First Aid Awareness Bureau of Workers Compensation PA

First Aid Awareness Bureau of Workers’ Compensation PA Training for Health & Safety (PATHS) Recognizing first aid needs and requirements for establishing a first aid kit per 29 CFR 1910. 151 - Subpart KMedical and First Aid PPT-149 -01 1

First Aid Defined First aid: emergency care provided for injury or sudden illness before emergency medical treatment is available. The First-Aider: one trained in the delivery of initial medical emergency procedures, using a limited amount of equipment to perform a primary assessment and intervention while awaiting arrival of emergency medical service (EMS) personnel. PPT-149 -01 2

Workplace First Aid Program Four essential program elements: § Management Leadership and Employee involvement § Worksite Analysis § Hazard Prevention and Control § Safety and Health Training PPT-149 -01 3

Basic Program Elements § Identifying/assessing injury risks § Designing/implementing a first-aid program that: o Aims to minimize the outcome of accidents or exposures o Complies with OSHA requirements relating to first aid o Sufficient/appropriate quantities of supplies and first-aid equipment, i. e. bandages and automated external defibrillators PPT-149 -01 4

Employer Responsibilities Those assigned are trained as first-aid providers: § With training suitable to the specific workplace § Periodic refresher courses § Instruct all workers about the first-aid program and actions for ill or injured coworkers § Put policies and program in writing § Schedule evaluation and changing of program § Keep program current PPT-149 -01 5

The Risks On average, there are 23, 000 onthe-job injuries in the United States daily. This amounts to 8. 5 million injuries per year and a huge cost to workers, their families, and our economy, approximately $192 billion. Workers deal with more than just injuries. Hundreds of thousands of them develop illnesses on the job, costing $58 billion a year. PPT-149 -01 6

OSHA’s Top 10 Hazards 2015 § Fall Protection § Hazard Communication § Scaffolding § Respiratory protection § Lockout/tagout § Powered Industrial Trucks § Ladders § Electrical-Wiring Methods § Machine Guarding § Electrical-General Requirements PPT-149 -01 7

Other Workplace Events § Electrocution § Exposure to low oxygen environments can lead to sudden cardiac arrest (SCA) § Exposure to chemicals § Overexertion at work can also trigger SCA in those with underlying heart disease § Temperature extremes Prompt, proper first aid may mean the difference between rapid or prolonged recovery, temporary or permanent disability, and even life or death PPT-149 -01 8

Assessing Risks Designing a First-Aid Program Specific for the Worksite § Evaluate injuries, illnesses and fatalities at a worksite are essential first steps in planning a first-aid program. § Use OSHA 300 log, § OSHA 301 forms, § Workers’ Compensation insurance carrier reports § National data for injuries, illnesses and fatalities may be obtained from the Bureau of Labor Statistics (BLS) website at www. bls. gov/iif. PPT-149 -01 9

1910. 151 -Medical/First Aid The employer shall ensure the ready availability of medical personnel for advice and consultation on matters of plant health. In the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available. PPT-149 -01 10

1910. 151 -Medical/First Aid Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use. PPT-149 -01 11

Appendix A to 1910. 151 First aid kits (Non-Mandatory) First aid supplies are required to be readily available under paragraph § 1910. 151(b). An example of the minimal contents: Generic first aid kit is described in American National Standard (ANSI) Z 308. 1 -1998 “Minimum Requirements for Workplace First-aid Kits. ” The contents of the kit listed in the ANSI standard should be adequate for small worksites. PPT-149 -01 12

Appendix A to 1910. 151 When larger operations or multiple operations are being conducted at the same location, employers should determine the need for additional first aid kits at the worksite, additional types of first aid equipment and supplies and additional quantities and types of supplies and equipment in the first aid kits. PPT-149 -01 13

Appendix A to 1910. 151 Employers with unique or changing first-aid needs in their workplace may need to enhance their first-aid kits. PPT-149 -01 14

BBP Exposure If it is reasonably anticipated that employees will be exposed to blood or other potentially infectious materials (OPIM) while using first aid supplies, employers are required to provide appropriate personal protective equipment (PPE) in compliance with the provisions of the Occupational Exposure to Blood borne Pathogens standard, § 1910. 1030(d)(3) (56 FR 64175). PPT-149 -01 15

Developing a Program § Consult with the local fire and rescue service or emergency medical professionals § SCA should be considered when planning § Get estimates of EMS response times for all permanent and temporary locations and for all times of the day and night when workers are on duty, § Use information when planning their first-aid program PPT-149 -01 16

Program Policies § In writing § Communicated to all employees, including those workers who may not read or speak English § Language barriers should be addressed in instruction and in your procedures PPT-149 -01 17

OSHA Requirements OSHA First Aid Standard (29 CFR 1910. 151) Requires trained first-aid providers at all workplaces of any size if there is no “infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees. ” OSHA standards also require training in CPR where sudden cardiac arrest from asphyxiation, electrocution, or exertion may occur. PPT-149 -01 18

Required CPR Training § 1910. 146 Permit-required Confined Spaces § 1910. 266 Appendix B: Logging Operations – First-Aid and CPR § Training § 1910. 269 Electric Power Generation, Transmission, and Distribution § 1910. 410 Qualifications of Dive Team § 1926. 950 Construction Subpart V, Power Transmission and Distribution PPT-149 -01 19

First Aid Supplies § Assign a person to choose types and amounts of first aid supplies and for maintaining same. § The supplies must be adequate, § Reflect the kinds of injuries that occur, and § Must be stored readily available for emergency use. § Automated external defibrillator (AED) should be considered when selecting first-aid supplies and equipment. PPT-149 -01 20

Kit Sizes Small businesses, ANSI Z 308. 1 - 2003, Minimum Requirements for Workplace First Aid Kits. For large operations, determine how many kits are needed and is other specialty equipment needed. Unique or changing needs: consider upgrading kits. § Consult with the local fire and rescue service or emergency medical professionals § Assess specific workplace needs § Periodically reassess supply needs and inventories. PPT-149 -01 21

Kit Maintenance Inspect: § At assigned location? § Contents complete and undamaged? § Contents condition. § Non-required items removed from kit? § Contents out-of-date? Replace. § First Aid Manual included? § Sign to call 911? Establish a periodic inspection schedule. PPT-149 -01 22

Situationals § Welder: burns, electrolyte, cuts § Nursing § Manufacturing § Mining § Transportation § Real estate § Education § Administration PPT-149 -01 23

Welding Injuries: § Burns § Cuts § Dehydration § Eye injuries Consider: § Electrolytes § Burn Spray & Compounds § Eye pads § Calling 911 PPT-149 -01 24

Nursing Injuries: § Finger § Dental § Strains & Sprains § Specific to patient condition Consider: § Patient needs which arise § Calling a special Code PPT-149 -01 25

Manufacturing Injuries: § Vary with type of manufacturing § Punctures/impalement § Cuts § Crushing § Broken bones Consider: § CPR § AED § Calling 911 PPT-149 -01 26

Mining Injuries: § Silica exposure § Crushing § Amputation § Carbon monoxide exposure Consider: § CPR, AED § Oxygen § Calling 911 PPT-149 -01 27

Transportation Injuries: § Carbon Monoxide poisoning § Struck-by/Crushing § Heat exhaustion § Haz. Mat Exposure Consider: § Oxygen cylinder § CPR § AED § Call 911 PPT-149 -01 28

Real Estate Injuries to self and Client: § Chest pain, stroke § Heart attack, Seizures § Anaphylactic reaction Consider: § CPR § AED § Calling 911 PPT-149 -01 29

Retail Trade Injuries to self and Client: § Chest pain, stroke § Heart attack, Seizures § Anaphylactic reaction § Pregnancy complications Consider: § CPR § AED § Special kit to counter reactions § Calling 911 PPT-149 -01 30

Education Injuries: § Falls § Eye injuries § Ingestion Consider: § CPR § AED § Calling 911 PPT-149 -01 31

Administration Injuries: § High Blood Pressure § Insulin Problems § Heart Attack Consider: § CPR § AED § Calling 911 PPT-149 -01 32

AEDs Automated External Defibrillators § (AEDs) treat sudden cardiac arrest (SCA) caused by ventricular fibrillation § Using AEDs within 3 -4 minutes, can lead to a 60% survival rate. 3 § All worksites are potential candidates for AED programs § Assess an AED program as part of your first-aid response PPT-149 -01 33

AED Program § Physician oversight; § Compliance with local, state and federal regulations; § Coordination with local EMS; § Quality assurance program; § Periodic program review PPT-149 -01 34

First Aid Courses Training is offered by: § American Heart Association § American Red Cross § National Safety Council § Other nationally recognized and private educational organizations. PPT-149 -01 35

Training Programs § Individualize to workplace needs § Consider unique conditions at a specific worksite and customize your program Training Elements Considered 1. Teaching Methods 2. Preparing to Respond to a Health Emergency 3. Assessing the Scene and the Victims 4. Responding to Life-Threatening Emergencies 5. Responding to Non-Life Threatening Emergencies PPT-149 -01 36

1. Teaching Methods § Curriculum based on a consensus of scientific evidence where available; § “Hands-on” skills and partner practice; § Appropriate supplies and equipment available; § Stress acute injury and illness settings as well as appropriate response by using visual aids; PPT-149 -01 37

1. Teaching Methods § Course information resource for reference both during and after training; § Allow emphasis on commonly occurring situations; § Emphasize skills training and confidence-building over classroom lectures; § Emphasize quick response to first-aid situations. PPT-149 -01 38

2. Preparing to Respond Instruction/discussion in: § Prevention to reducing fatalities, illnesses and injuries; § Interacting with local EMS; § Current emergency telephone numbers (police, fire, ambulance, poison control) accessible by all employees; § Understand legal aspects of providing first-aid care, including Good Samaritan legislation, consent, abandonment, negligence, assault and battery, State laws and regulations; PPT-149 -01 39

2. Preparing to Respond § Understand effects of stress, fear of infection, panic; how they interfere with performance; and what to do to overcome these barriers to action; § Universal precautions and body substance isolation; § Personal protective equipment (PPE); § Appropriate management and disposal of bloodcontaminated sharps and surfaces; and § OSHA’s Bloodborne Pathogens standard PPT-149 -01 40

3. Assessment § Assess scene for safety, number injured, nature of event; § Assess the toxic potential and the need for respiratory protection; § Establish the presence of a confined space and the need for respiratory protection and specialized training to perform a rescue; § Prioritize care, treat for shock PPT-149 -01 41

3. Assessment § Assess each victim for responsiveness, airway blockage, breathing, circulation, and medical alert tags; § Take a victim’s history determining the mechanism of injury; § Perform a logical head-to-toe check for injuries; § Continuously monitor the victim; § Emphasize early activation of EMS; § Indications for and methods of safely moving and rescuing victims; § Repositioning ill/injured victims to prevent further injury. PPT-149 -01 42

4. Life-Threatening Events § Adapt program to specific worksite: § Establishing responsiveness; § Establishing and maintaining an open and clear airway; § Performing rescue breathing; § Treating airway obstruction in a conscious victim; § Performing CPR; § Using an AED; PPT-149 -01 43

4. Life-Threatening Events § Recognizing the signs and symptoms of shock and providing first aid for shock due to illness or injury; § Assessing and treating a victim who has an unexplained change in level of consciousness or sudden illness; § Controlling bleeding with direct pressure; PPT-149 -01 44

4. Life-Threatening Events Poisoning § Ingested poisons: alkali, acid, and systemic poisons. Role of the Poison Control Center (1800 -222 -1222) § Inhaled poisons: carbon monoxide; hydrogen sulfide; smoke; and other chemical fumes, vapors, and gases § Assessing the toxic potential of the environment and the need for respirators PPT-149 -01 45

4. Life-Threatening Events § Knowledge of the worksite chemicals and first aid and treatment for inhalation or ingestion; § Effects of alcohol and illicit drugs to recognize physiologic and behavioral effects; § Recognizing asphyxiation and confined space dangers; § Responding to Medical Emergencies PPT-149 -01 46

5. Non-Life Threatening Wounds § Assessment and first aid for wounds including abrasions, cuts, lacerations, punctures, avulsions, amputations and crush injuries § Principles of wound care, including infection precautions § Principles of body substance isolation, universal precautions § Use of personal protective equipment PPT-149 -01 47

5. Non-Life Threatening Burns § Assess severity § Is burn thermal, electrical, or chemical and the appropriate first aid; § Review your corrosive chemicals and appropriate first aid. Temperature Extremes § Exposure to cold: frostbite and hypothermia; § Exposure to heat: heat cramps, heat exhaustion and heat stroke. PPT-149 -01 48

5. Non-Life Threatening Musculoskeletal Injuries § Fractures; § Sprains, strains, contusions and cramps; § Head, neck, back and spinal injuries; § Appropriate handling of amputated body parts. Eye injuries § First aid for eye injuries; § First aid for chemical burns. PPT-149 -01 49

5. Non-Life Threatening Mouth and Teeth Injuries § Oral injuries; lip and tongue injuries; broken and missing teeth; § The importance of preventing aspiration of blood and/or teeth. Bites and Stings § Human and animal bites; § Bites and stings from insects; instruction in first-aid treatment of anaphylactic shock. PPT-149 -01 50

Trainee Assessment of successful completion of the firstaid training program should include: § Instructor observation of acquired skills and § Written performance assessments. PPT-149 -01 51

Skills Update § Retention rate of 6 -12 months of these critical skills. § Skills review and practice sessions at least every 6 months for CPR and AED skills. § Instructor-led retraining for life-threatening emergencies should occur at least annually. § Retraining for non-lifethreatening response should occur periodically. PPT-149 -01 52

Program Update § Review program periodically § Does it continue to address the needs of the specific workplace? § Add or modify training, supplies, equipment and first-aid policies to account for changes in workplace safety and health hazards, worksite locations and worker schedules since the last program review. § Keep program up-to-date with current techniques and knowledge. Replace/remove outdated training and reference materials. PPT-149 -01 53

Summary § Employers are required by 29 CFR 1910. 151 to have a person(s) adequately trained to render first aid for worksites not near an infirmary, clinic, or hospital. § Design a program for a workplace reflecting known and anticipated risks. § Consult local emergency medical experts and providers of first-aid training when developing a program. PPT-149 -01 54

Summary § Program must comply with all applicable OSHA standards and regulations. § OSHA requires certain employers to have CPRtrained rescuers on site. § Seriously consider establishing a workplace AED program. § First-aid supplies must be available in adequate quantities and readily accessible. PPT-149 -01 55

Summary § First-aid training courses should include instruction in general and workplace hazardspecific knowledge and skills. § CPR training should incorporate AED training if an AED is at the worksite. § Repeat first-aid training periodically to update knowledge and skills. PPT-149 -01 56

Summary Management commitment and worker involvement is vital in developing, implementing and assessing a workplace first-aid program. PPT-149 -01 57

Questions PPT-149 -01 58

Contact Information Health & Safety Training Specialists 1171 South Cameron Street, Room 324 Harrisburg, PA 17104 -2501 (717) 772 -1635 RA-LI-BWC-PATHS@pa. gov Like us on Facebook! - https: //www. facebook. com/BWCPATHS PPT-149 -01 59

Bibliography Best Practices Guide: Fundamentals of a Workplace First Aid Program, OSHA 3317 -06 N 2006 Virginia school emergencies www. doe. virginia. gov/. . . /health_emergencies/fir st_aid_emergencies. pdf The Cost of Debilitating Workplace Injuries Tuesday, May 24, 2016 by Chelsie King Garza research. lawyers. com PPT-149 -01 60

Bibliography www. bls. gov/iif American National Standard (ANSI) Z 308. 1 -1998 “Minimum Requirements for Workplace First-aid Kits. ” OSHA First Aid Standard, 29 CFR 1910. 151, Appendix A 29 CFR 1910. 1030, Bloodborne Pathogen Standard PPT-149 -01 61

Bibliography OSHA Recording and Reporting Occupational Injuries and Illnesses regulation (29 CFR 1904) provides specific definitions of first aid and medical treatment. American Heart Association in collaboration with International Liaison Committee on Resuscitation. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science, Part 4: The Automated External Defibrillator. Circulation. 2000; Vol. 102, Supplement: I 61. PPT-149 -01 62

Bibliography Additional Resources on First Aid, CPR and AEDs American Association of Occupational Health Nursing at www. aaohn. org National Safety Council at www. nsc. org PPT-149 -01 63

Bibliography Segal, Eileen B, “First Aid for a Unique Acid: HF, ” Chemical Health and Safety, September/October 1998, Vol. 5, No. 5, p. 25, Bronstein, A. C. and Currance, P. L. “Emergency Care for Hazardous Materials Exposures, “ Mosby Company, 1988. PPT-149 -01 64

Other Suggested Programs The following may aid your in-house program: ü ü ü Bloodborne Pathogen Standard Fall Protection Heat-related injuries PATHS – PA Training Cold weather injuries for Health & Safety Infectious Diseases Struck-by Hazards Please contact us for a full list of other free programs available to you. PPT-149 -01 65