1910.151 – Medical Services and First Aid

“Preparing for medical issues at work is critical for safety leaders across all industries. Employees can be reluctant to help in these situations if they are not sure what to do. ZOLL Public Safety products are designed to offer bystanders the equipment and guidance they need to manage a variety of medical emergencies. ZOLL automated external defibrillators (AEDs) and Mobilize Rescue Systems™ provide real-time, step-by-step instructions, giving bystanders the confidence and support needed.” ZOLL Medical Corporation, 800-804-4356, zoll.com/public-safety

This is one of OSHA’s more succinct standards. It consists of three provisions:

• In the absence of an infirmary, clinic or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available.
• The employer shall ensure the ready availability of medical personnel for advice and consultation on matters of plant health.
• Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.

© masahiro – stock.adobe.com

First aid is not intended to take the place of professional medical care, although it may suffice if the injury or sudden illness is not severe. In the event of a health emergency, the person who administers the first aid performs a primary assessment and intervention until emergency medical technicians (EMTs) arrive.

A workplace first-aid program is part of a comprehensive safety and health management system. It should include:

• Identifying and assessing the workplace risks that have potential to cause worker injury or illness.
• Designing and implementing a workplace first-aid program that:
• Minimizes the outcome of accidents or exposures
• Complies with OSHA requirements relating to first aid
• Has sufficient quantities of appropriate and readily accessible first-aid supplies and first-aid equipment, such as bandages and automated external defibrillators.
• Assigns and trains first-aid providers who:
• receive first-aid training suitable to the specific workplace
• receive periodic refresher courses on first-aid skills and knowledge
• Instructing all workers about the first-aid program, including what workers should do if a coworker is injured or ill.
• Putting the policies and program in writing is recommended to implement this and other program elements.
• Providing for scheduled evaluation and changing of the first-aid program to keep the program current and applicable to emerging risks in the workplace, including regular assessment of the adequacy of the first-aid training course.

Medical equipment and supplies

Employers are required to evaluate the potential hazards in their workplace and have first aid supplies that could be used to treat injuries resulting from those hazards. Most workplaces are potential candidates for an automated external defibrillator (AED), which provides critical treatment for a person who suffers a sudden cardiac arrest (SCA). SCA occurs when a heart’s electrical system malfunctions and causes the heart to stop beating or to beat irregularly. Workplace events such as electrocution or exposure to low oxygen environments can lead to SCA. Overexertion at work can also trigger SCA in those with underlying heart disease. Scarring of the heart tissue from a previous heart attack, thickened heart muscle, blood vessel abnormalities and recreational drug use are among the causes of cardiac arrest. Whatever the underlying conditions, a cardiac arrest can happen quickly. Having AEDs and employees who are trained in the use of it and in administering CPR can mean the difference between survival and death when a person experiences a cardiac arrest.

An estimated 5% or less of victims of sudden cardiac deaths are successfully resuscitated and discharged alive from the hospital. According to OSHA, there are approximately 10,000 cardiac arrests in the workplace each year in the United States. However, only about 50% of people can locate an AED at work. A survey of 2,000 employees in corporate offices, hospitality, education and industry/labor found that:

• Half of all U.S. workers cannot locate an AED at work.
• In the hospitality industry, 66% of employees cannot locate an AED.
• 55% can’t get first aid or CPR and AED training from their employer.

Having an AED on-site is not enough; workers must know its location and be trained in how to administer it. Using an AED as soon as possible after sudden cardiac arrest, within 3-4 minutes, improves the victim’s chances of survival by 60%. CPR training is also important; using CPR with a SCA on someone who collapses suddenly and has no pulse supports the circulation and ventilation of the victim until an electric shock delivered by an AED can restore the fibrillating heart to normal.

Advancements in AED technology mean high-quality devices have more features while at the same time being user-friendly. When choosing AEDs for the workplace, the focus should be on AEDs that are designed for lay rescuers to use. Available features include voice and text prompts; automatic shock delivery, dual-language functionality and self-tests that keep rescuers refreshed on use procedures. Check to see whether the AED aligns with American Heart Association and the National Institute for Occupational Safety and Health’s Education and Research Center’s (ERC) guidelines.

Issues to consider when setting up a worksite AED program include physician oversight; compliance with local, state and federal regulations; coordination with local EMS; a quality assurance program; and a periodic review, among others. WMHS

For more information

• Visit the American Heart Association at americanheart.org and the American Red Cross at www.redcross.org for more information. The National Center for Early Defibrillation at www.early-defib.org has additional information about AED program development. OSHA’s Best Practices Guide: Fundamentals of a Workplace First-Aid Program is available at: https://tinyurl.com/bdmuan2f