HS218 Medical assistance and incident management
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
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.
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
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 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.
When assessing whether you comply with HS218
Questions we are likely to ask
What steps do/would you take when a child becomes seriously ill or injured?
How do/would you make sure parents are notified about their child’s incident, illness or injury?
How are injury/illness/incidents records reviewed?
We are likely to look at, measure or count
How you record injuries/illnesses/incidents and how you inform parents.
We are likely to request
Sample of records of injuries, illnesses and incidents that have occurred at the service.
Your procedure outlining the service’s response to injury, illness and incident, including the review and implementation of practices as required.
The tools below are here to support you, but you do not have to use them. You can use other tools or methods that work better for your service.
Review your incident response register and procedures – Inclusive Education
Getting medical assistance straight away puts children’s health and safety first. Quick action can prevent things from getting worse and helps families trust your service. Recording all injuries, illnesses, and incidents supports children’s health by providing useful information to parents and medical professionals and will help you to identify any safety risks in your service.
Doing more than the minimum can shape better outcomes for children. Here are some ideas or examples you might like to consider.
When drafting your service’s procedure to respond to injuries, illnesses, and incidents, it’s a good idea to think about:
what would happen if a child needed to go to hospital or the doctor, who would go with them and how will you make sure that the other children are cared for
any costs associated with calling an ambulance, in the event that one is needed
how you will keep an up-to-date list of all children’s allergies, especially those related to medications or medical conditions
how you will engage with parents who might be very distressed when contacted. For example, try to find out whether they have adult support available to help manage the situation, such as assistance with other children or transport.
Although you must keep records for 5 years from the date of the incident if the injury/incident is notifiable under the Health and Safety at Work Act 2015 (HSWA), for other incidents it’s good practice to keep injury/illness/incident records for 2 years from the date of the incident. You might choose to keep them longer if you're concerned about a child or situation, as they can help track patterns or support future decisions about a child’s wellbeing.