First aid at work

As an employer, you are responsible for making sure that your employees receive immediate attention if they take ill, or are injured at work. First aid can save lives and prevent minor injuries from becoming major ones …

Even a low-risk workplace such as a small office should have a first-aid kit and a person appointed to take charge of first-aid arrangements, such as calling the emergency services, if necessary, and stocking the first-aid kit. In this instance, the appointed person does not need specific first-aid training.

Workplaces where there are more significant health and safety risks are more likely to need a trained first aider. A first-aid needs assessment will help employers decide what first-aid arrangements are appropriate for their workplace. Such an assessment should include consideration of the workplace, the workforce and the hazards and risks that are present.

The findings should indicate the level of first-aid equipment, facilities and personnel required.

Occupational Health and Safety Training (OHST) is a fully accredited Sector Education and Training Authority (SETA) institute with further accreditations with the Department of Labour. Gary Singh, business manager at OHST, says: “We offer expertly delivered first-aid courses on levels one, two and three.” Singh shares the following useful information regarding first-aid training:

The key aims of first aid (also known as the “three Ps”):

• Preserve life: the main aim of all medical care, including first aid, is to save lives and minimise the threat of death.

• Prevent further harm: this covers both external factors, such as moving a patient away from any cause of harm, as well as applying first-aid techniques to prevent the condition from worsening; for example, applying pressure to
stop bleeding.

• Promote recovery: first aid also involves trying to start the recovery process after the illness or injury, and in some cases might involve completing a treatment, for instance applying a plaster to a small wound.

The first aider is also likely to be trained in dealing with injuries such as cuts, grazes or bone fractures. He or she may be able to deal with the situation in its entirety (a small adhesive bandage on a paper cut, for instance), or may be required to maintain the condition of something like a broken bone, until the next stage of definitive care (usually an ambulance) arrives.

Skills – It is all about the ABCs

Certain skills are considered essential to the provision of first aid and are taught ubiquitously. ABC stands for Airway, Breathing, and Circulation. The ABCs, which focus on critical life-saving intervention, must be rendered before treatment of less serious injuries.

The same system is used by all emergency health professionals. Attention must first be brought to the airway to ensure it is clear and open. Obstruction (choking) is a life-threatening emergency. Following evaluation of the airway, a first aider would determine adequacy of breathing and provide rescue breathing if necessary. Assessment of circulation is done to determine if artificial circulation (chest compressions) is required.

Training is generally provided by attending a course, typically leading to certification. Due to regular changes in procedures and protocols, based on updated clinical knowledge, and to maintain skills, attendance at regular refresher courses or re-certification is often necessary.

In South Africa, the legislation is promulgated by the Occupational Health and Safety Act no. 85 of 1993. Specifically, the General Safety Regulation – GSR 3(4) provides for the requirement on compliance.

Know your duties as an employer

The training institute must be SETA-accredited. It should also have further accreditation with the Department of Labour and be issued with a certification number, which must be displayed on all certificates.

• The validity of these certificates must be three years.

• First aiders must be trained and appointed, as per GSR3(4).

• First-aid kits must be made available by the employer, as per GSR3(a).

First-aid kits

At least one first-aid kit should be provided for each workplace, although more than one might be required on larger sites. Kits should be made easily accessible. The contents should be checked frequently and restocked after any use.The kit should provide basic equipment for administering first aid for injuries including:

• cuts, scratches, punctures, grazes and splinters;

• muscular sprains and strains;

• minor burns;

• amputations and/or major bleeding wounds;

• broken bones;

• eye injuries; and

• shock.

Quick access to the kit is vital. First-aid kits should be kept in a prominent, accessible location where they can be retrieved promptly. Access should also be ensured in security-controlled workplaces.

In addition, kits should be located close to areas where there is a higher risk of injury or illness. For example, a school with a science laboratory or carpentry workshop should have first-aid kits located in these areas.

If the workplace occupies several floors in a multi-storey building, at least one kit should be located on every second floor. Emergency floor plans displayed in the workplace should include the location of first-aid kits.

A portable first-aid kit should be provided in the vehicles of mobile workers if that is their workplace (for example, couriers, taxi drivers, sales representatives, bus drivers and inspectors). These kits should be safely stored so as not to become a projectile in the event of an accident.

Evacuation chairs for stairway evacuation

“In case of emergency, do not use the lifts, use the stairs!” This a familiar sign next to all lifts, but few stop to think of the implications for those people who cannot use the stairs, due to injuries or other mobility impairments. These people’s lives would indeed be in danger if an emergency evacuation from the upper levels had to take place and there were no adequate plans to ensure their safety.

Employers are required to maintain proper evacuation plans and equipment, train staff accordingly and to practise the procedures during regular fire drills.

First aiders are trained and equipped to provide “basic life support and emergency first aid” to people with injuries, but may not be adequately equipped to provide for safe evacuation down the stairs. It is always a slow and difficult process to carry a stretcher down stairs and would require at least four able-bodied people.

Specialised equipment, such as stairway evacuation chairs, are available and should be considered as one of the essential tools necessary to protect valued staff, customers and other visitors to the upstairs levels of buildings.

Roger Buckley, managing director of Edwards & Buckley Systems, which manufactures the Evac Chair in South Africa, stresses the importance of having a comprehensive emergency evacuation plan, which includes safe evacuation for people with injuries or physical disabilities. “Having the right equipment in place, as well as ensuring correct usage through proper training and practise, are the keys to providing a truly safe environment for all building occupants. Evac Chairs are not just for people with disabilities. Anybody could be injured or collapse, for example due to smoke inhalation, and would then also need the correct equipment to be available.”