First Aid and Burns

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The correct and established treatment for burns is

“.. to hold the burn under cool running water for at least 20 minutes”.

This reduces the continuing damage generated by burning tissue.  

This has been the advice for decades and was recently reemphasised by the Victorian Government.  So why are burn creams still on the market?  

Perhaps there is a place  for burn creams – when 20 minutes’ supply of cool running water is not available.

In December 2008, the Australian Defence Forces used burn cream.  According to a media release

The ADF has been advised that four Iraqi civilian vehicles were damaged and two Iraqi men received superficial burns to their hands when they reportedly attempted to remove hot debris from their cars.

The Iraqi men were treated at the scene by Coalition Forces with burn cream.

Child Safety Australia recommends burn cream in a domestic first aid kit for the treatment of blisters.

The Australian Red Cross are emphatic, but allow room to move:

“NEVER use burn cream as an initial treatment.  This should only be used a doctor’s recommendation.”

In 2003 (reference not publicly available), the Mayo Clinic in Rochester advised the following first aid treatments for burns

  • With chemical burns, make sure the chemical and any clothing or jewelry in contact with the chemical are removed.
  • Cool the burn under running water long enough to reduce the pain, usually 15 to 20 minutes. If this isn’t possible, immerse the burn in cold water or cover with cold compresses. Don’t put ice directly on the burn. Ice can cause frostbite and further damage.
  • Once the burn is cooled, apply a lotion or moisturizer to soothe the area and prevent dryness. Don’t apply butter. It holds heat in the tissues and may cause more damage.
  • Cover the burn with a sterile gauze bandage. Wrap loosely. Bandaging keeps air off the burn and reduces the pain.
  • Take an over-the-counter pain medication unless your doctor has told you to avoid these medications.
  • Don’t break blisters. If the blister is broken, wash with antibacterial soap and water, apply an antibiotic ointment and bandage.

No mention of burn cream and only an antibiotic cream in relation to blisters.

Safety professionals seek evidence, from which solid and valid decisions can be made.  Why then does the initial treatment of burns have such a variety of advice? Can we simply put it down to the commercial desires of cream manufacturers? Or the  lack of  explanation from the defence forces?

I am old enough to have experienced my mother applying butter to my burns.  We have had generational change in this treatment but how much more change would have occurred if workplace first aiders, and parents, had not had burn creams advocated as a legitimate first aid treatment?

Kevin Jones

Teenage worker’s death

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AAP and The Australian newspaper today reported on the death of an 18-year-old in a factory located  just north of SafetyAtWorkBlog’s office on 18 February 2009.

Initial reports say that the man was “dragged head first into a box-printing machine” when his clothing was caught.  Firefighters took 45 minutes to extract the worker who died later in hospital.

It will be interesting to follow this case as the investigation and potential prosecution proceeds.  It fits all the elements of safety campaigns over the last few years – young workers, inadequately guarded machines, risk assessments, risk controls, unnecessary deaths.

It is only a couple of months until International Workers’ Memorial Day when this worker’s name will be added to the annual roll-call of the dead.

Kevin Jones

Lessons from a draft medical code of conduct

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The safety industry in Australia may be seeking to become a recognised profession but, as with most business processes, continuous improvement is an important element of remaining current.

The Australian Medical Council has released a revised draft code of conduct with which several members of the Australian Medical Association (AMA) disagree.

According to an AMA media release,  Professor Paul Komesaroff, Director of Monash University’s Centre for Ethics in Medicine and Society, and Associate Professor Ian Kerridge, Director of Sydney University’s Centre for Values, Ethics and the Law in medicine, believe the draft Code

“was likely to be counterproductive for four main reasons:

  • it was very unclear how standards could be enforced; 
  • the Code was based on a single concept of ethics, lacking a sufficient appreciation of our multicultural diversity; 
  • it contributed to an insidious, creeping authoritarianism; and, lastly, 
  • the code would suggest that good practice involved following the same rules in all circumstances rather than responding to individual circumstances and needs.”

The professors said

“Codes of conduct can either expand the ability of individuals to make their own decisions and maximise their opportunities for ethical action, or they can claim authority beyond their capacity and encourage the belief that good practice simply involves following a formula and applying the rules.”

The medical code of conduct is only a draft so there should be robust debate.To do so publicly may appear unseemly to some but ultimately, when issues are resolved, the public (the clients) can bear witness to the exhaustive and open process organisations have used to establish professional standards.  

The lesson for embryonic professions like safety is to follow the advice I provdie consultants of any profession – look outside your comfort zone to better understand what you do.

The quote above suggests that a registered profession does not need to be regimented and controlling.  To be described as professional is a compliment, but the risk is that “professional” can come to mean blinkered and, ultimately, fearful.  A profession risks becoming infected by “an insidious, creeping authoritarianism”.

Many in the safety profession are promoting “leadership”, “innovation”, “resilience”.  Perhaps we should be promoting an inclusive terminology that has an established and, usually, reputable history, like medicine.  Safety “profession” can include all of the modern business jingo in a proven framework rather than confusing ourselves, our clients and our regulators, with “Newspeak“.

Now that would be doubleplusgood.

Kevin Jones

Initial union comments on OHS Law Review Panel report

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The Australian Council of Trade Unions’ submission to the national review of model OHS law was entitled “The Highest Standards For Harmonised OHS Law”.  This is intriguing as the union movement is not happy with the concession that the final report of the review panel made concerning the right of a union to instigate and manage OHS prosecutions.

Geoff Fary
Geoff Fary

Geoff Fary, Assistant Secretary of the ACTU, told SafetyAtWorkBlog on 17 February 2009 said that the ACTU is still assessing the recommendations of the final review panel report and will probably release a more detailed response in early March 2009 but that the OHS harmonization process “should not result in a reduction in protection of workers’ entitlements or the rights of any group of workers.”

The ACTU has concerns

“if the result of this process is that the people who have benefited from that [right] no longer have it available.  It therefore follows that one of the key things we are concerned about in the recommendation of the second report is that if it was adopted it would no longer be open for unions to initiate prosecutions when regulators fail to do so.”

Fary said that prosecutorial action by unions in New South Wales have always been successful and have lead to legislative change. 

“Undoubtedly, in our view, the ability for unions to prosecute has been in the best interests of health and safety outcomes for workers.”

To some extent workers and the media are getting confused by the parallel reform processes of industrial relations and workplace safety.  There is the potential for one stream to retard the process of the other.  Geoff Fary said that this is unlikely as he thinks that the IR reforms could be “up and running before all of the OHS changes”.

Fary expressed the ACTU’s support for the declarations and actions of the International Labour Organisation but it is noted that media reports on 18 February illustrate that not all the union movement supports the ACTU President, Sharan Burrows’ perspective that Australia’s new industrial relations legislation meets international obligations “on balance”.

Kevin Jones

Edited audio of the interview with Geoff Fary can be accessed HERE

Previous SafetyAtWorkBlog postings concern Geoff are available

Should the OHS Profession be Regulated?

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There is a strong campaign to improve the level of professionalism in occupational health and safety in Australia.  Several safety-related bodies have achieved this already by being far-sighted and progressive, others have not.  Concerns over the inconsistency of health and safety advice spurred WorkSafe Victoria to coordinate the establishment of a Health & Safety Professionals Alliance (HaSPA).

However it is possible that even this very recent initiative is becoming outdated.

Lessons from Accountants

One of the models that HaSPA is following is that of the accounting profession.  Certification of this profession has existed for decades and has been supported by government as the preferred avenue for tax preparation and other similar financial measures.  The prominence and solidity of the qualification and the diligence of enforcement by the professional bodies is impressive but part of that sector will soon become regulated by legislation.

Legislation being considered by the Australian Parliament will, according to  media reports,

  • establish minimum standards for those professionals completing taxation returns;
  • maintain a registry of those suitably qualified;
  • improve the quality of advice of those not already in an accountancy professional body;
  • establish a national tax practitioner board;
  • introduce a code of professional conduct; and
  • develop civil penalties for certain types of misconduct by tax practitioners.

HaSPA has many hurdles to meet through its member bodies but there are several external to the process that should be considered.

Where’s the evidence?

Safety professionals are constantly advocating for evidence-based decisions.  Sometimes this comes from researchers who also have one eye on research grants but given that decisions should be based on evidence, is there evidence that safety professionals have provided poor advice in the past?  If so, where is it?

Buyer Beware

Also, is this so important?  OHS legisaltion throughout Australia stipulates that the principal responsibility for managing safety in the workplace resides wiht the employer.  The employer has an obligation to maintain a suitable state of knowledge of the hazards in their workplace and can seek advice from external advisers, should they choose.  Why should caveat emptor not apply in the case of safety consultants?

The debate on OHS professionalism can be seen as a tussle between caveat emptor and caveat venditor with the argument tilting toward emptor because of the employer obligations in OHS law.

The move to somehow regulate the safety profession is an acknowledgement that the profession, as a whole, has done a poor job of regulating itself and establishing its credentials in the marketplace.  

The business community is struggling with the global financial crisis showing that a free market leads to greed and chaos at the same time it is ideologically opposed to regulatory interference.  The government’s OHS legislation is being pushed as an update, not new, in order to minimise the opposition from business.  The business cost benefits are also being heavily promoted.  

Could an argument be made that workplace safety could be improved more quickly and more effectively through a national registration of the safety profession?  Accountancy is providing a model.  Private certification is available in North America.  Singapore already registers its safety professionals.  

Either way, let’s see some evidence.

Kevin Jones