Choking, allergic reactions, falls, febrile seizures — these things happen fast, and they happen when parents are not home. A babysitter with first aid training is not a luxury. It is the minimum standard for safe childcare. Below are the five skills that matter most, with the exact, current techniques each one requires.

1. Infant and Child CPR

Cardiac arrest in children is rare, but when it happens it is most often caused by a breathing emergency — choking, drowning, or a severe asthma attack that progresses to respiratory arrest. Because of this, starting CPR quickly matters more than almost anything else. CPR technique differs by the child’s age:

• Infant (under 1 year): use the two-thumb encircling technique (thumbs on the lower half of the breastbone, hands wrapping the chest) or the heel of one hand. Push at least one-third the depth of the chest. The older two-finger method is no longer the recommended technique.
• Child (1 year to puberty): use one or two hands on the centre of the chest, pushing at least one-third the depth of the chest. Do not use the infant two-thumb technique on a child.

For both ages, compress at 100–120 per minute, allow full chest recoil between pushes, and use a ratio of 30 compressions to 2 breaths for a single rescuer.

Source: Canadian Red Cross 2025; Heart & Stroke Foundation / ILCOR 2025 Basic Life Support. See our step-by-step baby CPR guide.

2. Choking Response

Choking is a leading cause of injury and death in young children. The response depends on the child’s age — and getting this right matters, because the wrong technique can cause harm:

• Infant (under 1 year): alternate 5 back blows (between the shoulder blades, baby face-down along your forearm) with 5 chest thrusts (with the heel of one hand, or two fingers, on the lower half of the breastbone). Never give abdominal thrusts to an infant.
• Child (over 1 year): give abdominal thrusts (the Heimlich manoeuvre). Some programs teach alternating back blows with abdominal thrusts — follow the method you were trained in.

For any age, if the child becomes unresponsive, start CPR and call 911.

Source: Canadian Red Cross 2025; Heart & Stroke Foundation / ILCOR 2025 first aid guidance.

3. Allergic Reaction and EpiPen Use

If the child has a known allergy, the babysitter must know where the epinephrine auto-injector (EpiPen) is, how to use it, and when to use it — before they need it. Anaphylaxis escalates in minutes, and hesitation can be fatal.

At the first signs of a severe allergic reaction (trouble breathing, swelling of the face or throat, widespread hives, vomiting, or sudden weakness): give the epinephrine first, then call 911. If there is no improvement, a second dose can be given after about 5 minutes. Lay the child down with legs raised (or sitting up if breathing is hard) and stay with them until help arrives.

Source: Canadian Red Cross 2025; Heart & Stroke Foundation / AHA 2024 first aid guidance on anaphylaxis.

4. Wound Care and Bleeding Control

Children fall, scrape, and cut themselves constantly. Most injuries need only cleaning and a bandage. But a babysitter should also know:

• Bleeding: apply firm direct pressure with a clean cloth to control heavier bleeding, and keep pressing — don’t lift to peek.
• When a cut needs a doctor: deep or gaping wounds, cuts to the face or over a joint, or bleeding that won’t stop with pressure.
• Burns: cool a thermal burn under cool (not ice-cold) running water for 10 to 20 minutes. Cool every thermal burn this way, even a severe one. Never use ice, butter, or creams, and don’t break blisters.

Source: Canadian Red Cross 2025; Heart & Stroke Foundation / AHA 2024 first aid guidance (burn cooling 10–20 min).

5. When to Call 911

Many babysitters hesitate to call 911, worried about overreacting or alarming the parents. Train them to call first, then notify you. Situations that always require 911 include: unresponsiveness, difficulty breathing, suspected poisoning, seizures, severe allergic reactions, head injuries with vomiting or confusion, and any injury they are unsure how to handle.

The Emergency Information Sheet

Every time you leave your child with a caregiver, they should have a written emergency sheet posted in a visible location. Include:

• Home address (for 911 — this is number one)
• Parent phone numbers (both parents, if applicable)
• Backup emergency contact (a nearby friend, relative, or neighbour)
• Child’s doctor and clinic phone number
• Health card number
• Known allergies and location of emergency medications
• Medication schedule if applicable
• Location of first aid kit
• Ontario Poison Centre: 1-800-268-9017

Common Emergencies Babysitters Face

Febrile Seizures

Febrile seizures occur in roughly 2 to 5 percent of children between 6 months and 5 years, triggered by a rapid rise in body temperature. They look terrifying — the child may shake, stiffen, or lose consciousness — but most are brief and stop on their own. The babysitter’s job is to protect the child, not to fight the seizure:

• Help the child to the floor and clear hard objects away; cushion the head.
• Do not restrain the child and put nothing in the mouth — no food, drink, or medication during the seizure.
• Once the seizure stops, place the child on their side (recovery position) and stay with them.
• Note the time it starts. Call 911 if the seizure lasts more than 5 minutes, if it is the child’s first seizure, if the child does not return to normal, if there is trouble breathing, or if the child is an infant under 6 months.

Do not rely on fever medication to stop a febrile seizure — acetaminophen and ibuprofen do not stop or prevent them. Always notify the parents.

Source: American Heart Association & Canadian Red Cross 2024 first aid guidance on seizures.

Head Injuries

Children fall. A minor bump needs ice and observation. But if the child vomits, seems confused, loses consciousness even briefly, has unequal pupils, or complains of worsening headache, the babysitter should call 911 and then call the parent.

Nosebleeds

Lean the child slightly forward (not backward), pinch the soft part of the nose firmly for about 10 minutes without releasing to check. If it does not stop after about 15 to 20 minutes of continuous pressure, seek medical attention.

Source: Canadian Red Cross 2025 first aid guidance.

What Parents Should Do Before Leaving

• Walk through the house. Show the babysitter the first aid kit, fire extinguisher, emergency exits, and any locked areas
• Demonstrate medications. If your child takes any medication or has an EpiPen, show the babysitter how to administer it
• Review allergy protocols. Name specific allergens, describe what a reaction looks like, and confirm the babysitter knows how to use the auto-injector
• Discuss sleep safety. For infants: back to sleep, empty crib, no blankets or stuffed animals
• Set expectations for 911. Tell the babysitter explicitly: “If you are ever unsure, call 911 first, then call me. I will never be upset that you called for help.”

Gift Them the Training

The most valuable gift you can give your babysitter is not a tip — it is the knowledge to help save your child’s life. A first aid and CPR course covers all five essential skills in a single hands-on session. Many parents now cover the cost of certification as part of hiring a nanny or regular babysitter.