First Aid Awareness Training Program by Sushil Kumar Kushwaha

First Aid Basics Training & Awareness

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First Aid Defined First Aid: emergency care provided for injury or sudden illness before emergency medical treatment is available. The First-Aider: One trained in the delivery of initial medical emergency procedures, using a limited amount of equipment to perform a primary assessment and intervention while awaiting arrival of emergency medical service (EMS) personnel. Health, Safety & Environment

Basic Program Elements  Identifying/assessing injury risks  Designing/implementing a first-aid program that:  Aims to minimize the outcome of accidents or exposures  Complies with OSHA requirements relating to first aid  Sufficient/appropriate quantities of supplies and first-aid equipment, i.e. bandages and automated external defibrillators Health, Safety & Environment

Employer Responsibilities Those assigned are trained as first-aid providers:  With training suitable to the specific workplace  Periodic refresher courses  Instruct all workers about the first-aid program and actions for ill or injured coworkers  Put policies and program in writing  Schedule evaluation and changing of program  Keep program current Health, Safety & Environment

OSHA’s Top 10 Hazards 2017  Fall Protection  Hazard Communication  Scaffolding  Respiratory protection  Lockout/tagout  Powered Industrial Trucks  Ladders  Electrical-Wiring Methods  Machine Guarding  Electrical-General Requirements Health, Safety & Environment

Other Workplace Events  Electrocution  Exposure to low oxygen environments can lead to Sudden Cardiac Arrest (SCA)  Exposure to chemicals  Overexertion at work can also trigger SCA in those with underlying heart disease  Temperature extremes Prompt, proper first aid may mean the difference between rapid or prolonged recovery, temporary or permanent disability, and even life or death Health, Safety & Environment

Medical/First Aid ď ś The employer shall ensure the ready availability of medical personnel for advice and consultation on matters of plant health. ď ś 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.

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Medical/First Aid ď ś 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.

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Developing a Program  Consult with the local fire and rescue service or emergency medical professionals  Sudden Cardiac Arrest should be considered when planning  Get estimates of Emergency Medical Services (EMS) response times for all permanent and temporary locations and for all times of the day and night when workers are on duty.  Use information when planning their first-aid program Health, Safety & Environment

OSHA Requirements OSHA First Aid Standard  Requires trained first-aid providers at all workplaces of any size if there is no “infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees.”  OSHA standards also require training in CPR where sudden cardiac arrest from asphyxiation, electrocution, or exertion may occur.

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First Aid Supplies  Assign a person to choose types and amounts of first aid supplies and for maintaining same.  The supplies must be adequate,  Reflect the kinds of injuries that occur, and  Must be stored readily available for emergency use.  Automated external defibrillator (AED) should be considered when selecting first-aid supplies and equipment. Health, Safety & Environment

Kit Maintenance Inspect:  At assigned location?  Contents complete and undamaged?  Contents condition.  Non-required items removed from kit?  Contents out-of-date? Replace.  First Aid Manual included?  Sign to call 108? Establish a periodic inspection schedule.

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Situationals  Welder: burns, electrolyte, cuts  Nursing  Manufacturing  Mining  Transportation  Real estate  Education  Administration Health, Safety & Environment

Welding Injuries:  Burns  Cuts  Dehydration  Eye injuries Consider:  Electrolytes  Burn Spray & Compounds  Eye pads  Calling 911 Health, Safety & Environment

Nursing Injuries:  Finger  Dental  Strains & Sprains  Specific to patient condition Consider:  Patient needs which arise  Calling a special Code

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Manufacturing Injuries:  Vary with type of manufacturing  Punctures/impalement  Cuts  Crushing  Broken bones Consider:  CPR  AED  Calling 911 Health, Safety & Environment

Mining Injuries:  Silica exposure  Crushing  Amputation  Carbon monoxide exposure Consider:  CPR, AED  Oxygen  Calling 911 Health, Safety & Environment

Transportation Injuries:  Carbon Monoxide poisoning  Struck-by/Crushing  Heat exhaustion  HazMat Exposure Consider:  Oxygen cylinder  CPR  AED  Call 911 Health, Safety & Environment

Real Estate Injuries to self and Client:  Chest pain, stroke  Heart attack, Seizures  Anaphylactic reaction Consider:  CPR  AED  Calling 911

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Retail Trade Injuries to self and Client:  Chest pain, stroke  Heart attack, Seizures  Anaphylactic reaction  Pregnancy complications Consider:  CPR  AED  Special kit to counter reactions  Calling 911 Health, Safety & Environment

Education Injuries:  Falls  Eye injuries  Ingestion Consider:  CPR  AED  Calling 911

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Administration Injuries:  High Blood Pressure  Insulin Problems  Heart Attack Consider:  CPR  AED  Calling 911

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AEDs Automated External Defibrillators  (AEDs) treat sudden cardiac arrest (SCA) caused by ventricular fibrillation  Using AEDs within 3-4 minutes, can lead to a 60% survival rate.  All worksites are potential candidates for AED programs  Assess an AED program as part of your first-aid response Health, Safety & Environment

AED Program  Physician oversight;  Compliance with local, state and federal regulations;  Coordination with local EMS;  Quality assurance program;  Periodic program review Health, Safety & Environment

First Aid Courses Training is offered by:  Indian Heart Association  Indian Red Cross Society  National Safety Council of India  Other nationally recognized and private educational organizations.

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Training Programs ď&#x201A;§ Individualize to workplace needs ď&#x201A;§ Consider unique conditions at a specific worksite and customize your program Training Elements Considered 1. Teaching Methods 2. Preparing to Respond to a Health Emergency 3. Assessing the Scene and the Victims 4. Responding to Life-Threatening Emergencies 5. Responding to Non-Life Threatening Emergencies Health, Safety & Environment

1. Teaching Methods  Curriculum based on a consensus of scientific evidence where available;  “Hands-on” skills and partner practice;  Appropriate supplies and equipment available;  Stress acute injury and illness settings as well as appropriate response by using visual aids;

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1. Teaching Methods  Course information resource for reference both during and after training;  Allow emphasis on commonly occurring situations;  Emphasize skills training and confidence-building over classroom lectures;  Emphasize quick response to first-aid situations.

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2. Preparing to Respond Instruction/discussion in:  Prevention to reducing fatalities, illnesses and injuries;  Interacting with local EMS;  Current emergency telephone numbers (police, fire, ambulance, poison control) accessible by all employees;  Understand legal aspects of providing first-aid care, including Good Samaritan legislation, consent, abandonment, negligence, assault and battery, State laws and regulations;

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2. Preparing to Respond  Understand effects of stress, fear of infection, panic; how they interfere with performance; and what to do to overcome these barriers to action;  Universal precautions and body substance isolation;  Personal protective equipment (PPE);  Appropriate management and disposal of blood-contaminated sharps and surfaces; and  OSHA’s Bloodborne Pathogens standard

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3. Assessment  Assess scene for safety, number injured, nature of event;  Assess the toxic potential and the need for respiratory protection;  Establish the presence of a confined space and the need for respiratory protection and specialized training to perform a rescue;  Prioritize care, treat for shock

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3. Assessment  Assess each victim for responsiveness, airway blockage, breathing, circulation, and medical alert tags;  Take a victim’s history determining the mechanism of injury;  Perform a logical head-to-toe check for injuries;  Continuously monitor the victim;  Emphasize early activation of EMS;  Indications for and methods of safely moving and rescuing victims;  Repositioning ill/injured victims to prevent further injury. Health, Safety & Environment

4. Life-Threatening Events  Adapt program to specific worksite:  Establishing responsiveness;  Establishing and maintaining an open and clear airway;  Performing rescue breathing;  Treating airway obstruction in a conscious victim;  Performing CPR;  Using an AED;

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4. Life-Threatening Events  Recognizing the signs and symptoms of shock and providing first aid for shock due to illness or injury;  Assessing and treating a victim who has an unexplained change in level of consciousness or sudden illness;  Controlling bleeding with direct pressure;

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4. Life-Threatening Events Poisoning  Ingested poisons: alkali, acid, and systemic poisons. Role of the Poison Control Center.  Inhaled poisons: carbon monoxide; hydrogen sulfide; smoke; and other chemical fumes, vapors, and gases.  Assessing the toxic potential of the environment and the need for respirators

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4. Life-Threatening Events  Knowledge of the worksite chemicals and first aid and treatment for inhalation or ingestion;  Effects of alcohol and illicit drugs to recognize physiologic and behavioral effects;  Recognizing asphyxiation and confined space dangers;  Responding to Medical Emergencies

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5. Non-Life Threatening Wounds  Assessment and first aid for wounds including abrasions, cuts, lacerations, punctures, avulsions, amputations and crush injuries  Principles of wound care, including infection precautions  Principles of body substance isolation, universal precautions  Use of personal protective equipment Health, Safety & Environment

5. Non-Life Threatening Burns  Assess severity  Is burn thermal, electrical, or chemical and the appropriate first aid;  Review your corrosive chemicals and appropriate first aid. Temperature Extremes  Exposure to cold: frostbite and hypothermia;  Exposure to heat: heat cramps, heat exhaustion and heat stroke. Health, Safety & Environment

5. Non-Life Threatening Musculoskeletal Injuries  Fractures;  Sprains, strains, contusions and cramps;  Head, neck, back and spinal injuries;  Appropriate handling of amputated body parts. Eye injuries  First aid for eye injuries;  First aid for chemical burns.

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5. Non-Life Threatening Mouth and Teeth Injuries  Oral injuries; lip and tongue injuries; broken and missing teeth;  The importance of preventing aspiration of blood and/or teeth. Bites and Stings  Human and animal bites;  Bites and stings from insects; instruction in first-aid treatment of anaphylactic shock. Health, Safety & Environment

Trainee Assessment Assessment of successful completion of the firstaid training program should include: ď&#x201A;§ Instructor observation of acquired skills and ď&#x201A;§ Written performance assessments.

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Skills Update  Retention rate of 6-12 months of these critical skills.  Skills review and practice sessions at least every 6 months for CPR and AED skills.  Instructor-led retraining for life-threatening emergencies should occur at least annually.  Retraining for non-lifethreatening response should occur periodically. Health, Safety & Environment

Program Update  Review program periodically  Does it continue to address the needs of the specific workplace?  Add or modify training, supplies, equipment and first-aid policies to account for changes in workplace safety and health hazards, worksite locations and worker schedules since the last program review.  Keep program up-to-date with current techniques and knowledge. Replace/remove outdated training and reference materials.

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Summary  Employers are required by to have a person adequately trained to render first aid for worksites not near an infirmary, clinic, or hospital.  Design a program for a workplace reflecting known and anticipated risks.  Consult local emergency medical experts and providers of first-aid training when developing a program.

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Summary  Program must comply with all applicable OSHA standards and regulations.  OSHA requires certain employers to have CPRtrained rescuers on site.  Seriously consider establishing a workplace AED program.  First-aid supplies must be available in adequate quantities and readily accessible. Health, Safety & Environment

Summary  First-aid training courses should include instruction in general and workplace hazardspecific knowledge and skills.  CPR training should incorporate AED training if an AED is at the worksite.  Repeat first-aid training periodically to update knowledge and skills. Health, Safety & Environment

Questions

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