4.4. The role of the occupational health physician or nurse

First aid and its organization are part of the functions of occupational health services, where they exist. In addition, these services provide, or help to obtain, further or specialized medical care, if this is needed. They also provide professional back-up to first-aid personnel. In particular, they participate in organizing first aid, training or advising on the training of first-aid personnel, and advising on the evaluation of the manner in which first aid is organized and delivered.

There are several important roles that occupational health services could play as regards first aid, accident prevention, treatment, readaptation and reinsertion in work.

First, it is not infrequent that several small incidents or minor accidents take place before a severe accident occurs. Accidents requiring only first aid represent a signal which should be heard and should be used to guide and promote the preventive action.

Secondly, occupational health services should ensure follow-up of the injured worker from the medical and social points of view, starting with help in receiving appropriate and rapid medical treatment and then in obtaining assistance in social security, readaptation, compensation and finally reinsertion in active life. This represents a continuum, as there is sometimes a long, hard way between the accident and resuming work. The injured worker needs assistance in many respects - medical, psychological and social - to help to restore him or her to health in the best conditions, and this is far from always being the case. It is unacceptable that workers should lose their health because of their job and then lose their job because their health is impaired by their work, and this without proper compensation or alternative employment or even without mechanisms to impart new skills and retraining. In some countries this problem has received special attention. More efforts should be made to provide for follow-up of injured workers.

Finally, it should not be forgotten that the conditions in which first aid is administered may have a real impact on the final outcome of the injury: recovery or disability. Physicians and nurses should receive proper information and training on organizing first aid, planning for a sequence of events and administering first aid in an adequate manner and within the purview of an overall health approach. Where applicable, information and training on intervention in an emergency situation, emergency medicine and planning in the case of major hazards should be included.