Cover Image
close this bookThe Organization of First Aid in the Workplace (ILO, 1999, 70 p.)
View the document(introduction...)
View the documentPreface
close this folder1. Why first aid and the organization of first aid?
View the document1.1. What is first aid?
View the document1.2. The need to prevent accidents
View the document1.3. If an accident occurs
View the document1.4. An organized approach to first aid
View the document2. What first aid must do
close this folder3. Responsibilities and participation
close this folder3.1. Responsibilities of the employer
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View the document3.1.1. Equipment, supplies and facilities
View the document3.1.2. Human resources
View the document3.1.3. Other
View the document3.2. Workers’ participation
close this folder4. How first aid is organized
close this folder4.1. Variables to be considered in the assessment of first-aid requirements
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View the document4.1.1. Type of work and associated risks
View the document4.1.2. Size and layout of the enterprise
View the document4.1.3. Other enterprise characteristics
View the document4.1.4. Availability of other health services
close this folder4.2. First aid in the context of the general organization of safety and health in the enterprise
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View the document4.2.1. Occupational health services
View the document4.2.2. Safety and health committees and safety delegates
View the document4.2.3. The labour inspectorate
View the document4.2.4. Other institutions
close this folder4.3. First-aid personnel
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View the document4.3.1. Functional tasks
View the document4.3.2. Type and number of first-aid personnel required
View the document4.3.3. Advice to, and supervision of, first-aid personnel
View the document4.4. The role of the occupational health physician or nurse
close this folder4.5. Equipment, supplies and facilities for first aid
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View the document4.5.1. Rescue equipment
View the document4.5.2. First-aid boxes, first-aid kits and similar containers
View the document4.5.3. Specialized equipment and supplies
View the document4.5.4. The first-aid room
View the document4.5.5. Means for communicating the alert
View the document4.6. Planning for access to additional care
View the document4.7. Records
close this folder5. The training of first-aid personnel
View the document5.1. General considerations
close this folder5.2. Basic training
View the document(introduction...)
View the document5.2.1. General
View the document5.2.2. Delivery of first aid
View the document5.3. Advanced training
View the document5.4. Training material and institutions
View the document5.5. Certification
View the document6. Relation to other health-related services
close this folderAnnexes
close this folderAnnex I. Examples of first-aid legislation
View the document1. New Zealand
View the document2. United Kingdom
View the document3. Federal Republic of Germany
View the documentAnnex II. Be ready for emergencies1
View the documentAnnex III. Rescue equipment: An example
close this folderAnnex IV. First-aid boxes
View the document1. Belgium
View the document2. India
View the document3. New Zealand
View the document4. United Kingdom
View the documentAnnex V. Antidotes: Some useful examples
View the documentOccupational Safety and Health Series
View the documentBack cover

4.6. Planning for access to additional care

The need for a referral of the victim to more advanced or specialized medical care must always be foreseen. The employer should have plans for such a referral, so that when the case arises everybody involved will know exactly what to do. However, it is not sufficient merely to prepare a plan. The plan must be updated and all persons concerned must know and understand the plan and how to implement it.

The first question to be considered in the preparation of the plan relates to the possible need for referral. This can be derived from (i) the assessment by the employer of the potential risks at work and the type and severity of the injuries which might be incurred, and (ii) the capacity of the first-aid system devised on the basis of this assessment. Once the possible needs for referral are established, the relevant medical facilities must be identified and located, and their specific capacity and assigned roles recorded in the plan.

In some cases the plan will be rather simple, but in others it may be elaborate, especially where unusual or special risks are involved at work and when accidents with complex or serious implications cannot be ruled out. In the construction industry, for instance, referral may be required after serious falls or crushings, and the end-point of referral will most probably be a general hospital, with adequate orthopaedic or surgical facilities. In the case of a chemical works, the end-point of referral will be a poison centre or a hospital with adequate facilities for the treatment of poisoning. No uniform pattern will exist. Each referral plan will be tailored to the needs of the enterprise under consideration, especially if higher, specific or unusual risks are involved. This referral plan is an important part of the emergency plan of the enterprise.

The referral plan must be supported by a system of communication and means for transporting casualties. In some cases, this may involve communication and transport systems organized by the enterprise itself, especially in the case of larger or more complex enterprises. In smaller enterprises, transport of the victim may need to rely on outside capacity such as public transport systems, public ambulance services, taxis, and so on. Careful planning is indispensable, and stand-by or alternative systems should be set up in case public facilities do not always function for one reason or another. Employers must foresee such possibilities in their own emergency planning. For instance, if there is a likelihood that public telephones will not work at the time they are needed, they must have other means of alerting the relevant medical facility. To avoid delays in communication and transport of casualties, the plan should list and exhibit all relevant addresses, names, telephone numbers and optimal routes of transportation.

The plan established to meet emergency conditions must be communicated to all concerned, including first-aiders, safety officers, occupational health services, the health service facilities to which victims may be referred, and all other institutions which may be involved, including those that play a role in communications and the transport of casualties (e.g. telephone services, ambulance services, taxi companies, etc.). The plan must be communicated and explained further to all workers as part of their overall briefing on health and safety, and first aid. It is not enough simply to post it in strategic locations (although this should always be done). Communicating the plan to all concerned must be made through individual briefings, and even these must be repeated from time to time.