First Aid

Besides being required to take steps to prevent injuries and ill health at work, employers are also obliged by law to provide first aid facilities.

When someone falls ill or is injured at work, a trained first aider should be there to attend to them. Even minor injuries such as cuts and bruises may otherwise be ignored or become infected and complications may develop.

Sometimes proper first aid provision can make the difference between life and death by stopping minor injuries or sudden-onset illnesses becoming major problems. The first few minutes after an event are vital, even when an ambulance or a doctor or a nurse has to be called.

First aid arrangements at work should be reviewed regularly to identify problems and the scope for improvements. Typical problems with first aid cover include:

• too few or no first aiders in more dangerous areas;
• first aid boxes which are too few or empty or poorly maintained;
• no first aid facilities for employees working away from the workplace; or for shift workers;
• poorly equipped first aid rooms;
• employees not knowing who is the first aider or where the first aid box is kept;
• reduced first aid cover when work systems are reorganised; and
• ignorance of first aid procedures.

The Law

Since 1982 the minimum legal standard for nearly all workplaces has been the Health and Safety (First Aid) Regulations 1981.

An up-dated ACoP and Guidance was produced in 1997. The Regulations put five clear duties on employers to:

1. provide adequate and appropriate first-aid equipment and facilities; Reg 3(1)
2. provide an adequate number of trained and qualified first-aiders; Reg 3(2)
3. provide an 'appointed person' if the first-aider is absent; Reg 3(3)
4. in certain workplaces (defined by level of risk, number of Reg 3(4) employees and location), to provide an ‘appointed person’ instead of a first aider; and
5. to provide information to all workers about the provision of first-aid, Reg 4 location of equipment, facilities and personnel.

What is Required?

When providing first aid under the Health and Safety (First Aid) Regulations 1981, the employer has to take into account the following:

• workplace hazards and risks;
• size of organisation; 68
• accident history of organisation
• nature and distribution of workforce;
• extent of shift work;
• employees working or shared or multi-occupied sites;
• annual leave and other absences of first aid personnel;
• location of the establishment; workers in remote areas will need more first-aiders and equipment than those working near a hospital;
• first aid needs of workers while working away from the main site; and
• trainees and the public. T

he employer must regularly review any assessment of first aid needs. Safety Reps have a right to be consulted (HASAWA 2(6)) on decisions about the level of hazard in the workplace. They should also be consulted about the implementation of the 1997 ACoP and Guidance.

First-Aiders and Appointed Persons

First-aiders are people who have been trained and been given certificates to show that they are capable of administering first-aid. According to the ACoP the types of first-aider who are “suitable” are:

• first-aiders who have been on an HSE approved training course and hold a current certificate; and
• any other person who has undergone training and obtained qualifications approved by the HSE, such as medical practitioners and practicing nurses.

The ACoP also gives guidance on the ratio of first-aiders to employees. This should be decided based on assessments of risk and number of workers. For low risk premises (eg shops, offices, libraries etc), if there are 50 employees there should be at least one first aider.

For medium risk (eg, light engineering, assembly work, food processing etc) if there are 20 employees there should be at least one first aider. For high risk premises (work with dangerous machinery, construction, etc) if there are 5 employees there should be at least 1 first aider.

Primary schools would come in the low risk category and most secondary schools in the medium risk. Colleges and universities would consider the number of first aiders required in specific departments or schools. There is no duty to provide first aid for non-employees, ie pupils, students or the public. If there is no first aider for a particular workplace there must be an appointed person.

An appointed person has two main tasks:

• to take charge of the situation (call an ambulance for instance) in the absence of a first-aider; and
• to keep first-aid facilities and equipment in good order in the absence of a firstaider.

Training

The training of first-aiders can only be done by organisations or employers approved by the HSE a free list is available. On successfully completing such a course a 69 certificate is awarded and is valid for three years.

A refresher course and reexamination are required before a new first-aid certificate can be issued. It is advised that instruction in emergency first-aid (resuscitation, control of bleeding, treatment of unconsciousness) should be given to all appointed persons and to all workers who work in small groups away from the employer's main workplace.

The possible legal liability of first-aiders may put people off volunteering for the job. Some employers have been persuaded to put in writing that they will take responsibility for the treatment given by first-aiders acting on their behalf. There is no legal or contractual requirement for a teacher or lecturer to become a first-aider.

First Aid Boxes

The Guidance gives details of what should be in, or near, first aid boxes, and the quantities required; and the contents of traveling first-aid kit. Whenever items are used, they must be replaced. The contents of first aid boxes and kits need to be regularly checked.

Every workplace must have at least one first-aid box, and the box - and all its contents - must be accessible at all times that workers are present (see next page for guidance on contents). First aid boxes and kits should contain only the items that a first-aider has been trained to use.

They should not contain medication of any kind. They should always be adequately stocked. First-aid kits may be provided for particular situations, and should be stocked accordingly. An antidote or special equipment needed to deal with a specific hazard may be kept near the hazard area or in the first-aid box.

Other first-aid equipment which could be necessary will include stretchers, blankets, and protective clothing if needed when first-aiders themselves might be put at risk going to the aid of an injured person. Any extra first-aid equipment must be stored near the first-aid box, protected from dust and damp, and regularly checked.

According to ACoP 3(1) a first -aid room is only necessary in an establishment if there is a special or unusual hazard; if workers are dispersed over a wide area; or if there is difficulty in getting the injured to hospital.

Information

People need to be able to find the nearest first-aider, and the nearest facilities in an emergency. The Regulations include the following requirements:

• employers have to tell workers of the first-aid arrangements, the location of the equipment, facilities, and personnel - Reg 4;
• new workers should be given this information as part of their induction training. Workers who move to other departments or areas need to be given information about the procedures in the area they move to - ACoP 4(1); 70
• there should be at least one notice in each workplace, giving locations of facilities and equipment, and names and locations of first aiders - ACoP 4(2); • notices should be in English and other languages commonly used in the workplace – ACoP 4 (3)
• the location of first-aid facilities should be clearly marked. Signs should comply with the Safety Signs Regulations.