|The Organization of First Aid in the Workplace (ILO, 1999, 70 p.)|
|4. How first aid is organized|
|4.5. Equipment, supplies and facilities for first aid|
First-aid personnel must be provided with adequate equipment, supplies and facilities. The type and quantity of equipment, supplies and facilities should be determined in the light of the assessment made by the employer in planning and organizing first aid. This should take into account the regulatory and other standards. The employer is responsible for providing equipment, supplies and facilities.
In some emergency situations, specialized rescue equipment to remove or disentangle an accident victim may be necessary. Although it may not be easy to predict, certain work situations (such as working in confined space, at heights or above water) may have a high potential for this type of incident. When the possible need for rescue exists, special equipment should be provided and first-aid personnel should be trained to use it.
Rescue equipment may include items such as protective clothing, blankets for fire-fighting, fire extinguishers, respirators, self-contained breathing apparatus, cutting devices, and mechanical or hydraulic jacks, as well as equipment such as ropes, harnesses and specialized stretchers to move the victim. It must also include any other equipment required to protect the first-aid personnel against becoming casualties themselves in the course of delivering first aid. More information on this is contained in Annex III.
Although initial first aid should be given before moving the patient, simple means should also be provided for transporting an injured or sick person from the scene of the accident to the first-aid facility. Stretchers should always be kept available and easily accessible.
The materials included in first-aid boxes, kits and containers must be suitable and sufficient in number for delivering basic first aid, especially for attending to bleeding, broken or crushed bones, simple burns, eye injuries and minor indispositions.
In some countries, only the principal requirements are set out in regulations, e.g. that adequate amounts of suitable materials and appliances are included, and that the employer must determine what precisely may be required and in which quantity, depending on the type of work, the associated risks and the configuration of the enterprise. In most countries, however, more specific requirements have been set out, with some distinction made as to the size of the enterprise and the type of work and potential risks involved.
The contents of these containers must obviously match the skills of the first-aid personnel, the availability of a factory physician or other health personnel, and the proximity of an ambulance or emergency service. The more elaborate the tasks of the first-aid personnel, the more complete must be the contents of the containers. Annex II gives further information on first aid and first-aid boxes, and this may be especially useful for small-scale enterprises.
A relatively simple first-aid box will usually include the following items:
- individually wrapped sterile adhesive dressing;
- bandages (and haemostat bandages, where appropriate);
- a variety of dressings;
- sterile sheets for burns;
- sterile eye pads;
- triangular bandages;
- safety pins;
- a pair of scissors;
- antiseptic solution;
- cotton wool balls;
- a card with first-aid instructions.
First-aid boxes should always be easily accessible and should be located near areas where accidents could occur. They should be able to be reached within as short a delay as possible (one to two minutes). They should be made of suitable materials, and should protect the contents from heat, humidity, dust and abuse. They need to be identified clearly as first-aid material; in most countries, they are marked with a white cross or a white crescent, as applicable, on a green background with white borders.
If the enterprise is subdivided into departments or shops, at least one first-aid box should be available in each unit. However, the actual number of boxes required will be determined on the basis of the needs assessment made by the employer. In some countries the number of containers required, as well as their contents, has been established by law.
Soap and clean water and disposable drying materials should also be readily available. If possible, there should be a water tap within reach or, if this is not available, water should be kept in disposable containers near the first-aid box for eye wash and irrigation.
Small first-aid kits should always be available where workers are away from the establishment in such sectors as lumbering, agricultural work or construction; where they work alone, in small groups or in isolated locations; where work involves travelling to remote areas; or where very dangerous tools or pieces of machinery are used. The contents of such kits, which should also be readily available to self-employed persons, will vary according to circumstances, but they should always include:
- a few medium-sized dressings;
- a bandage;
- a triangular bandage;
- safety pins.
Examples of first-aid boxes, first-aid kits and similar containers required in a number of countries are listed in Annex IV.
Further equipment may be needed for the provision of first aid where there are unusual or specific risks. This applies specifically to situations where first-aid personnel are expected to assist in the case of shock, respiratory and cardiac arrest, electrocution, serious burns and especially chemical burns, and poisonings. Equipment for resuscitation is of particular importance.
This equipment and material should always be located near the site or sites of a potential accident, and in the first-aid room (see subsection 4.5.4). Transporting the equipment from a central location (such as an occupational health service facility) to the site of the accident may take too long. If the equipment and supplies are located on site, they will be ready and available upon the arrival of the physician or the nurse according to a plan which the employer must devise in advance.
If poisonings are a possibility, antidotes must be immediately available in a separate container, though it must be made clear that their application is subject to medical instruction. Long lists of antidotes exist, many for specific situations. Only the assessment of the potential risks involved will indicate which antidotes are needed. Annex V lists some important antidotes and the chemicals in relation to which they might be used.
A room or a corner, prepared for administering first aid, should be available. Such facilities are required by regulations in many countries. Normally, first-aid rooms are mandatory when there are more than 500 workers at work or when there is a potentially high or specific risk at work. In other cases, some facility must be available, even though this may not be a separate room, e.g. a prepared corner with at least the minimum furnishings of a full-scale first-aid room, or even a corner of an office with a seat, washing facilities and a first-aid box in the case of a small enterprise.
Whatever the specific requirements in a given enterprise, a first-aid room or other facility should meet the following requirements:
- It should be easily accessible taking into account that the casualty may arrive on a stretcher or by some other means of transportation, and must have easy access for removing the victim to an ambulance or other means of transportation to a hospital.
- It should be large enough to hold a couch with space for people to work around it.
- It should be kept clean, well ventilated, well lit and maintained in good order.
- It should be reserved for the administration of first aid.
- It must be clearly identified as a first-aid facility and appropriately marked (in most countries with a white cross or white crescent on a green background) and should be under the responsibility of first-aid personnel.
- There should be clean running water, preferably both hot and cold, soap and a nail brush.
- There should be towels, pillows and blankets, clean clothing for use by the first-aid personnel, and a refuse container.
Following an accident or sudden illness, it is important that immediate contact can be made with the first-aid personnel. This requires means of communication between work areas, the first-aid personnel and the first-aid room. Communications by telephone may be preferable, especially if distances are more than 200 metres, but this will not be possible in all establishments. Acoustic means of communication such as a hooter or a buzzer may serve as a substitute as long as it can be ensured that the first-aid personnel arrive at the scene of the accident rapidly.
Lines of communication should be pre-established. Requests for advanced or specialized medical care, or an ambulance or emergency service, are normally made by telephone. The employer should ensure that all relevant addresses, names and telephone numbers are clearly posted throughout the enterprise and in the first-aid room, and that they are always available to the first-aid personnel.