Objective To understand the level of medical personnel′s mastery of children′s on-site rescue capabilities in Hunan Province and to investigate the demand for conducting first witness training for children, in order to inform future training in this area. Methods From April 10 to 24, 2024, a self-made survey questionnaire was used to survey medical personnel in Hunan Province through WeChat questionnaires. The questionnaire data was collected and subjected to descriptive and chi square test. Results Among the 10 746 medical staff who participated in the survey, 5 862(54.6%) had received training as the first witness for children, and 9 313(86.7%) of medical staff believed that they had the ability to identify the critical condition of children. Among the self-evaluation of first witness abilities, the mastery rates of child cardiopulmonary resuscitation [9 674(90.0%)] and child Heimlich maneuver [10 089(93.9%)] were very high, while the mastery rates of child AED [7 900(73.5%)] and trauma four techniques [7 857(73.1%)] were relatively low. Among the investigators, 10 226(95.2%) believed there is a difference between adult and child first witnesses, and 10 524(97.9%) believed it is necessary to conduct training for child first witnesses. In addition, 9 988(92.9%) had a need to participate in the training of children′s first witnesses, and 7 927(73.8%) had a need to participate in the training of children′s first witness mentors. The higher the level of hospital institutions, the higher the professional titles of personnel, the longer the working years, the professionals engaged in pediatrics, and the investigators with the first witness training certificate, the higher the necessity of affirming the first witness of children, self-evaluation of the first witness ability, and training needs. The differences are statistically significant (all P<0.05). Conclusions Medical personnel in Hunan Province should strengthen the training of children′s first witnesses, especially in grassroots medical institutions, junior medical personnel, and child AED use and the four techniques of child trauma in children′s first witness abilities, which need to be further trained.