Defibrillator in a Nursery: Requirements and Best Practices

A nursery, whether a municipal childcare centre, an association-run creche, a private micro-creche or a childminders' collective, receives the public in the regulatory sense as soon as it welcomes children and their families from outside the operator's own household. It therefore falls under the classification of buildings open to the public, known in France as ERP (établissement recevant du public), with a category that depends on the total number of people accommodated, children and staff combined. ERP categories 1 to 3 have been required to have a defibrillator since 1 January 2020, category 4 since 2021, and part of category 5 since 2022, under the French loi 2018-527 (law) and its décret 2018-1186 (implementing decree).

Most nurseries, especially micro-creches limited to around ten places, fall into category 5 for lack of sufficient headcount to move into a higher category. That does not exempt them from considering the question: a larger childcare centre with dozens of places, together with its staff and the families passing through morning and evening, quickly adds up to a number of people present well above that of a single school class. The operator, whether a town council, a local welfare body, an association or a private network, is the one responsible for checking the exact category of its establishment.

Cardiac arrest affecting an infant or young child remains an exceptional event. In a nursery, the most likely scenario involves an adult: an early years professional, a parent dropping off their child, a grandparent, a delivery driver or an outside visitor. About 50,000 cardiac arrests occur every year in France, and every minute that passes without defibrillation lowers the chances of survival by roughly 10%. A nursery, like any place where adults cross paths every day, is no exception to this reality.

This changes how the equipment should be thought about. The defibrillator is not installed only for the young children in care, but for anyone present on the premises or nearby, including during outings to the park or outdoor activities organised by the setting.

When the victim is a child, the energy an automated external defibrillator, or DAE (AED), delivers by default, calibrated for an adult, can be excessive for a child under 25 kilograms or under eight years old, which describes every child cared for in a nursery. Manufacturers address this with pediatric pads or energy attenuator keys, which automatically reduce the shock delivered.

A nursery that equips itself should therefore check that its device offers this option and keep the pediatric pair within easy reach of staff, stored with the device and tracked for its expiry date just like the adult pads. Failing that, adult pads remain usable rather than forgoing defibrillation, but that should stay the exception rather than the rule in a setting dedicated to early childhood.

Early years professionals often receive, during their initial training, an introduction to first aid suited to infants and young children. This grounding does not always cover using a defibrillator or performing chest compressions on an adult, two skills that need specific, regular practice.

Basic life saving training, open to the whole team rather than management alone, lets every staff member respond without waiting for the one qualified person on duty that day. Renewing it every year, alongside a staff meeting or training day, keeps the reflex sharp without taking up disproportionate time.

Like any defibrillator installed in a building open to the public, a nursery's device remains the operator's responsibility to maintain, under article R. 5212-25 (French public health code) of the Code de la santé publique. Registration with Géo'DAE remains mandatory so that emergency services can locate the device during a call, and the signage displayed must follow the model set out in the arrêté du 29 novembre 2018 (French ministerial order).

The chosen location has to reconcile two apparently conflicting demands: staying reachable within seconds for an adult in an emergency, while remaining out of reach of children who explore every corner of the premises. A high wall mount, in the entrance hall or near the management office, generally meets both requirements better than a low cabinet.

Nurseries with a garden or a yard should also plan for quick access from outside, especially during outdoor activities, without multiplying installation points in a setting that is often small. One well placed cabinet known to the whole team is worth more than several poorly identified locations.