What Should a Babysitter Do in an Emergency? The Step-by-Step Protocol

In a genuine emergency, a babysitter who knows the protocol acts correctly within the first 60 seconds. A babysitter who does not freezes, guesses, or spends precious time trying to reach the parent before calling 911. The protocol is simple: assess the situation, call 911 for anything serious, call the parent, then manage until help arrives. Here is the complete step-by-step guide.

The universal emergency priority order

Regardless of the specific type of emergency, the priority order is always:

• 1. Ensure safety. Get the child out of immediate danger — away from fire, traffic, water, the source of injury — before anything else.
• 2. Call 911. For anything serious — unconsciousness, difficulty breathing, severe allergic reaction, significant bleeding, suspected poisoning, or any situation that scares you — call 911 first. Do not call the parent first and wait. Call 911, then call the parent.
• 3. Call the parent. After 911 has been called and emergency services are on the way, call the parent. If the situation allows it, call the parent simultaneously.
• 4. Stay on the line with 911. The dispatcher will tell you exactly what to do until help arrives. Follow their instructions.
• 5. Manage until help arrives. Perform first aid as directed, keep the child calm, and do not leave them alone.

The most common babysitter mistake in an emergency is calling the parent first and waiting for a response before calling 911. In a serious emergency, every minute matters. Call 911 first.

When to call 911 immediately

These situations require an immediate 911 call — before calling the parent:

• The child is unconscious or unresponsive
• The child is not breathing or is having difficulty breathing
• Suspected severe allergic reaction — throat tightening, difficulty swallowing, swelling of the face or tongue
• Suspected poisoning or ingestion of a dangerous substance
• Seizure that lasts more than 5 minutes, or a second seizure shortly after the first
• Significant bleeding that does not stop with direct pressure
• A fall from a significant height or head injury with loss of consciousness
• Suspected broken bone near the spine, neck, or skull
• Chest pain or heart symptoms in an older child
• A fire, gas leak, or carbon monoxide alarm in the home
• Any situation where your instinct says something is seriously wrong

Trust your instinct. Calling 911 for a situation that turns out to be less serious costs nothing. Not calling 911 for a situation that turns out to be serious can cost everything.

When to call the parent first

These situations are worth a parent call before escalating to 911:

• A moderate injury — a cut that needs cleaning, a bump or bruise from a fall, a mild burn from touching a warm surface
• Illness that came on during the sit — fever, vomiting, stomach pain — that is concerning but not severe
• Behavioral situations you are not sure how to handle
• A child who will not sleep and is escalating
• Any medical symptom you are not sure how to interpret

If you call the parent and get no answer, call the backup contact the parent left. If you still cannot reach anyone and the situation is concerning or worsening, call 911. No symptom should go unaddressed because you could not reach the parent.

Specific emergencies: what to do

Severe allergic reaction (anaphylaxis)

• If there is an EpiPen prescribed for this child: use it immediately. Do not wait to see if the symptoms worsen.
• Call 911 after using the EpiPen — do not skip this step even if the child seems to improve.
• Keep the child lying down with legs elevated unless they are having difficulty breathing (in which case, allow them to sit up slightly).
• Do not give water or food.
• A second EpiPen dose can be given 5-10 minutes after the first if symptoms persist and a second pen is available.

Choking

• If the child is coughing forcefully: encourage continued coughing and do not interfere. A child who can cough and make sound is moving air.
• If the child cannot cough, cannot make sound, or cannot breathe: for a child over 1 year old, perform abdominal thrusts (Heimlich maneuver). For an infant under 1, use back blows and chest thrusts.
• Call 911 if the object does not clear, if the child loses consciousness, or if you are not confident in your ability to perform the maneuver.

Seizure

• Do not restrain the child or put anything in their mouth.
• Clear the area of hard or sharp objects and place something soft under the child's head.
• Turn the child on their side if possible (recovery position) to prevent choking on saliva or vomit.
• Time the seizure from when it starts.
• Call 911 if the seizure lasts more than 5 minutes, if the child does not regain consciousness, or if a second seizure follows quickly.
• If there is prescribed rescue medication (nasal midazolam, rectal diastat), administer it per the parent's written instructions, then call 911.

Bleeding

• Apply firm, direct pressure with a clean cloth. Do not remove the cloth if it becomes soaked — add more cloth on top and maintain pressure.
• Keep the injured area elevated above the heart if possible.
• Call 911 if bleeding is severe, does not slow with pressure, or the child is pale and weak.
• Do not apply a tourniquet unless bleeding is life-threatening and you have been trained to do so.

Head injury

• If the child is unconscious, is not acting normally, or lost consciousness even briefly: call 911.
• Do not move the child if a spinal injury is possible (fall from height, car accident, diving injury).
• Concussion symptoms that develop after a head injury — headache, vomiting, confusion, unequal pupils — require a call to the parent and often a call to 911.
• A small bump or bruise from a typical fall that does not cause loss of consciousness and does not produce concerning symptoms: call the parent, monitor, and apply ice to the bump.

Suspected poisoning

• Call Poison Control at 1-800-222-1222 immediately — before calling the parent or 911 in most cases. They will assess the situation and tell you what to do.
• Have the container the child may have ingested available so you can tell Poison Control exactly what was taken.
• Do not induce vomiting unless Poison Control specifically instructs you to — this can worsen some poisonings.
• Call 911 if the child is unconscious, is having a seizure, is having difficulty breathing, or if Poison Control instructs you to.

Fire or carbon monoxide alarm

• Get all children out of the house immediately. Do not gather belongings.
• Close doors behind you as you exit (this slows fire spread).
• Do not use the elevator — use stairs.
• Once outside, call 911. Do not go back inside for any reason.
• Call the parent after you are safely outside and 911 has been called.

Information to have before an emergency happens

The time to prepare is before you need it. Before a babysitting job, confirm you have:

• Parent's cell number and backup contact
• The home address (for giving to 911)
• The child's full name and date of birth
• Any allergies and the location of the EpiPen
• Any medical conditions that might produce an emergency
• Pediatrician after-hours number
• Poison Control: 1-800-222-1222
• The parent's explicit rule: when to call 911 first versus when to call parent first

When families use Baton Pass, babysitters can access all of this organized information in one link — allergies, medications, emergency contacts, and medical conditions, in the right priority order for the moment they actually need it.

Frequently Asked Questions

Should I call 911 or the parent first?

For any serious emergency — unconsciousness, difficulty breathing, severe allergic reaction, significant bleeding, suspected poisoning — call 911 first. Then call the parent. For non-urgent situations — a fever, a moderate fall, a child who will not sleep — call the parent first. The rule is: when in doubt about whether something is serious, treat it as serious and call 911.

What do I tell 911 when I call?

State your location (the address), what happened, and the child's condition. "I am at [address]. A four-year-old child I am babysitting is not breathing normally. Please send help." Stay on the line. The dispatcher will ask questions and give you instructions. Follow their instructions exactly until help arrives.

What if I am too panicked to think clearly in an emergency?

This is normal. Having the protocol written down and having thought about it in advance dramatically improves performance under stress — not because you will be calm, but because you will have a practiced sequence to fall back on. The sequence is: safety, 911, parent. If you can remember those three steps, the dispatcher will walk you through the rest.

Am I protected legally if I give first aid to a child I am babysitting?

Every US state has a Good Samaritan law that provides legal protection to someone who provides emergency assistance in good faith. A babysitter who performs CPR, uses an EpiPen as prescribed, or calls 911 is acting in good faith and is protected from liability under these laws. The risk of not acting — of not calling 911, not using the EpiPen — is far greater than any risk associated with acting in good faith.