Teachers are reluctant to apply first aid to pupils in an emergency because they are scared of being sued by parents, research has found.
However, no teacher has ever been taken to court as a result of helping a pupil in a medical emergency. And acting appropriately in an emergency can significantly improve chances of survival.
Carolyn Crouchman, senior lecturer in health and human sciences at Thames Valley University, who has been researching the first aid knowledge of secondary teachers, points out that almost 400,000 children suffer accidents or injuries on school premises every year.
In the past 20 years, the numbers of pupils with asthma, epilepsy, severe allergies and heart conditions have risen significantly. This reflects not only increased numbers of sufferers, but also improved screening and diagnosis. And government inclusion policies mean there are more pupils with special needs and physical disabilities in mainstream education.
Legally, a teacher in charge of pupils is expected to display the "responsible mental qualities" of a prudent parent. But the law recognises that teachers are at school, rather than at home.
The expected standard of care, therefore, is the ordinary skill of a professionally competent teacher. This is influenced by the circumstances of the classroom, the subject being taught and the age of the pupils.
Given the increased number of pupils with medical conditions, Ms Crouchman asks: "Is first aid training deemed one of the reasonable steps that teachers need to take in order not to be seen as negligent if an emergency arises?"
But significant numbers of teachers are unwilling to learn emergency first aid for children. Ms Crouchman suggests there is some misunderstanding over what such training would involve. Many teachers, she believes, confuse it with comprehensive first aid knowledge.
"It is impractical for teachers to be able to cover all aspects of first aid," she says. "Emergency first aid is likely to be a very infrequent but life-saving event."
She also says: "There is perhaps an unfounded fear of litigation, which may be fuelled by inaccurate and sensationalist media stories.
"There is no case to date where legal action has been taken as a result of a teacher (or any other) applying first aid in an emergency."
The law does not expect teachers to apply first aid perfectly. It recognises that witnessing a medical emergency is not an everyday occurrence for most people, and that reasonable competence is therefore the most that can be expected.
Some teachers are reluctant to carry out chest compressions on pupils for fear of harming them. But Ms Crouchman points out that their worries are unfounded: the benefit to the recipient would outweigh any harm.
And schools can be reluctant to release teachers for first aid training because of costs.
"Perhaps whole-day training is inappropriate," Ms Crouchman says. She recommends including "first response to collapse" training as part of in-service days. This would train teachers in basic emergency procedures, as well as how to respond to seizures and administer appropriate injections. "With a full curriculum and the working life of teachers already very full, it is understandable that they may feel this is not a role they wish to undertake," she says.
Increasingly, pupils are learning basic first aid as part of the personal health and social education curriculum. Teachers trained in first aid could also deliver these lessons.
"The way forward may need to include demystifying the concept of first aid, perhaps changing it to 'emergency response'," she said.
"Knowing what to do in an emergency, before anyone else arrives, should, perhaps, become part of every employee's role."
FIRST AID IN SCHOOLS: THE FACTS
- It is not mandatory for British schools to have staff trained in the first aid of children, but they must be able to minister to adults.
- General first aid training is designed for adults in the workplace. It focuses on work-based injuries such as bleeding and broken bones.
- The most common conditions among pupils who need first aid are asthma attacks, seizures, severe allergies and heart conditions.
- A survey of 1,000 adults, conducted by the charity Asthma UK, found that only half knew what to do if they witnessed an asthma attack.
- There should be at least one, fully stocked first aid container on site. Additional first aid boxes are needed for split sites, sports fields or distant playgrounds.
- There is no mandatory list of contents for first aid boxes.
- All schools should provide access to disposable gloves and hand-washing facilities, so that staff are able to avoid infection.