Paediatric First Aid

Debate between Alistair Burt and Mark Hunter

Monday 15th December 2014 Westminster Hall

[Mark Hunter]

Again, I thank the hon. Gentleman for his intervention and he is absolutely right. I will come on to the point about how the North West Ambulance Service has responded to this case in the positive way that he has indicated.

On the day in question, Millie was being fed by the supervisor of the nursery, who had worked in child care for some 20 years; she was an experienced person. Yet, when this tragic incident happened, Millie received no treatment from the supervisor, because she was not trained in paediatric first aid. Instead, she handed Millie to another member of staff.

After Millie had received the slaps to her back, she was left in the arms of someone who was trained in first aid at work, not paediatric first aid. That should not have been the case. Sadly, of the two paediatric first-aiders at the nursery, one chose not to be involved and went to look after the other children while the second administered the back slaps and then left the building, through the nursery grounds, and went to the main road to wait for the ambulance. This should never have happened. The paediatric-trained first-aider should not have left Millie’s side until the paramedics arrived.

I will outline the treatment that Millie should have received and what should have happened at that point in time. Millie, as I said, received a few back slaps and was then held in a non-paediatric-trained first aider’s arms for around 10 minutes. On arrival, the paramedics immediately began standard choking treatment for a baby. By this point, it was tragically too late and Millie’s heart had stopped beating.

In a statement from the nursery, it was stated that one of the untrained staff members finger-swept Millie’s mouth, which all guidelines and all paediatric first aid courses state is the wrong thing to do. The treatment for a choking baby, as outlined on the NHS Choices website, is as follows:

“A baby who is choking will be distressed and may be unable to cry, cough or breathe.

Lie the baby face down along your forearm or thigh, with their head low. Support their head.

Give up to five firm slaps to the baby’s back between the shoulder blades with the heel of your hand. (The heel is between the palm of your hand and your wrist.)

Stop after each slap to check if the blockage has cleared. Look inside the baby’s mouth and remove any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage. You may push it further in.

If the airway is still blocked, give up to five chest thrusts.

Stop after each thrust to check if the blockage has cleared.

If the baby’s airway is still blocked after three cycles of back slaps and chest thrusts, you should: dial 999 for an ambulance immediately. Do not leave the baby—take him or her with you to the phone; continue with the cycles of back slaps and chest thrusts until help arrives.

In babies under one year old”—

remember that Millie was under one year old—

“chest thrusts are used in an emergency to clear a blockage from their airway. Important: do not use abdominal thrusts with babies under one year old.

Lie the baby along your forearm on their back, with their head low. Support their back and head.

Give up to five chest thrusts. Using two fingers, push inwards and upwards (towards the head) against the baby’s breastbone, one finger’s breadth below the nipple line.

Check if the blockage has cleared after each thrust, by looking inside the baby’s mouth and removing any obvious blockage.”

Again,

“Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage as you may push it further in.”

This is standard choking advice and every paediatric first aid course teaches these guidelines, which means that the staff involved that day should have given a statement as I just stated it.

[Alistair Burt (North East Bedfordshire) (Con)]

We are all moved by the hon. Gentleman’s description of what has happened, and impressed that he has put on the record exactly what should be done. I am the grandfather of a seven-year-old child, and we all go through these agonies about what we would do. Has he made any estimate of the amount of time and difficulty there would be in incorporating this work in a straightforward, standard course for paediatric care workers, so that we can see just how little time would need to be spent to make sure that all those working in nurseries have that sort of information available to them, and have practice doing what he has stated needs to be done, should there be a choking incident involving a baby?

[Mark Hunter]

I welcome the right hon. Gentleman’s intervention. The Millie’s Trust campaign has done an awful lot of work in this regard and is satisfied, I think, as most hon. Members who have considered the issue would be, that this can be done at no great cost. We hope that the Minister will make it clear that the Government are serious about their intention to address the subject. As other hon. Members have already said, with the benefit of hindsight, there is a loophole in the regulation that needs to be addressed urgently.