6. Relation to other health-related services

It has been stressed throughout this monograph that first aid is the immediate intervention following an accident or in case of an indisposition at work, and that there will be cases in which specialized medical care will be required. The possible listing of institutions which may exist and provide such care include the following:

(a) the occupational health service of the enterprise itself or other occupational health entities;

(b) other institutions which may provide services, such as:

- ambulance services;
- public emergency and rescue services;
- hospitals, clinics and health centres, both public and private;
- private physicians;
- poison centres;
- civil defence;
- fire departments; and
- police.

Each of these institutions will have a variety of functions, capabilities and facilities, but it must be understood that what applies to one type of institution, say a poison centre in one country, may not necessarily apply to a poison centre in another country. An assessment must therefore be made by the employer of the institutions in the vicinity of the enterprise, in consultation with the factory physician and, if applicable, outside medical advisers, to ensure that the capabilities and facilities of these institutions are adequate to deal with the injuries expected in the event of serious accidents. This assessment is the basis for deciding which institutions will be entered into the referral plan discussed in section 4.6.

The cooperation of these related services is very important in providing proper first aid, particularly for small enterprises. Many of them may provide advice on the organization of first aid and on planning for emergencies. Enterprises may very often rely on them for the services they need in case of emergency, and this will be particularly efficient if it is planned in advance. There are good practices which are very simple and effective; for example, even a shop or a small enterprise may invite the fire brigade to visit its premises. Such a practice will have several advantages because the employer or owner will receive advice on fire prevention, fire control, emergency planning, extinguishers, the first-aid box, and so on. In addition, the fire brigade will know the enterprise and will be ready to intervene more rapidly and more efficiently.

The issue can be seen in even broader terms of relationships between fire-fighters, the police, the emergency and intervention services and the public. Is their potential for assisting the public sufficiently known? Are contacts made easier? Are such contacts planned systematically outside emergency situations (courtesy visits, conferences, contacts with children, etc.)? It is obvious that much remains to be done and that sometimes the overall approach is missing. This is linked to the need for development of public services as a true “service to the public”. When such an approach is followed, it should be possible for small-scale enterprises, small shops, families and individuals (including old persons living alone) to make arrangements for facing emergencies.

One of the aims of organizing first aid is that everyone, employer or worker, will be able to answer the question: “What will I do now if an accident happens now?” Emergency preparedness is one of the important features of organizing first aid. It will contribute to the development of a spirit of prevention and may lead to an improvement of occupational safety and health in all occupations.