is it effective coughing or airway obstruction?

• Assess: Look for inability to breathe/speak, high-pitched sounds, silent cough, cyanosis.
• Secure: Assign another adult to move other children away and call supervisor/911.
• Act: Use the correct technique for the child’s age and your certification (infant vs. child choking response). Continue until the object is expelled or help arrives.
• After the event: Even if the child seems fine, notify supervisor and family; follow policy about medical evaluation after a choking episode.
• Document: What was being eaten/handled, time, actions taken, outcome, and any follow-up care.

3) Allergic Reactions (Including Anaphylaxis)

Know the difference: Mild reactions may involve localized hives/itching; anaphylaxis can involve breathing difficulty, swelling of lips/tongue, widespread hives, vomiting, dizziness, or collapse.

• Assess: Check breathing, swelling, voice changes, vomiting, lethargy, or faintness.
• Secure: Remove allergen exposure if possible (stop food, wipe mouth/hands, remove stinger if trained and safe).
• Act fast for anaphylaxis: Follow the child’s emergency care plan. If authorized and trained, administer epinephrine immediately when anaphylaxis is suspected—do not “wait and see.” Call emergency services right away.
• Position and monitor: Keep the child under close observation; be ready for CPR if trained and needed; note time of medication.
• Notify: Supervisor immediately; emergency services for severe symptoms; then family.
• Document: Suspected trigger, symptoms observed, time symptoms started, medication name/dose/time (if applicable), who administered, and response.

4) Missing Child Prevention and Response

Prevention is the best response. Use consistent headcounts and clear handoff points during transitions, outdoor time, and arrivals/departures. If a child is unaccounted for, treat it as urgent.

Immediate response steps

1. Assess: Confirm the child is missing (quickly re-check attendance list and last known location).
2. Secure: Freeze movement—stop transitions; keep remaining children with a staff member in a safe area.
3. Search: Assign adults to specific zones (classroom corners, bathrooms, closets, playground perimeter, nearby exits). Use radios/phones if available.
4. Notify supervisor: Immediately. The supervisor coordinates broader search and external calls per policy.
5. Escalate: If not found within the timeframe set by policy (often minutes), call emergency services/law enforcement.
6. Inform family: Supervisor leads; share facts and actions taken.
7. Document: Timeline, who searched where, when calls were made, and outcome.

Sample caregiver language (to children during a search)

“We are going to stay together right here. I need everyone to keep their bodies calm and stay where I can see you.”

5) Fire / Evacuation

Goal: Get everyone out quickly and account for every child.

1. Assess: If you see smoke/fire or hear alarm, begin evacuation immediately.
2. Secure: Take attendance list, emergency contact info, and any required emergency medications/go-bag if it is immediately accessible and does not delay evacuation.
3. Evacuate: Use the nearest safe exit; close doors behind you if possible; do not stop to gather personal items.
4. Assemble: Go to the designated meeting point.
5. Account: Conduct headcount/roll call immediately and again after regrouping.
6. Notify: Supervisor coordinates calling emergency services if not already dispatched; follow facility protocol.
7. Do not re-enter: Wait for official clearance.
8. Document: Time alarm sounded, exit used, headcount results, any injuries, and who was notified.

Sample caregiver language (during evacuation)

“Follow me. We are walking quickly and quietly to our safe spot. Hold hands/hold the rope and keep your eyes on me.”

6) Severe Weather (Thunderstorms, Tornado Warning, Extreme Heat/Cold)

Goal: Move to the safest location and maintain accountability.

• Assess: Check alerts and the facility’s trigger points (watch vs. warning). If a warning is issued, act immediately.
• Secure: Bring children indoors; move to the designated shelter area (often interior rooms, away from windows).
• Protect: Have children sit low; cover heads/neck if instructed by your plan; keep away from glass.
• Account: Headcount/roll call; keep attendance list with you.
• Notify: Supervisor; follow communication plan for families if needed.
• Document: Time moved to shelter, headcount, any injuries, and when “all clear” occurred.

Sample caregiver language (in shelter)

“We’re going to our safe room. Your job is to stay close, stay quiet, and listen for my directions.”

7) Lockdown / Shelter-in-Place (Security Threat Nearby)

Goal: Keep children out of sight, quiet, and protected until cleared by authorities.

1. Assess: If you receive a lockdown signal or credible threat information, initiate lockdown immediately.
2. Secure: Bring children inside the room; lock doors; cover windows if possible; turn off lights; silence phones; stop movement in hallways.
3. Position: Move children to a pre-identified safe corner away from doors/windows.
4. Quiet and comfort: Use calm, minimal language; offer a quiet activity (soft song, finger play without sound, breathing).
5. Communicate: Follow the facility’s communication method (text/app/radio). Do not open the door for anyone unless verified by the designated all-clear procedure.
6. Account: Headcount; note any missing children immediately to the supervisor.
7. Document: Time lockdown began/ended, headcount, communications received, and any concerns.

Sample caregiver language (lockdown)

“We’re going to play our quiet hiding game. Sit close to me, keep your body still, and use whisper voices or no voices.”

Who to Notify (A Simple Communication Ladder)

Follow your site’s policy, but a common order is:

• Immediate danger / life-threatening: Call emergency services first (or have someone call while you provide care), then notify supervisor.
• Urgent but stable: Notify supervisor immediately; supervisor decides whether to call emergency services/medical advice line and when to contact family.
• Always: Inform family as soon as the child is stable and the situation is controlled, using clear facts and next steps.

When you call or report, use a short, factual script:

1) Who you are and where you are. 2) What happened. 3) Child’s current condition. 4) What actions you took. 5) What you need next (medical help, supervisor support, family pick-up).

Documenting the Incident: Facts That Matter

In the moment, write down quick notes (time stamps help). Later, complete the formal report according to your program’s requirements. Keep documentation objective—describe what you saw and did, not assumptions about blame.

Include

• Date/time and exact location
• Child’s name and age/group
• What led up to the incident (activity, materials involved)
• What you observed (symptoms, behavior, visible injuries)
• First aid or actions taken (include times)
• Who was notified and when (supervisor, emergency services, family)
• Witnesses (staff/children) if applicable
• Outcome (returned to play, sent home, EMS transport)
• Follow-up steps (monitoring plan, environmental changes)

Avoid

• Speculation (“He must have…”) or diagnoses
• Blame statements
• Private information about other children

Readiness Checklist: Supplies and Information to Keep Current

First-Aid Kit Contents (Baseline)

• Disposable gloves (multiple sizes if possible)
• Gauze pads, roller gauze, adhesive bandages (various sizes)
• Medical tape
• Antiseptic wipes (non-stinging if possible)
• Cold packs (instant)
• Scissors (blunt tip) and tweezers
• CPR face shield or mask
• Thermometer (per program practice)
• Eye wash/saline (single-use)
• Emergency blanket
• Biohazard bags
• Flashlight and extra batteries
• Notepad/pen for time-stamped notes

Medication note: Any child-specific emergency medications (e.g., epinephrine auto-injector, inhaler) should be stored and carried according to your program’s medication policy and the child’s plan, with staff trained and authorized to use them.

Critical Information to Keep Accessible (Not Locked Behind Passwords During an Emergency)

• Emergency contact list for each child (multiple contacts)
• Allergy and medical alert list (with photos if permitted)
• Emergency care plans for relevant children
• Attendance/roll sheet (current)
• Evacuation routes and meeting points
• Emergency numbers (local emergency services, poison control, facility address)
• Staff call tree and roles (who calls whom)

Go-Bag (Grab-and-Go) Items

• Attendance list + emergency contacts
• Basic first-aid kit
• Any required emergency medications (per plan)
• Small water supply and cups (as appropriate)
• Diapers/wipes for younger children (as appropriate)
• Whistle (for group management outdoors)
• Phone charger/power bank (if used by your program)

Practice Scenarios (Drills for Thinking, Not Just Compliance)

Use short role-play scenarios in staff meetings. After each, debrief with three questions: What went well? What was confusing? What needs to change in supplies or roles?

Scenario A: Playground Fall With Bleeding

• Setup: Child trips and has a bleeding knee; other children gather around.
• Practice goals: Assign roles (one adult manages group, one provides first aid), pressure on wound, calm language, supervisor notification.
• Sample caregiver language: “I see you’re hurt. I’m going to press this clean pad here to help the bleeding stop. Take slow breaths with me.”

Scenario B: Suspected Choking During Snack

• Setup: Child suddenly stops making noise and looks distressed.
• Practice goals: Rapid assessment (can/can’t cough), calling for help, correct choking response per training, post-incident monitoring and family notification.
• Sample caregiver language: “I’m here. I’m going to help you. (To another adult) Call for emergency help now.”

Scenario C: Allergic Reaction After Art Activity

• Setup: Child develops hives and lip swelling.
• Practice goals: Recognize anaphylaxis signs, follow emergency care plan, time-stamp medication, call emergency services, communicate clearly to supervisor/family.
• Sample caregiver language: “You’re having a reaction. I’m staying with you and we’re getting help right now.”

Scenario D: Missing Child During Transition

• Setup: After returning indoors, one child is not in the line.
• Practice goals: Freeze movement, immediate headcount, zone search, escalation timeline, keeping remaining children calm.
• Sample caregiver language: “Everyone sit on the rug with your hands in your lap. I’m going to check our list and then we’ll continue.”

Scenario E: Fire Alarm During Nap Time

• Setup: Alarm sounds; lights flashing.
• Practice goals: Quick wake-up routine, evacuation with attendance list/go-bag, meeting point headcount, no re-entry.
• Sample caregiver language: “Wake up, friends. Stand up and come to the door. We’re going to our safe place now.”

Scenario F: Tornado Warning While Outdoors

• Setup: Warning issued; dark clouds and sirens.
• Practice goals: Fast movement to shelter area, headcount, safe positioning away from windows.
• Sample caregiver language: “We are going inside now. Hold the rope and keep moving. You’re doing a great job staying together.”

Scenario G: Lockdown During Morning Centers

• Setup: Lockdown announcement; unclear duration.
• Practice goals: Lock door, lights off, quiet corner, silent activity, verifying all-clear procedure.
• Sample caregiver language: “Come with me to our quiet corner. We’re going to listen and stay very still until we hear it’s safe.”