First Aid Basics

What paras should know about common first aid situations in school — and the critical distinction between providing first aid and making medical decisions.

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| Audience | Paras working with students of any age or disability profile; school staff responsible for first aid protocols. |

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| Why This Matters |

| Paras are often the adult closest to a student when a minor injury or medical event occurs. Knowing what to do in the first 30 seconds — and when to immediately get the nurse — is a foundational safety skill. First aid basics belong in every para's toolkit. |

The Para's Role in a Medical or Injury Event

The school nurse is the medical authority in the building. The para's role in a first aid situation is to: stay calm, ensure the student is safe, provide basic first aid as trained, and get the nurse. These steps happen in seconds, sometimes simultaneously.

What paras do NOT do: make medical decisions, administer medication (unless specifically delegated and trained), diagnose, or provide treatment beyond their training. The line between supportive first aid and medical intervention matters.

Common Situations and What to Do

Minor Cuts and Scrapes

Apply pressure with a clean cloth or gauze until bleeding slows.

If bleeding does not stop within a few minutes, or the wound is deep, get the nurse immediately.

Use gloves if available. Universal precautions always apply when there is blood.

Document the incident and notify the nurse even for minor injuries — some districts require documentation for all injuries.

Nosebleeds

Have the student lean slightly forward (not back — this causes blood to flow into the throat).

Pinch the soft part of the nose firmly for 10 minutes without releasing to check.

Get the nurse if bleeding does not stop after 10 to 15 minutes, if it follows a head injury, or if the student takes blood thinners.

Bumps and Head Injuries

Any head injury requires nurse evaluation — even if the student seems fine immediately after.

Apply a cold pack (wrapped in cloth — never directly on skin) to reduce swelling.

Do not leave the student alone after a head injury. Watch for: loss of consciousness, confusion, vomiting, pupils of unequal size, or increasing headache.

If the student loses consciousness at any point, call 911 and the nurse simultaneously.

Choking

If the student can cough, speak, or cry, encourage them to cough — do not intervene.

If the student cannot cough, speak, or is turning blue: call for help and perform abdominal thrusts (Heimlich maneuver) if you are trained. Call 911 immediately.

Paras who work with students at risk for choking (those with swallowing difficulties, seizure disorders, or complex needs) should be trained in choking response before the first day of school.

Falls

Do not move a student who has fallen until you have assessed for injury, especially if they struck their head or there is any possibility of spinal involvement.

Get the nurse for any fall that involves the head, loss of consciousness, complaint of neck or back pain, or inability to move a limb.

For minor falls with no apparent injury, still document and notify the nurse per district protocol.

Allergic Reactions

Know which students have diagnosed allergies and where their emergency medication (EpiPen) is stored.

Mild reactions (hives, itching without breathing difficulty): Get the nurse immediately.

Severe reactions (difficulty breathing, swelling of throat or face, sudden drop in energy combined with other symptoms): Call 911, get the nurse, and use the EpiPen per the student's emergency action plan if you are trained and authorized.

Do not wait to see if a suspected allergic reaction gets better on its own.

When to Call 911

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| Call 911 Immediately For: |

| Any loss of consciousness (even brief). |

| Difficulty breathing or stopped breathing. |

| Suspected spinal injury or severe head injury. |

| Severe allergic reaction (anaphylaxis). |

| Uncontrolled bleeding. |

| Suspected poisoning or ingestion. |

| Seizure lasting more than 5 minutes, or a second seizure without recovery. |

First Aid Training

Paras who work with students with medical needs should complete CPR and first aid certification appropriate to the student's age (pediatric CPR for elementary students). Many districts require this. If you do not have current CPR/first aid training, ask your supervisor how to access it through the district.

Specific conditions (seizure response, anaphylaxis, G-tube feeding, trach suctioning) require individualized training beyond general first aid. General first aid certification does not qualify a para to respond to these specialized situations.

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| ✅ Try this | ⚠️ Watch out for |

| Know where the nurse is, how to call for help, and which students have emergency action plans before you need this information. Stay calm, provide basic first aid within your training, and get the nurse promptly. | Wait to get the nurse because you think the situation might resolve on its own, or attempt to manage a medical event that exceeds your training. When in doubt, get the nurse immediately — that is always the right call. |

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| Bottom line | First aid basics are about those first crucial moments: staying calm, keeping the student safe, and getting professional help. The para's job is to bridge the gap between the moment of injury and the nurse — not to be the nurse. |

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