The Organization of First Aid in the Workplace (ILO, 1999, 70 p.): 4. How first aid is organized: 4.3. First-aid personnel: 4.3.1. Functional tasks

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

4.3.1. Functional tasks

The arrangements for first aid must be practical. There is no merit in insisting that first-aid personnel be medically qualified. It is impossible to have medically qualified persons standing by on sites of potential accidents until the accidents occur. On the other hand, human life and health cannot be left to just anybody who happens to be at the site of an accident.

The concept of first-aid personnel implies that a person on the scene, usually a worker familiar with the specific conditions of work, is trained and prepared to perform specific tasks. The first-aider is provided with adequate equipment and supplies and with access to back-up medical services and facilities. Ultimately, the tasks of the first-aider, and accordingly the training, supervision and advice required, must be determined in the light of the specific situation in the enterprise. Yet there will be tasks common to many situations and they should be considered the basis for further refinement.

The following description of functional tasks is therefore intended to indicate what first-aid personnel must be able to do; it does not include all the actions which the first-aider will take. Books have been written and many guidelines exist on precisely how first aid should be given; some are referred to in Chapter 5 (footnote 1). These books should be consulted once the assessment of the potential needs for first aid have been made. From this assessment will emerge the precise nature and depth of the training for first-aid personnel, as well as the type and quantity of equipment and supplies which should always be ready in close proximity to the sites where accidents are likely to occur.

General tasks

1.	Assess the situation, the magnitude and severity of the injury, and the need for urgent additional medical care.

2.	Protect the victim against further injury by eliminating or reducing factors which may further aggravate his or her condition. If the victim is in danger, remove him or her from the site of the accident. (The classic examples are fire, electrocution or exposure to a toxic gas. The electric current must be switched off; the person exposed to toxic gases must be removed to prevent further gassing; etc. The first-aider must pay attention and take necessary measures to avoid becoming a victim of the same hazard. He or she must be instructed during training on the measures to be taken.)

3.	Assess the victim’s vital functions, i.e.:

		- Is the victim conscious? Can the victim talk or not? Is the air passageway clear?
		- Is the victim breathing?
		- Is the victim’s heart beating?
		- Is there severe bleeding?
		- Is the victim in shock?

4.	Give the alarm and call for medical help. If clearly indicated by the victim’s condition, help transport him or her to the appropriate medical care facility. The alarm must include the following information:

		- the name of the person giving the alarm, indicating the place from which it originates (telephone number);
		- the exact location of the accident;
		- the nature of the accident;
		- the number of victims;
		- the assessment of the victim’s vital functions (see above); the need for specific rescue equipment, if necessary.

5.	Provide the first aid (see below).

6.	Keep a record of the actions taken.

Provision of first aid in case of injury

The major situations to which the first-aider will usually respond include respiratory arrest, cardiac arrest, bleeding, shock, various burns including chemical burns, crushed or broken bones and joints, eye injuries, other skin injuries and infections. The first-aider must be provided with clear instructions in response to these situations:

- Unconsciousness: the first-aider must give priority to preserving vital functions; he or she will keep the airway open, clear the mouth and ensure that the tongue does not block the back of the throat, and carefully place the casualty in a recovery position while considering the possibility of hidden injuries.
- Respiratory arrest: the first-aider must start resuscitation and maintain it until the victim’s breathing is restored or until relieved by a qualified health professional.
- Cardiac arrest: as instructed, the first-aider must immediately initiate cardio-pulmonary resuscitation and continue until the victim’s breathing is restored or until relieved by a qualified health professional.
- Severe external bleeding, following cuts or the severing of limbs: the first-aider will apply direct pressure to the wound or, if that does not control the bleeding, apply pressure to the supplying artery; or, should both fail, apply a tourniquet which should later only be released by medical personnel. The first-aider should be prepared to respond to shock.
- Spinal injury: the first-aider should ask the victim whether he or she is able to move extremities; if not, in doubtful cases or when there are indications of a neck or back injury, the first-aider should always assume that there is a spinal injury; the victim should only be handled in accordance with instructions given for such cases; the spinal column should be kept in a straight position and never rotated.
- Crushed or broken bones or joints: the first-aider’s major concern will be (i) the immobilization of the broken or crushed bone or joint; (ii) treatment for shock; and (iii) attending to open wounds.
- Chemical eye injuries: unless it is clearly indicated to the contrary, the first-aider will flush the eye at once with clean, cool water and continue to do so for several minutes; he or she will then take the victim for subsequent medical examination.
- Burns: the burnt area of the body should be placed in cool, clean water, and a moist sterilized dressing subsequently applied. Resuscitation or rehydration may be necessary. The first-aider will watch for symptoms of shock and respiratory arrest. Appropriate medical care and follow-up should be ensured.
- Chemical burns: assuring his or her own safety, the first-aider will immediately flush the area with cool, clean water unless otherwise indicated, and remove contaminated clothing, unless it sticks to the skin. He or she will apply sterilized dressings to exposed and damaged skin and clean towels to damaged areas where the clothing cannot be removed. Appropriate medical care and follow-up should be ensured.
- Electric shock: the first-aider will ensure that the current is switched off and help in freeing the person. He or she will watch for respiratory or cardiac arrest and, where necessary, start and maintain resuscitation until medical personnel can take over.