?8 elements to a compliant, effective first-aid program
Anyone who has been designated by an employer to provide first aid must have thorough training on how to respond to the injuries and illnesses anticipated in the workplace. Employees who are not designated first-aiders should know how to promptly report injuries and illnesses. Here are eight elements that can be used as a general introduction to first-aid programs.
1. Introduce OSHA’s expectations for first-aid programs
Where an accident is possible based on hazards and can result in suffocation, severe bleeding or other life-threatening or permanently disabling injury or illness, OSHA expects a three- to four-minute response time from the time of injury to the time of administering first aid. If such a life-threatening or serious injury is unlikely, OSHA allows a longer response time, such as 15 minutes.
To ensure treatment is available within these time frames, OSHA requires the employer to train persons to render first aid when there’s no nearby hospital, clinic or infirmary that’s used to treat all injured or ill employees.
First-aid providers perform the initial assessment of injuries and illnesses and provide immediate care and life support before emergency medical service (EMS) professionals arrive.
2. Display your first-aid supplies
First-aid supplies must be readily available in an emergency. There must be appropriate supplies (in adequate amounts) for the types of injuries and illnesses that are likely to occur based on an understanding of the activities in the workplace.
OSHA says that medical personnel must be available to consult with the employer on matters of plant health. Employers can work with the medical professionals who treat injured employees to get help in determining what supplies should be in the facility’s first-aid kits and how many kits are needed.
As guidance, employers can consult American National Standards Institute standard Z308.1, Minimum Requirements for Workplace First Aid Kits. It describes two classes of basic kits.
The Class A kit contains the following:
• Adhesive bandages, 1 inch x 3 inch • Adhesive tape, 2.5 yards • Antibiotic ointment • Antiseptic • Breathing barrier • Gel-soaked burn dressing • Burn ointment • Cold pack • Eye covering with a means of attachment • Eye/skin wash • First-aid guide • Hand sanitizer • Medical examination gloves • Roller bandage, 2 inches • Scissors • Sterile pad, 3 inches x 3 inches • Trauma pad, 5 inches x 9 inches • Triangular bandage
The Class B kit contains a larger quantity of all of the items listed in the Class A kit, and also includes:
• Roller bandage, 4 inches • Splint • Tourniquet
3. Emphasize the importance of first-aiders taking universal precautions to prevent exposure to bloodborne pathogens
Blood can carry microorganisms such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV) that can cause serious diseases. OSHA’s bloodborne pathogens standard, 1910.1030, applies to all “occupational exposure” to blood or other potentially infectious materials (OPIMs). Employees who are expected to provide first aid as part of their job duties are covered by the standard.
When a first-aid response involves exposure to blood and OPIMs, first-aiders must use “universal precautions.” This is an approach to infection control where all human blood and certain body fluids are treated as if they were known to be infectious for bloodborne pathogens. Wearing rubber exam gloves and protective clothing is part of following universal precautions.
4. Explain how first-aid providers start by assessing the situation
When first-aid providers arrive at an accident scene, they first evaluate what happened, how many people are injured, and whether it’s safe to enter the area. In serious situations, they’ll make sure EMS professionals are on the way.
First-aiders must ensure their own safety before they can help the injured. They’ll consider everyone’s safety when they decide on making rescues and moving victims. They’ll assess the injuries of each victim. They’ll check for responsiveness, breathing, and circulation; and they’ll look for any medical alert tags a victim might be wearing.
5. Outline first-aid response to life-threatening emergencies
Life-threatening medical emergencies can involve conditions such as:
• Chest pain • Stroke • Breathing problems • Allergic reactions • Seizures • Severe bleeding
If an injury is life-threatening, first-aid providers are trained to:
• Perform rescue breathing, perform cardiopulmonary resuscitation ( CPR), and use an automated external defibrillator ( AED) • Recognize the signs and symptoms of shock and provide treatment • Control bleeding with direct pressure • Provide other treatment to stabilize the victim
6. Discuss AED programs
OSHA’s Best Practices Guide: Fundamentals of a Workplace First-Aid Program says that an AED should be considered when selecting first-aid supplies.
AEDs provide the critical and necessary treatment for sudden cardiac arrest (SCA) caused by ventricular fibrillation. Ventricular fibrillation is the uncoordinated beating of the heart leading to collapse and death. An electric shock delivered by an AED can restore the heart to a normal rhythm. Using an AED within three to four minutes after the victim has suffered SCA significantly improves the survival rate.
Administer CPR until the AED unit is brought to the victim. This basic form of life support uses chest compressions and artificial respiration.
7. Outline some non-life-threatening emergencies encountered by first-aid providers
First-aid providers know how to provide initial treatment for conditions such as:
• Cuts, abrasions, puncture wounds, crushing injuries, and other wounds • Burns • Frostbite, hypothermia, heat stroke, and other temperature-related conditions • Sprains and strains • Eye injuries
Even though these conditions may not be life-threatening, the victim may still need medical treatment beyond first aid.
8. Summarize your program
Every employee needs to know how to report a medical emergency. A quick response is necessary when there is an injury or sudden illness. However, the response needs to be made by personnel who have proper training.
Judie Smithers is an editor at J. J. Keller & Associates, a compliance resource company that offers products and services to business professionals. Smithers’ subject matter expertise covers safety training, lockout/tagout, permit-required confined spaces, hearing conservation, exposure monitoring, personal protective equipment, asbestos, lead, radiation, and illumination. Previously, Smithers was the health and safety information coordinator for an industrial company.