“Best Practice…First Aid”? – not sure

First aid is one of the most neglected areas of workplace health and safety but, when required , vital.  The neglect comes from it rarely being integrated into the safety management system and on relying of the advice from first aid training and equipment suppliers.  “Why shouldn’t it be relied on?  They’re the experts.”

In a previous career I worked for a first aid equipment and training provider in various roles.  A major task was to visit workplaces and assist them in determining their first aid needs.  Over the years that I undertook this role I came to the general conclusion that first aid kits were almost always over stocked in comparison to what was needed. (Assessing the first aid needs of 28 McDonalds restaurants in 2 days was fun, at first)

In relation to first training, most companies had insufficient first aiders and those they had were trained fair beyond the needs of their workplaces.

Granted most of these workplaces were not high risk organisations or in isolated locations,  mostly they were in urbanised areas.  But it was also this fact that generated most of the oversupply of equipment.

I was reminded of my many years in that role in the 1990s when SafeWork SA announced the release of its “Approved Code of Practice for First Aid”. (The Code will be available on the SafeWork SA website in a couple of days, and I will review it then)  This Code comes into effect on 10 December 2010 which means a busy 12 months for most South Australian OHS professionals.

According to SafeWork SA’s media statement, the new Code:

  • provides a more contemporary and best-practice approach to first aid
  • gives workplaces more flexibility to tailor their first aid arrangements to suit their type of business
  • better aligns South Australia with provisions interstate.

SafeWork SA’s Executive Director, Michele Patterson, says

“An extensive two-year consultation by SafeWork SA revealed that existing workplace first aid kits were often too big, not relevant to the individual workplace needs, and resulted in considerable wastage……”Under the new Code, first aid kits can be smaller, will cover more types of injuries and should reduce wastage.”

The capacity for tailoring first aid kits to the needs of the workplace has been allowed in Victoria for almost twenty years.  New packaging and configurations were designed by suppliers,  – cloth pouches, wall-mounted plastic boxes, back packs…   But the contents and packaging was determined in relation to the manufacturers costs, more than the needs of the client.

Here is my first aid kit.  A pair of disposable gloves, a disposable resuscitation faceshield, a ziplock bag to keep them in and a mobile phone.  Everything else should be determined by need.

If you don’t remember that first aid is “emergency medical treatment”, you will be ripped off by equipment providers.

Of course it is possible to provide first aid without even this amount of equipment.  The above package is purely personal protective equipment to stop infectious liquid passing between the injured and the first aider.  There are plenty of cases of people who have no access to this PPE still saving lives.

Patterson says that a benefit of the Code is that it brings South Australia’s first aid training levels up to the standards of the other States.  This is relevant for some workplaces but most will wait to see what the national OHS harmonisation process produces and then apply that.

But Patterson says something that holds more wisdom than she expected.

“The more people trained in basic first aid who may be able to keep a person alive until an ambulance arrives – the safer both our workplace and communities will be.”

Here is the core of first aid.  The skills are basic, usually stop the bleeding and keep someone breathing.  I used to refer to this as “plug them and puff them”.  If a first aider achieves these two aims on an injured person until an ambulance arrives, they are fulfilling their tasks.

The other vital element is “until an ambulance arrives”.  Most workplaces are in urbanised locations with good emergency response.  Victoria has a targeted ambulance response time of around 15 minutes and over the last couple of decades the ambulance service has been supplemented by emergency medical services from the fire brigade.

Too many workplace first aid courses teach people how to immobilise a broken leg.  In most circumstances, a broken leg will be treated by ambulance officers.  Only yesterday a high school student attending an end-of-school function broke their nose.  The supervising teacher did the correct action and called an ambulance.  I am sure the boy’s parents also supported the decision.

Companies may consider the skills gained from a five-day first aid training course to be worthwhile for those employees who have children or bushwalk but in relation to workplace first aid, they were overtrained.  First aid courses have been trimmed from the standard workplace first aid course of fifteen years ago but as long as one signs up to an off-the-shelf training course, there will be training elements that are not required.

The last nugget of wisdom from Michele Patterson’s statement above is that the more people trained the better.  Imagine if everyone on one office floor were training in basic first aid.  There would always be a first aider present in the workplace, regardless of the hours of work.  No juggling of this level first aider and that level, or training additional people to cover the absences of the designated first aiders.  The emergency first aid response would the fastest possible and therefore the survival rate would be the best achievable.

Teach everyone in the workplace to “plug them and puff them” and you will be looking after your own health too.  For if you keel over and stop breathing, you will have at least one first aider at your side within a minute.  More likely you’ll have more than one and two-person CPR is very effective.  In this circumstance “reasonably practicable” may increase the level of first aid response rather than diminish OHS standards as it usually does.

It is also worth considering what provides the best first aid coverage in your workplace one first aider trained to a high level (who may be away on the day they’re most needed) or five first aiders trained only in CPR.  The cost would be about the same but which scenario provides the better emergency response and which scenario is more likely to provide compliance.

Kevin Jones

UPDATE – 11 December 2009

SafeWorkSA has identified the August 2009 First Aid Code of Practice on its website as the version which will apply from 10 December 2010.

Categories consultation, first aid, government, health, OHS, safety, Uncategorized, workplaceTags , , ,

4 thoughts on ““Best Practice…First Aid”? – not sure”

  1. Many first aid training providers conduct corporate emergency response competitions which are an excellent way of practicing time-critical first aid. In Australia this is particularly popular, and for good reason, in the mining sector.

    Of course most workplaces are not in this high-hazard category and, I suspect, would have difficulty justifying the expense for AED’s or advanced first aid training unless there has recently been a death or serious injury at work. If that occurs often cost is dismissed.

    Thanks for contributing

  2. Considering we just went through AED training again today, I completely agree that it is in the training of who is next to the fallen individual. Even among our well trained team, there was hesitancy in just practice runs. In these cases, there really is no substitute for practice, practice, and then even more practice so it becomes automatic. As we all know, it is usually the person who is afraid of the unknown that has someone grasp their chest and tip over in their office.

    The use of first aid is especially interesting when people here in the US are becoming increasingly afraid of not documenting enough for applying a bandaid incorrectly.

  3. The other thing you can do is invest about $3K in a defibrillator. You don’t even need first aid training to use one (although it’s recommended, of course.) These days the defibrillator talks you through what to do, tells you when to stand back, etc. In the days of aging workforce profiles, they will become – are already becoming – standard equipment in many workplaces, shopping centres, airports, etc…

    1. Ross

      I fully approve the placement and use of defibrillators but they present the same problem as a wall-mounted first aid kit. One has to provide assistance to the patient wherever they fall which is unlikely to be next to a defibrillator or first aid kit. The ideal scenario would be for a first aider to begin CPR immediately and have someone else run for the defib.

      This is another justification in my opinion for multiple first aiders in every workplace. This increases the likelihood of the application of emergency first aid AND improves the efficiency of the first aid process.

      Kevin

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