The cost of not having first aid

On 30 August 2010, WorkSafe Victoria released a media statement about a case in a Magistrates’ Court concerning the death of a worker.  Nothing new in that but in this case first aid gains a prominence that is rarely seen because in this case adequate first aid was not provided.  The uniqueness of the case justifies reproducing the media release in full:

“A Melbourne magistrate has described the failure of a Cheltenham company to seek first aid for a worker who hit his head and later died as ‘outrageous’.

Metal products manufacturer Pressfast Industries Pty Ltd was convicted and fined last week after a 2008 incident where a worker fell over and hit his head on concrete after being struck by a forklift.

The 60 year-old man was later found unconscious at work and died in hospital two days later.

“There was no qualified first aider on site, and the company failed to call an ambulance or seek first aid for the worker,” WorkSafe Victoria’s Strategic Programs Director Trevor Martin said. “The only staff member with first aid training was certified in 1984, and wasn’t alerted until it was too late,” he said.

In handing down his sentence, Magistrate Andrew Capell referred to the company’s decision not to seek help from the first aider, despite the expired certificate, as ‘outrageous’. Continue reading “The cost of not having first aid”

Important OHS court decisions go unreported

On 20 May 2010 a Victorian magistrate fined an employer over $A500,000 following a workplace prosecution.  Almost all of it went to charity, according to WorkSafe Victoria.

There are several issues raised by Magistrate Vandersteen’s decision:

  • Why to charity?
  • Why the particular charities?
  • Why not allocate the funds to OHS-related organisations or initiatives?
  • Why does the Magistrates’ Court not make court decisions publicly available?

The workplace incident that started this case was that in August 2008, a 40-year-old man had his arm ripped out of the socket when it became tangled in an unguarded post peeler.   He was taken to hospital by an emergency ambulance helicopter where his life was saved. Continue reading “Important OHS court decisions go unreported”

Non-fatal injuries summary

Below is a summary of non-fatal workplace incidents handled by Victoria’s Metropolitan Ambulance Service over the last few weeks.

Many of these incidents gain no media attention principally due to the fact that the workers did not die but the incidents are of relevance ot safety professionals and provide a better perspective on the frequency of workplace incidents.


Hand injuries

The first case saw advanced life support paramedics from Footscray called to an Altona North address at 8am.

The Paramedic, Cameron Joyce, said when they arrived they were told the 42-year-old woman had been working with machinery when the accident happened.  “‘The woman told us that the fingers on her left hand were crushed for only two or three seconds. Continue reading “Non-fatal injuries summary”

Two workplace incidents – zookeeper and jockey

On 1 February 2010 a zookeeper at the Werribee Zoo was pinned for several minutes under a gate weighing around 200 kilograms.  The Metropolitan Ambulance Service reported that

“…the woman in her 20s was pinned under a gate weighing more than three hundred kilograms, for approximately three minutes.”

According to Paramedic Brett Parker,

“Thankfully a number of staff were nearby and three men managed to lift the gate off her body.  Incredibly when we arrived the woman was upright and talking, but she was in significant pain.  Given the potential for spinal injury we gave her pain relief medication before fitting her with a neck brace.” Continue reading “Two workplace incidents – zookeeper and jockey”

Does OHS training work?

Businesses thrive on the concept of return on investment (ROI) but it has been very hard to apply this to training in workplace safety and SafetyatWorkBlog can only provide clues to this relationship.

Training is an important component in any company’s safety management program but it will not solve all OHS ills, regardless of  the claims of some training providers.  Specific training to achieve licences is one type of training where skills become directly practical but other training, such as First Aid, Health & Safety Representative (HSR) training or general OHS training, is more difficult to quantify. Continue reading “Does OHS training work?”

“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.

Heimlich maneuvre has no scientific evidence

The Heimlich manoeuvre is an established first aid technique for removing a blockage, commonly from food.  First aid courses in Australia do not teach the technique as the evidence for the efficacy of the technique is lacking.  The Australian recommendation is to relax the person so that they can cough and to dislodge the blockage through solid thumps on the back.

First aid instructors need to spend time in almost every first aid class to counter the cultural dominance of the Heimlich manoeuvre.

The Australian Broadcasting Corporation’s “The Health Report” investigates the evidence for and against the Heimlich manoeuvre with interviews with Dr Henry Heimlich and with one of Dr Heimlich’s critics, his son Peter.  Peter describes his father as a celebrity doctor.

A Wikipedia article on choking includes the following quote from a 2005 article in the Cincinatti Magazine:

“According to Roger White MD of the Mayo Clinic and American Heart Association (AHA), “There was never any science here. Heimlich overpowered science all along the way with his slick tactics and intimidation, and everyone, including us at the AHA, caved in.”

The relevance of this podcast is very important for OHS professionals as an indication of the competence and validity of first aid training providers.

The podcast also raises other relevant issues concerning evidence-based decision-making, the manipulation and power of the media, and the credibility of subject-matter experts.

The podcast is a fascinating medical tale, a family saga and, perhaps, a case study for media students, but mostly as a precautionary tale for OHS professionals.

Kevin Jones

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