Worker fatalities exceed 10,000 per year and work-related disabling injuries amount to 1.8 million. Direct and indirect costs associated with these accidents exceed $47 billion. Given these figures, it’s clear to see why first aid is an important part of any safety program. Prompt, proper care affects the severity of the injuries. In some cases, it literally makes the difference between life and death.

From a contractor’s perspective, what may surprise is the special link the Occupational Safety and Health Administration seems to have established between first aid and electrical hazards. The key interpretation on when a first-aid responder is needed on a job site centers on electric shock. The regulations state that a responder must be in the work area, if a hospital, infirmary or physician is not in “close proximity.” When clarification of “close proximity” was requested, OSHA stated the following:

"As a general rule, we recommend that a person trained in first aid be available on the site whenever professional medical attention is more than eight minutes away from any point on the site. However, the conditions present on any particular job site may make this eight-minutes guideline inadequate. If employees are working with materials that could adversely affect their respiration, or are subject to electrical shock that could cause loss of the breathing function, the eight-minutes time period is too long. Irreversible brain damage can result in four minutes due to the lack of oxygen.”

The OSHA statement goes on to say that if such hazards are present (except in isolated instances) “and professional medical attention is not available within four minutes of the onset of the condition, then the employer should comply with the requirement for a person trained in first aid be available at the worksite.”

There are also special provisions for first aid found in the electric transmission and distribution standards. The Construction Rule (29 CFR 1926.950) states: “The employer shall provide training or require that his employees are knowledgeable and proficient in: Procedures involving emergency situations, and First-aid fundamentals including resuscitation.” The General Industry Rule (29 CFR 1910.269) calls for at least two individuals trained in CPR on every field crew.

With OSHA regulations regarding the need to have a first-aid responder on the job site so clearly defined, one would think specific mandates would be in place for first-aid trainee qualifications and an employer’s program. But, there are no rules on content. OSHA does not teach or certify first-aid courses. Although Red Cross and National Safety Council courses are referenced as nationally recognized programs, OSHA does not even provide their programs with a seal of approval.

Instead, OSHA has developed guidelines for compliance officers to evaluate the adequacy of training offered. OSHA believes the guidelines provide direction to institutions that have developed instructor courses and the individuals who may choose to take a first-aid course. Electrical contractors should be aware of these guidelines to ensure employees have been properly trained.

OSHA expects courses to include hands-on work with mannequins and partners, and to explore injuries and illnesses through visual aids. Students should receive a workbook. Throughout the course, the need for quick response should be stressed. The particular types of workplace injuries that may be encountered by trainees need to be emphasized as well.

The basic elements of the course should be the principles of triage, methods for surveying the scene and victim(s), cardiopulmonary resuscitation (CPR), basic first-aid intervention, and management of first-aid supplies. As part of the intervention techniques, students should learn to bandage, splint, move and rescue victims. The course should cover shock, bleeding, poisoning, burns, temperature extremes, musculoskeletal injuries, and bites and stings. In addition, management of such medical emergencies as heart attacks, strokes and asthma attacks should be part of the curriculum.

A complete program will not only train on the actual injury and illnesses, it will also include instruction on interactions with the local emergency medical services system, legal concerns for the responder, and the precautions a first-aid responder must take to protect from harm. A copy of OSHA’s “Bloodborne Pathogens” standard should be provided to trainees.

Finally, all courses should perform an assessment of the trainees and the program itself. One part of the assessment is instructor observations of the trainee’s performance. The other part is a written test. Trainees must be reassessed for first aid every three years and CPR every year. The program needs to be reviewed periodically to remove obsolete content and materials. Updated courses will include the latest techniques and knowledge. EC

O’CONNOR is with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. Based in Waverly, Pa., he can be reached at 607.624.7159 or joconnor@intecweb.com.