A child falls from the climbing frame, lands hard, and starts crying. Around her, twenty children gather, someone shouts for a teacher, and the duty teacher arrives to a scene that feels urgent even though the injury may be minor. What happens in the next five minutes depends almost entirely on preparation: whether the teacher has a pouch with the basics, knows the simple routines for the common injuries, and stays calm enough that the injured child calms too. Playground first aid is not hospital medicine and it is not a substitute for a nurse or a doctor. It is the bridge — competent, calm, immediate care that stops a small injury becoming a bigger one and gets a serious injury to proper help without delay. Every duty teacher can learn it in one training session, and every school can equip it for a few thousand rupees.
The reason this matters so much is timing. Break-time injuries happen far from the school clinic, often at the far edge of the ground, and the walk to fetch help takes minutes during which a bleeding wound keeps bleeding, a frightened child keeps crying, and well-meaning classmates offer advice that ranges from useless to harmful — applying toothpaste to a burn, pouring water into a bleeding nose held backwards, or pulling a child with a hurt arm to their feet. A duty teacher who arrives with a pouch and a routine replaces that chaos with order: sit the child down, look, treat what is treatable, and send for help early when anything looks beyond a minor injury. This guide sets out the pouch, the routines for the injuries duty teachers actually meet, the handover that gets the child safely to the clinic, and the restocking discipline that keeps the pouch ready all term.
The Duty-Teacher First Aid Pouch
The pouch is deliberately small — a waist pouch or a small shoulder bag a teacher can actually carry while supervising, not a box left in the staff room. Contents: disposable gloves, a few sterile gauze pads and adhesive dressings in several sizes, a crepe bandage, adhesive tape, small scissors, an antiseptic solution or wipes, a cold pack (or a clean plastic bag to fill with ice from the canteen), a few cotton pads, a pen and a small incident card, and a charged mobile phone or the school's emergency number card. That is enough for the injuries that make up the large majority of playground incidents. Anything bigger — a deep wound, a suspected fracture, a head injury, a child who cannot be moved — is not treated from the pouch; it is stabilised and referred, which is exactly what the pouch routine is designed to recognise.
Two rules govern the pouch. First, it is checked and restocked by a named person, on a fixed day each week, against a written checklist — not "when someone remembers." A pouch with no gloves, no dressings or an empty antiseptic bottle is worse than no pouch, because it creates a false sense of readiness. Second, the pouch never contains medicines for children to take — no painkillers, no tablets of any kind — because duty teachers must not dispense medication, and parents must be consulted before any medicine is given. The pouch system works best alongside the school's main first aid kit audit routine, so the pouch, the clinic stock and the sports kits are all checked on the same weekly round.
Falls, Scrapes and Nosebleeds: The Everyday Injuries
Scraped knees and elbows are the commonest playground injury, and the routine is simple: sit the child down, put on gloves, clean the wound gently with clean water — antiseptic around, not scrubbed into, a graze — and cover it with a dressing. Pressure with a gauze pad stops most bleeding within a few minutes; if bleeding soaks through the first pad, add another on top rather than removing the first, and keep pressure on. Watch for gravel or dirt ground into the wound, which needs clinic cleaning, and for wounds over a joint, on the face, or that gape open, which need clinic assessment rather than a playground dressing. A child who can walk, talk and move the injured part normally, and whose bleeding has stopped, can usually return to class with a note to the teacher to watch them; a child who cannot do those things goes to the clinic.
Nosebleeds frighten children more than they harm them, and the routine is widely done wrong. The child sits upright, leans slightly forward — never backwards, which sends blood down the throat and causes vomiting — pinches the soft part of the nose firmly, and breathes through the mouth for ten minutes without checking every thirty seconds. Most nosebleeds stop in that time. If bleeding continues beyond twenty minutes, is very heavy, or follows a blow to the head, the child goes to the clinic or hospital. Bumps and bruises get a cold pack wrapped in cloth for ten to fifteen minutes, not ice directly on skin, and a child who bumped their head but is alert, talking and behaving normally still needs watching for the rest of the day, with the class teacher told what happened. These routines are simple, but they must be taught, not assumed — a short first aid training session for all duty teachers at the start of the year, with practice on each other, is what turns knowledge into reflex.
The First Five Minutes
Suspected Fractures and Head Injuries
A suspected fracture announces itself: obvious deformity, swelling that grows quickly, severe pain, inability to move or bear weight on the limb, or a limb that looks wrong in shape or length. The duty teacher's job is not to diagnose or to straighten anything; it is to keep the child still and comfortable, support the limb in the position found — a folded blazer or scarf as a sling for an arm, a rolled jacket supporting a leg — apply a cold pack around, not on, the injury if available, and send for help immediately. Do not move a child who may have injured their back or neck, and do not let classmates help them walk to the clinic if the leg or hip is suspected; the clinic staff or an ambulance should come to the child. A child with a suspected fracture stays put, stays calm, and is watched continuously until help arrives.
Head injuries follow a stricter rule: any child who loses consciousness even briefly, vomits, complains of worsening headache, becomes confused or unusually sleepy, has unequal pupils, or has fluid from the nose or ear after a blow to the head needs urgent medical attention, and the school calls the parents and arranges hospital transfer without waiting to see if the child improves. A child who bumped their head but is fully alert still needs a head-injury note: the class teacher and the parents are told, in writing, what happened and what to watch for over the next twenty-four hours — worsening headache, repeated vomiting, unusual sleepiness, confusion — because head injury symptoms can appear hours later. The same caution applies to sports injuries during games, where adrenaline masks pain and a child who insists they are fine may be the child who most needs assessment. When in doubt, refer: a clinic visit that turns out unnecessary costs an hour, while a missed serious injury costs far more.
The Incident-to-Clinic Handover
Good first aid fails at handover when the duty teacher's knowledge stays on the playground. The handover should be a short, structured message, given in person or by phone, covering five facts: who the child is and their class, what happened and when, what injury was seen, what first aid was given, and anything relevant about the child's condition — allergies, medication, or a known condition the school holds on record. The incident card in the pouch exists for exactly this: the teacher writes the five facts on the spot, and the card travels with the child to the clinic, so nothing is lost when the teacher returns to duty and the nurse takes over. A child sent to the clinic should always be accompanied — by a prefect, a classmate, or another adult — never sent alone, however minor the injury seems, because a child who feels faint halfway to the clinic needs the companion.
Parents are informed on a clear scale, agreed in advance. Minor injuries treated on the playground: a note home or a WhatsApp message to the parent at the end of the day, stating what happened and what was done, so parents do not first hear a dramatic version from their child. Clinic visits: a phone call the same day, before the child goes home if possible. Serious injuries or hospital transfers: an immediate phone call, and a staff member stays with the child until a parent arrives. This scale prevents two opposite failures: parents kept in the dark about a real injury, and parents panicked by a phone call about a scraped knee. It also protects the school, because a written record of what was told, and when, answers the questions that follow any injury. The clinic's own records, and the school's medical emergency procedure, should reference the same incident card, so playground, clinic and office tell one consistent story.
Restocking: The Checklist That Keeps the Pouch Ready
Restocking is where most first aid systems quietly die. The pouch is used on Monday, half-emptied by Wednesday, and discovered empty during a real incident the following week. The fix is a weekly check owned by one person — ideally the school nurse, or a senior teacher if the school has no nurse — on a fixed day, against a printed checklist taped inside the clinic cupboard: gloves, gauze, dressings by size, bandage, tape, scissors, antiseptic, cold packs, cotton, incident cards, pen. Used items are ticked off, replaced from clinic stock the same day, and expiry dates checked monthly, because sterile dressings and antiseptic do expire, and an expired dressing used on a child's wound is a needless risk. The check takes five minutes; skipping it for a month takes the pouch out of service silently.
Budget for restocking honestly. A school with several hundred students will use dressings, gauze and gloves steadily, and the term's first aid budget should include a monthly restocking line of a few thousand rupees, not a single annual purchase that runs out by October. Finally, review the pouch contents each term with the nurse: does it need a larger dressing for older students, a second cold pack in summer, or a spare whistle? A pouch that evolves with the school's actual injuries is a system; a pouch bought once and forgotten is a decoration. Schools appointing or supporting a nurse should read the school nurse hiring guide alongside this routine, because the nurse is the person who makes the whole chain — pouch, clinic, handover, restocking — hold together.
AI Help: Muse AI
Muse AI is Meta's personal AI assistant, available in the Muse app. A teacher can ask it to help write a simple one-page first aid reminder card for duty teachers, or to explain in plain words how to tell a minor scrape from an injury that needs the clinic. Join Muse with invite code LTGSWD — in the Muse app, go to Settings > Redeem token and enter the code.
Disclosure: LTGSWD is the author's Muse invite code.