First Aid in School Support: Essential Knowledge for Emergencies and Safe Care
A child trips on the playground and falls hard. Within seconds, swelling appears, the child cries, classmates gather around. In moments like these, first aid for school support workers is not just helpful but can be decisive. Studies show that around 1.3 million children in Germany experience a school accident every year [1]. School support workers are often the first adults on the scene. Those who are uncertain or act incorrectly in that moment risk not only the child's health but also bear legal responsibility. This article explains why first aid knowledge is essential in school support, which typical emergencies can occur, and how you can optimally prepare. You'll also learn which common mistakes are avoidable and how to respond confidently in practice.
For an introduction to this essential topic, Diingu offers a free foundational first aid course specifically tailored to the needs of school support workers. The course covers not only preventive measures but also structured procedures for acute emergencies and proper handling of specific situations.
What is First Aid in School Support and Why is it Important?
First aid for children encompasses all immediate measures taken after an accident, sudden illness, or in life-threatening situations. In the context of school support, this specifically means that educational professionals must be able to quickly recognize emergency situations, respond appropriately, and coordinate further assistance. Unlike with adults, emergency care for children requires specialized knowledge, as anatomy, physiology, and response patterns differ significantly.
School support workers frequently care for children with special needs, chronic conditions, or disabilities. These children often have an increased risk for certain medical emergencies. A child with epilepsy may experience a seizure, a child with diabetes could develop hypoglycemia, and children with mobility impairments may be at higher risk of falls. This makes solid first aid competencies for school assistants a core professional qualification. It's not just about applying techniques, but about a holistic understanding of prevention, risk awareness, and the ability to act calmly and systematically in stressful situations.
The importance is also evident in the legal dimension. School support workers have supervisory and duty of care responsibilities. Remaining inactive during an emergency or acting with gross negligence can have criminal and civil legal consequences [2]. At the same time, the so-called "Good Samaritan principle" protects first responders as long as they act to the best of their knowledge and belief. Nevertheless, the best protection is solid training and regular knowledge refreshers.
Why This Knowledge is Essential Today
Increase in Children with Chronic Conditions in Mainstream Schools
Through inclusion, more and more children with chronic conditions such as asthma, diabetes, allergies, or epilepsy are being educated in mainstream schools. According to the Robert Koch Institute, about 13 percent of all children and adolescents in Germany suffer from at least one chronic condition [3]. This development is fundamentally positive and reflects the right to participation. However, it places high demands on caregivers. A diabetic child who suddenly becomes shaky and confused requires immediate help. Those who don't recognize the symptoms of hypoglycemia lose valuable minutes.
School support workers are often the people who accompany a child most closely throughout the entire school day. They know the child's individual needs, observe behavioral changes, and are frequently the first point of contact for health concerns. Especially with non-obvious emergencies, such as an emerging allergic reaction or an oncoming asthma attack, a trained eye and quick action are required. Without appropriate background knowledge, these situations can escalate.
Legal Obligations and Liability Issues
The legal situation is clear. Anyone who assumes a supervisory or care function is obligated to provide assistance. Failure to render aid is a criminal offense. At the same time, school support workers must know where the boundaries of their responsibility lie and when medical help must be called in. Emergency situations in school support therefore require not only medical knowledge but also an understanding of legal frameworks and institutional procedures.
Many school support workers enter the field as career changers or have not completed educational training that includes first aid components. This creates a knowledge gap that must be closed. Employers are legally required to train their staff in occupational safety and health protection, but in practice the quality of these trainings varies greatly. Personal responsibility and proactive continuing education are therefore essential.
Psychological Safety for Everyone Involved
Children sense uncertainty. When a caregiver hesitates during an emergency, appears panicked, or doesn't know what to do, this insecurity transfers to the affected child and the group. Conversely, a calm, competent response conveys security and trust. Children feel protected, parents feel confident, and teachers and school administrators can rely on the school support worker.
Furthermore, solid knowledge protects school support workers themselves from psychological stress. Those who have experienced an emergency where they didn't know what to do often carry feelings of guilt or doubt for a long time. This feeling of helplessness can impair job satisfaction and, in the worst case, lead to leaving the profession. Being well prepared also means protecting yourself.
Quick Action Can Save Lives or Prevent Long-term Damage
In medical emergencies, every minute counts. During cardiac arrest, the chance of survival decreases by about 10 percent per minute without resuscitation [4]. Although cardiac arrest is rare in children, other time-critical situations such as severe allergic reactions (anaphylactic shock), choking episodes, or severe bleeding are quite realistic. Those who recognize these situations and initiate the right first aid measures at school can prevent worse outcomes.
But it's not just about life-threatening situations. Even with seemingly harmless injuries, incorrect handling can lead to complications. An improperly treated laceration can become infected, an unrecognized fracture can heal incorrectly. Especially with head injuries, it's important to recognize symptoms of concussion or more serious injuries and respond accordingly.
Responsibility Toward Vulnerable Children
Many of the children being cared for cannot express themselves or clearly communicate their complaints. A child with cognitive impairments or autism may not show pain or discomfort in the usual way. Here, observational skills and professional knowledge are required. School support workers must be able to correctly interpret changes in behavior, breathing, or skin appearance and act accordingly.
This special responsibility requires a deeper understanding than standard first aid training. Knowing the theory isn't enough. You must be able to adapt it to the individual needs and communication styles of the children in your care. This is exactly where specialized continuing education comes in, such as that offered in the first aid foundational course from Diingu.
Prevention as Part of First Aid
First aid doesn't start when an emergency occurs. A large part consists of prevention and protective measures. This includes recognizing and minimizing hazards in everyday school life, educating children age-appropriately about risks, and creating emergency plans in advance. What medications does a child need to take regularly? Where is the nearest defibrillator? Who will be informed in an emergency? These questions shouldn't be asked for the first time during an actual crisis.
A preventive attitude also means regularly conducting emergency drills and discussing as a team who takes on which role. School support workers who engage with these topics early on not only act faster in emergencies but also more systematically and effectively.
Common Challenges and Pitfalls
Despite good intentions, there are situations in practice that repeatedly pose major challenges for school support workers. One of the most common is uncertainty in assessing urgency. When is a situation truly critical? When is it enough to observe the child, and when must emergency services be called immediately? These gray areas cause stress and can lead to poor decisions. Those who wait too long when in doubt risk a deterioration of the condition. Those who sound the alarm too quickly may trigger unnecessary emergency responses.
Another problem is lack of routine. First aid measures are practiced in courses, but ideally they are rarely used in daily life. This lack of practice leads to uncertainty in actual emergencies. Many people have learned how the recovery position works but can no longer confidently recall the steps after years. Regular refreshers are therefore essential.
There's also emotional stress. An injured or seriously ill child triggers strong feelings in many helpers. Fear, compassion, and overwhelm can limit one's ability to act. Especially with children to whom one has a close bond, it's difficult to remain calm and rational. Only one thing helps here: training, mental preparation, and the knowledge that structured procedures are possible even in emotional situations.
Insufficient team communication is another stumbling block. In many schools, it's not clearly regulated who takes on which tasks during an emergency. School support workers sometimes feel left alone or are uncertain whether they're allowed to act independently or must first consult. When multiple adults are present, duplications or dangerous gaps can occur because everyone thinks someone else is handling it. Clear agreements and regular emergency drills as a team provide a remedy.
There are also organizational hurdles. Not every school has a complete and easily accessible first aid kit. Emergency numbers aren't always readily available, emergency plans exist only on paper. School support workers should proactively inquire and ensure they have access to all necessary materials and information in an emergency.
Finally, there's the danger of typical first aid mistakes. These include cooling burns with ice (instead of running water), elevating the head during unconsciousness (instead of recovery position), removing foreign objects from deep wounds, or administering medications without clear instruction. Such mistakes often arise from ignorance or well-intentioned but incorrect intuition. Solid training helps avoid these error sources.
Application in Practice
What does first aid in school support look like concretely in daily life? A typical scenario is a fall on the playground. The child being cared for falls, cries, and holds their knee. The school support worker approaches calmly, speaks reassuringly to the child, and gets an overview. She checks whether the child is conscious, can move, and has visible injuries. The knee is scraped, bleeding slightly, but mobility is intact. She leads the child to a quiet place, cleans the wound with clean water, disinfects it, and applies a bandage. While doing so, she explains each step to give the child security. Afterward, she documents the incident and informs the parents.
Another example involves a child with a known nut allergy. During lunch together, the school support worker notices that the child suddenly complains of itching in the mouth and the lips are swelling. She recognizes the signs of an allergic reaction, acts immediately, calls the teacher and emergency services, retrieves the child's emergency plan, and administers the prepared emergency medication (for example, an epinephrine auto-injector) following medical instruction. Meanwhile, she calms the child, monitors breathing and consciousness, and stays by their side until the rescue service arrives.
In a third scenario, a school support worker accompanies a child with epilepsy. During class, he notices that the child begins staring into space, no longer responds to address, and shows slight twitching. He recognizes a focal seizure, moves the child to a safe position, removes objects from the surroundings that could pose an injury risk, and remains calm beside the child. He looks at his watch to document the seizure duration, informs the teacher, and continues monitoring the child after the seizure until full recovery. Since the seizure didn't last longer than five minutes and matched the known pattern, no emergency call is needed. Nevertheless, he documents the incident and informs the parents.
These examples show that it's not just about spectacular rescue actions. Often it's the small but secure actions, the calm, and the structured approach that make the difference. School support workers must be able to assess situations, set priorities, communicate calmly, and call in professional help when in doubt. All of this is taught in specialized training programs.
Getting Started Successfully
Anyone who wants to become a school support worker or is already working in this field should view first aid skills not as a tedious obligation but as a core competency. Getting started begins with basic first aid training specifically focused on children and the school context. Such courses are offered by various providers, but not all adequately address the special requirements of school support.
It's important that the training not only conveys theoretical knowledge but also includes practical exercises. Resuscitation, recovery position, applying pressure bandages, handling unconsciousness – all of this should be actively practiced. Topics such as burns, poisoning, seizures, allergic reactions, and musculoskeletal injuries should also be covered. Additionally, the course should address the psychological aspects of emergency situations: How do I stay calm? How do I communicate with the child? How do I coordinate help?
Beyond this, regular refreshers are crucial. Experts recommend updating first aid knowledge at least every two years [5]. This doesn't always have to be a multi-day course. Even short refresher units, simulations, or e-learning modules can help keep knowledge fresh. Those who continuously engage with the topic build confidence and can respond faster and more precisely in emergencies.
Equally important is networking within the team. School support workers should exchange information with teachers, school social workers, and school administration about emergency plans. Who is responsible for what and when? Where are the first aid materials located? Are there children with special health risks, and if so, what are the individual emergency plans? This exchange should occur regularly and be documented.
Finally, it's advisable to become familiar with legal fundamentals. What am I allowed to do as a school support worker? When must I act, when am I not permitted to? What documentation obligations do I have? These questions should also be addressed in good training. Legal certainty provides not only protection but also self-confidence.
Anyone wishing to develop along this path will find valuable support in targeted continuing education. Digital formats in particular offer the opportunity to learn flexibly and at your own pace, deepen theoretical knowledge, and specifically prepare for the challenges of your own practice.
Related Training at Diingu
For everyone who wants to engage thoroughly and practically with the topic of first aid in school support, Diingu offers a free introductory course. The First Aid Foundations Course was developed specifically for school support workers and covers all essential aspects: from preventive protective measures through structured procedures in acute emergencies to proper handling of specific emergency situations. Additionally, typical mistakes are identified and strategies are conveyed for avoiding them.
The course is interactive, flexible, and allows you to engage with the content at your own pace. Whether you're just entering the profession or want to refresh your knowledge, the course provides a solid foundation for acting safely and competently in everyday school life.
Frequently Asked Questions
What First Aid Knowledge Do School Support Workers Need?
School support workers should master basic first aid measures, including wound care, recognizing and responding to unconsciousness, recovery position, cardiopulmonary resuscitation, and handling shock conditions. Particularly important is knowledge about child-specific emergencies such as seizures, hypoglycemia, asthma attacks, and allergic reactions. They must also know when to place an emergency call and how to coordinate professional assistance.
Is a First Aid Course Mandatory for School Support Workers?
Legal requirements vary by region and employer. Generally, employers are required to train their staff in first aid when they assume supervisory or care functions. In practice, current first aid certification is often a prerequisite for employment. Regardless of formal requirements, thorough training is essential from both professional and ethical perspectives.
What are Typical Emergencies in School Support?
The most common emergencies include falls with bruises, abrasions or lacerations, sprains, and fractures. Acute illnesses such as asthma attacks, allergic reactions, epileptic seizures, hypoglycemia in diabetes, and circulatory problems also occur. Rarer but particularly critical are unconsciousness, severe bleeding, poisoning, or choking episodes. School support workers should be prepared for all these scenarios.
How Does First Aid for Children Differ from That for Adults?
Children have anatomical and physiological differences compared to adults. Their heads are proportionally larger, airways narrower, and cardiovascular systems respond differently. During resuscitation, for example, different compression depths and ventilation techniques are applied. Communication is also different: children often cannot precisely articulate their complaints, making observation and assessment by the caregiver especially important. Additionally, psychological support is central to calming the child.
What Mistakes Commonly Occur During First Aid Measures?
Typical mistakes include cooling burns with ice instead of lukewarm water, elevating the head during unconsciousness, unnecessarily moving injured persons with suspected spinal injury, removing deeply embedded foreign objects, and administering medications without medical instruction. Hesitation or panic are also common problems. Good training and regular practice help avoid these mistakes.
Conclusion
First aid in school support is far more than a formal requirement. It's an ethical obligation, a core professional competency, and a protective factor for everyone involved. At a time when more and more children with special needs and chronic conditions are being educated inclusively, the responsibility of support workers increases. Those who are aware of this knowledge and continuously pursue training contribute decisively to the safety and wellbeing of the children in their care. At the same time, you gain confidence in action, self-assurance, and professional competence. The journey begins with the first step: solid training that addresses the specific requirements of school support. Use the available resources, exchange ideas with your team, and stay engaged. Because in an emergency, every second counts, and your knowledge can make the crucial difference.
Sources and Further Reading
[1] German Statutory Accident Insurance (DGUV) - School Accidents in Germany - https://www.dguv.de/de/zahlen-fakten/schueler-unfall-statistik/index.jsp
[2] German Federal Ministry of Justice - Criminal Code (StGB) § 323c Failure to Render Assistance - https://www.gesetze-im-internet.de/stgb/__323c.html
[3] Robert Koch Institute - Health of Children and Adolescents in Germany - https://www.rki.de/DE/Content/Gesundheitsmonitoring/Studien/Kiggs/kiggs_node.html
[4] German Red Cross - First Aid in Pediatric Emergencies - https://www.drk.de/hilfe-in-deutschland/erste-hilfe/erste-hilfe-bei-kindern/
[5] Federal Working Group for First Aid - Recommendations for Refreshing First Aid Knowledge - https://www.bag-eh.de/