Which of the following is a sign that a child may need immediate first aid?

Difficulty breathing or severe pain are critical signs that indicate a child may need immediate first aid. These symptoms can signify serious medical conditions that require prompt attention to prevent deterioration of the child's health. For instance, difficulty breathing could be a sign of an allergic reaction, asthma attack, or other respiratory issues, while severe pain might indicate an internal injury, fracture, or other serious medical conditions. Recognizing these signs early is essential for providing timely and appropriate care that can stabilize the child and prevent further complications.

In contrast, while extreme fatigue could indicate a need for rest or further evaluation, it does not necessarily suggest an urgent medical emergency, especially if the child is otherwise stable. Similarly, smiling, playing, and talking normally are typically signs of a child being in good spirits and do not point to any immediate health issues.