People at Work can suffer injuries or fall ill. It does not matter whether the injury or the illness is caused by the Work they do. What is important is that they receive immediate attention and that an ambulance is called in serious cases. First aid at Work (FAW) covers the arrangements employers must make to ensure this happens. It can save lives and prevent minor injuries from becoming major ones.
The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities, and personnel to enable first aid to employees if they are injured or become ill at Work. What is sufficient and reasonable will depend on the circumstances in a particular workplace.
The minimum first-aid provision on any work site is:
- a suitably stocked first-aid box;
- an appointed person to take charge of first-aid arrangements.
It is also important to remember that accidents can happen at any time. First-aid provision needs to be available at all times people are at Work.
Many small firms will only need to make the minimum first-aid provision. However, some factors might make greater provision necessary. The following checklist covers the points that should be considered.
Aspects to consider
The risk assessments carried out under the MHSW and COSHH Regulations should show whether there are any specific risks in the workplace.
The following should be considered:
- Are there hazardous substances, dangerous tools, and equipment;
- Dangerous manual handling tasks, electrical shock risks, dangers from neighbours or animals?
- Are there different levels of risk in parts of the premises or site?
- What is the accident and ill-health record, and what type and location of incidents?
- What is the total number of persons likely to be on-site?
- Are there young people, pregnant or nursing mothers on-site, employees with disabilities, or special health problems?
- Are the facilities widely dispersed with several buildings or compact in a multi-story building?
- What is the pattern of working hours?
- Does it involve night work?
- Is the site remote from emergency medical services?
- Do employees travel a lot or work alone?
- Do any employees work at sites occupied by other employers?
- Are members of the public regularly on-site?
Impact on first-aid provision if risks are significant
First-aiders may need to be appointed if risks are significant. This will involve a number of factors that must be considered, including:
- training for first aiders;
- additional first-aid equipment and the contents of the first-aid box;
- Siting of first-aid equipment to meet the various demands on the premises. For example, provision of equipment in each building or on several floors;
- There needs to be first-aid provision at all times during working hours;
- informing local medical services of the site and its risks;
- Any special arrangements that may be needed with the local emergency services.
Any first-aid room provided under these Regulations must be easily accessible to stretchers and other equipment needed to convey patients to and from the room. They must be signposted according to the Safety Signs and Signals Regulations.
If employees travel away from the site, the employer needs to consider:
- issuing personal first-aid kits and providing training;
- issuing mobile phones to employees;
- making arrangements with employers on other sites.
Although there are no legal responsibilities for nonemployees, the HSE strongly recommends that they are included in any first-aid provision.
Contents of the first-aid box
There is no standard list of items to put in the first-aid box. It depends on what the employer assesses the needs to be. Where there is no special risk in the workplace, a minimum stock of first-aid items is listed in the table shown here.
Tablets or medicines should not be kept in the first-aid box. Table 6.2 shows a suggested contents list only; equivalent but different items will be considered acceptable.
|Table 6.2 Contents of the first-aid box – low risk|
|Stock for up to 50 persons:|
|A leaflet giving general guidance on first aid, for example, HSE leaflet Basic advice on the first aid at work.|
|Medical adhesive plasters||40|
|Sterile eye pads||4|
|Individually wrapped triangular bandages||6|
|Individually wrapped: medium sterile unmedicated wound dressings||8|
|Individually wrapped: large sterile unmedicated wound dressings||4|
|Individually wrapped wipes||10|
|Pairs of latex gloves||2|
|Sterile eyewash if no clean running water||2|
An appointed person is someone who is appointed by management to:
- take charge when someone is injured or falls ill. This includes calling an ambulance if required;
- look after the first-aid equipment, for example, keeping the first-aid box replenished;
- maintaining records of treatment given.
Appointed persons should never attempt to give first aid for which they are not competent. Short emergency first-aid training courses are available. Remember that a designated person should be available when people are at Work on site – this may mean appointing more than one. The training should be repeated every 3 years to keep up-to-date.
A first aider
A first aider has undergone an HSEapproved training course in administering FAW and holds a current FAW certificate. Lists of local training organizations are available from the local environmental officer or HSE offices. The training should be repeated every 3 years to maintain a valid certificate and keep the first aider up-to-date.
It is not possible to give hard, and fast rules on when or how many first aiders or appointed persons might be needed. This will depend on the circumstances of each particular organization or work site. Table 6.3 offers suggestions on how many first aiders or appointed persons might be needed in relation to risk categories and the number of employees. The details in the table are suggestions only; they are not definitive, nor are they a legal requirement.
Employees must be informed of the first-aid arrangements. Putting up notices telling staff who and where the first aiders or appointed persons are and where the first-aid box is will usually be enough. Special arrangements will be needed for employees with reading or language difficulties.
To ensure cover when people are at Work and where there are special circumstances, such as remoteness from emergency medical services, shift Work, or sites with several separate buildings, there may need to be more first-aid personnel than set out in Table 6.3.
Implementation of changes to first-aid training and approval arrangements
HSE recently conducted a consultation exercise on draft guidance for employers and first-aid training providers to support changes in first-aid training and approval arrangements. In June 2008, the HSE set a date for implementing the changes and identifying the guidance to help employers and training providers.
HSE intends to introduce the changes to first-aid training courses from 1 October 2009, so employer duty holders will need to implement them from this date. Guidance on the changes to approval arrangements will be available for first-aid training providers earlier to prepare for the new training course structure.
Detailed guidance for employers will be available as a revision of the current document produced by HSE: First Aid at Work – The Health and Safety (First-Aid) Regulations 1981 – Approved Code of Practice and Guidance (L74). Only the guidance is being revised within this – the Regulations and Approved Code of Practice will remain the same. HSE also intends to revise its guidance for small- and medium-sized enterprises in First Aid at Work – Your Questions Answered (INDG214). Both publications will be available on 1 October 2009.
Employers will not be required to retrain all their first aiders as soon as the implementation date is reached. First aiders with a valid FAW certificate will only enter the new arrangements when their certificate expires. This means that it will take 3 years post-implementation before all first aiders in the workplace are captured within the new training structure.
Detailed guidance for first-aid training organizations is available on the HSE Web site: First-aid training and qualifications for the Health and Safety (First-Aid) Regulations 1981, www.hse.gov.uk/pubns/ web41.pdf.
The intention is that in the future, employers will be able to send suitable employees on either a 6-hour (minimum) emergency first aid at Work (EFAW) or an 18-hour (minimum) FAW course, based on the findings of their first-aid needs assessment (see Figure 6.24 ). After 3 years, first aiders will need to complete another course (either a 6-hour EFAW or 12-hour FAW requalification course, as appropriate) to obtain a new certificate. Within any 3-year certification period, first aiders should complete two annual refresher courses, covering basic life support/ skills updates, each lasting for at least 3 hours.