The Organization of First Aid in the Workplace (ILO, 1999, 70 p.): 4. How first aid is organized: 4.3. First-aid personnel: 4.3.2. Type and number of first-aid personnel required

The Organization of First Aid in the Workplace (ILO, 1999, 70 p.)

(introduction...)

Preface

1. Why first aid and the organization of first aid?

1.1. What is first aid?

1.2. The need to prevent accidents

1.3. If an accident occurs

1.4. An organized approach to first aid

2. What first aid must do

3. Responsibilities and participation

3.1. Responsibilities of the employer

(introduction...)

3.1.1. Equipment, supplies and facilities

3.1.2. Human resources

3.1.3. Other

3.2. Workers’ participation

4. How first aid is organized

4.1. Variables to be considered in the assessment of first-aid requirements

(introduction...)

4.1.1. Type of work and associated risks

4.1.2. Size and layout of the enterprise

4.1.3. Other enterprise characteristics

4.1.4. Availability of other health services

4.2. First aid in the context of the general organization of safety and health in the enterprise

(introduction...)

4.2.1. Occupational health services

4.2.2. Safety and health committees and safety delegates

4.2.3. The labour inspectorate

4.2.4. Other institutions

4.3. First-aid personnel

(introduction...)

4.3.1. Functional tasks

4.3.2. Type and number of first-aid personnel required

4.3.3. Advice to, and supervision of, first-aid personnel

4.4. The role of the occupational health physician or nurse

4.5. Equipment, supplies and facilities for first aid

(introduction...)

4.5.1. Rescue equipment

4.5.2. First-aid boxes, first-aid kits and similar containers

4.5.3. Specialized equipment and supplies

4.5.4. The first-aid room

4.5.5. Means for communicating the alert

4.6. Planning for access to additional care

4.7. Records

5. The training of first-aid personnel

5.1. General considerations

5.2. Basic training

(introduction...)

5.2.1. General

5.2.2. Delivery of first aid

5.3. Advanced training

5.4. Training material and institutions

5.5. Certification

6. Relation to other health-related services

Annexes

Annex I. Examples of first-aid legislation

1. New Zealand

2. United Kingdom

3. Federal Republic of Germany

Annex II. Be ready for emergencies1

Annex III. Rescue equipment: An example

Annex IV. First-aid boxes

1. Belgium

2. India

3. New Zealand

4. United Kingdom

Annex V. Antidotes: Some useful examples

Occupational Safety and Health Series

Back cover

4.3.2. Type and number of first-aid personnel required

The type and number of first-aid personnel required in an enterprise are determined by the variables previously discussed. Among them the type of work and the associated risks, and the size and configuration of the enterprise are the most important. The type of first-aid personnel relates to the specific tasks which may be performed and, accordingly, to the level of training, and depends primarily on the risks at work. The number of first-aid personnel required is mainly dependent on the size and configuration of the enterprise, but the potential risk at work and some other factors will also be determinants.

National regulations for first aid vary in respect of both the type and number of first-aid personnel required. In some countries the emphasis is on the number of persons employed in the workplace. In other countries, the overriding criteria are the potential risks at work. In yet others, both of these factors are taken into account. In countries where occupational safety and health is more advanced and the frequency of accidents is generally lower, more attention is usually given to the type of first-aid personnel. In countries where first aid is not regulated, emphasis is normally placed on numbers of first-aid personnel. The following four examples are indicative of the differences in approach used in determining the type and number of first-aid personnel in different countries:

The United Kingdom⁵
- If the work involves relatively low hazards only, no first-aid personnel are required unless there are 150 or more workers present at work; in this case a ratio of one first-aider per 150 workers is considered adequate. Even if fewer than 150 workers are at work, the employer should nevertheless designate an “appointed person” at all times when workers are present.
- Should the work involve higher risk, one first-aider will normally be required when the number of workers at work is between 50 and 150. If more than 150 workers are at work, one additional first-aider for every 150 will be required and, if the number of workers at work is less than 50, an “appointed person” should be designated.
- If the potential risk is unusual or special, there will be a need, in addition to the number of first-aid personnel already required under the criteria set out above, for an additional type of person who will be trained specifically in first aid in case of accidents arising from these unusual or special hazards (the occupational first-aider).
Belgium⁶
- One first-aider is usually required for every 20 workers present at work. However, a full-time occupational health staff member is required if there are special hazards and if the number of workers exceeds 500, or in the case of any enterprise where the number of workers at work is 1,000 or more.
- Some degree of flexibility is possible in accordance with particular situations, or if other specific measures are taken to cope with the immediate consequences of accidents at work.
Federal Republic of Germany⁷
- One first-aider is required if there are 20 or fewer workers present at work.
- If more than 20 workers are present, the number of first-aiders should be 5 per cent of those at work in case of offices or in general trade, or 10 per cent in all other enterprises. Depending on other measures which may have been taken by the enterprise to deal with emergencies and accidents, these numbers may be revised.
- If work involves unusual or specific risks (for instance, if hazardous substances are involved), a special type of first-aid personnel needs to be provided and trained; no specific number is stipulated for such personnel, i.e. the above-mentioned numbers apply.
- If more than 500 workers are present and if unusual or special hazards exist (burns, poisonings, electrocution, impairment of vital functions such as respiratory or cardiac arrest), specially trained full-time personnel must be made available to deal with cases where a delay in arrival of no more than 10 minutes may be allowable. This provision will apply in most cases of larger construction sites where a number of enterprises often employ a workforce of several hundred workers.
New Zealand⁸
- If more than five workers are present, a person employed at the enterprise is appointed and put in charge of the equipment, supplies and facilities for first aid.
- If more than 50 persons are present, the person appointed must be either a registered nurse or the holder of a certificate (issued by the St. John’s Ambulance Association or the New Zealand Red Cross Society).

Summary overview

In summary, the following principles regarding the type and number of first-aid personnel may be established:

(a) Type
A distinction may be made in practice between two types of first-aid personnel:

- The basic-level first-aider, who will receive basic training outlined in Chapter 5. This type of first-aid personnel will qualify for appointment where the potential risk at work is low.
- The advanced-level first-aider, who will receive the basic and advanced training outlined in Chapter 5, and will qualify for appointment where the potential risk is higher, special or unusual.

First-aid personnel should be available in any enterprise irrespective of its size. In the case of very small enterprises, and if the potential risk at work is low, the designation of an “appointed person” by the employer may suffice. The “appointed person” will be informed about the equipment and supplies provided by the employer and their location, and will be responsible for their maintenance. He or she will also be made aware of all other arrangements for medical care if needed (i.e. the alert and the referral to suitable medical facilities).
(b) Number
- One basic-level first-aider with basic training is often considered sufficient if the number of workers present does not exceed a range between 50 and 100, and if potential risks at work are low. In some countries this number is 20.
- In the case of small enterprises, the presence of a first-aider is always recommended, although this is not often made compulsory; there are sometimes alter- natives such as the need to nominate a person in charge of the first-aid box (careful custody and appropriate use) in all enterprises (Belgium).
- If the potential risks are higher, unusual or special, advanced first-aiders (in numbers as given above) should be required, with advanced training in respect of the specific needs established for the enterprise.
- Larger enterprises with 500 or more workers present and where the potential risks are higher, unusual or special, should, in addition, require permanent occupational health staff (one for every 500) to back up the first-aid personnel referred to above at relatively short notice (five to ten minutes).

The numbers set out above should be applied flexibly, depending on the specific circumstances of the enterprise, the first-aid needs assessment made by the employer and the level of safety in the enterprise.