Contractors
4.7 Requirements for, and effective provision of, first-aid in the
workplace
4.7.1 Introduction
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 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 be given to employees if they are injured or become ill at work.
What is adequate and appropriate will depend on the circumstances in a particular workplace.
The minimum first-aid provision on any work site is:
X
u a suitably stocked first-aid box;
X
u 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 to people who are at work.
Appointed persons should never attempt to give first-aid for which they are not competent. Short emergency first-aid training courses are available. An appointed person should be available at all times when people are working at the work site – this may mean appointing more than one. The training should be repeated every three years to keep up to date.
4.7.6 A first-aider
A first-aider is someone who has undergone an HSE-approved training course in administering FAW and holds a current FAW certificate. Lists of local training organisations are available from the local environmental officer or HSE offices. The training should be repeated every three years to maintain a valid certificate and keep the first-aider up to date.
It is not possible to give definitive rules on when or how many first-aiders or appointed persons might be needed.
This will depend on the circumstances of each particular organisation or work site. Table 4.2 offers suggestions on how many first-aiders or appointed persons might be needed in relation to categories of risk and number of employees. The details in the table are suggestions only;
they are not definitive, nor are they a legal requirement.
Table 4.2 Number of first-aid personnel Category of risk Numbers
employed at any location
Suggested number of first-aid personnel
Lower risk
For example shops and offices, libraries
Fewer than 50
At least one appointed person
50–100 More than 100
At least one first-aider One additional first-aider for every 100 employees Medium risk
For example light engineering and assembly work, food processing, warehousing
Fewer than 20
At least one appointed person
20–100
More than 100
At least one first-aider for every 50 employed (or part thereof)
One additional first-aider for every 100 employees Higher risk
For example most construction, slaughterhouses, chemical manufacture, extensive work with dangerous machinery or sharp instruments
Fewer than 5
At least one appointed person
5–50 More than 50
At least one first-aider One additional first-aider for every 50 employees Source: HSE.
Figure 4.28 (left) First-aid and stretcher sign (right) First-aid sign
X
u issuing personal first-aid kits and providing training;
X
u issuing mobile phones to employees;
X
u making arrangements with employers on other sites.
Although there are no legal responsibilities for non-employees, the HSE strongly recommends that they are included in any first-aid provision.
4.7.4 Contents of the first-aid box
There is no standard list of items to put in a 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 Table 4.1.
Tablets or medicines should not be kept in the first-aid box. Table 4.1 shows a suggested contents list only; equivalent but different items will be considered acceptable.
Table 4.1 Contents of first-aid box – low risk Stock for up to 50 persons
u A leaflet giving general guidance on first-aid, for example the HSE leaflet Basic Advice on First-aid at Work.
u Medical adhesive plasters 40 u Sterile eye pads 4 u Individually wrapped triangular bandages 6
u Safety pins 6
u Individually wrapped medium sterile unmedicated wound dressings
8
u Individually wrapped large sterile unmedicated wound dressings
4
u Individually wrapped wipes 10 u Paramedic shears 1 u Pairs of latex gloves 2 u Sterile eyewash if no clean running water 2
4.7.5 Appointed persons
An appointed person is someone who is appointed by management to:
X
u take charge when someone is injured or falls ill. This includes calling an ambulance if required;
X
u look after the first-aid equipment, for example keeping the first-aid box replenished;
X
u keep records of treatment given.
4
Employers are 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 4.29). After 3 years, first-aiders 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, which will each last for at least three hours.
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 at all times 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 4.2.
4.7.7 Implementation of changes to first-aid training and approval arrangements
The HSE published a report in 2003 following a
consultation of the Health and Safety (First-aid) at Work Regulations. Since these Regulations were introduced in 1981, there has been a significant transformation of the economy from manufacturing to service based industries. The report identified the following points:
X
u small organisations found it difficult to release employees to attend a four-day first-aid training course;
X
u confusion over the role and training requirement of an appointed person;
X
u a significant depletion in the retained information of a trained first-aider after a short period of time after the training course.
Training guidelines have been issued by the HSE to address these issues. These guidelines are:
X
u a short first-aid course – Emergency First-aid at Work (EFAW). This lasts for one day and will enable the first-aider to give emergency first-aid following an accident or ill-health problem. This is suitable for an organisation where the risk assessment has indicated that it is suitable for the level of risks present;
X
u a reduction to three days for the First-aid at Work (FAW) course;
X
u all first-aiders should undertake a half-day refresher course annually during the three-year certification period of the FAW and EFAW. This should address the depletion of information problem.
The first-aid training requirements have been amended so that the four-day course has been replaced by a First-aid at Work (FAW) course taught over three days.
The syllabuses of the two courses are very similar with some topics being brought up to date. For example, the protocols used for resuscitation have become much easier to understand. Many medical professionals recommend that there should be an annual refresher course to accompany the course. The one-day
Emergency First-aid at Work (EFAW) course is designed for low risk organisations and appointed persons.
First-aid needs assessment
Year 0
Year 1
Year 2
Year 3
Emergency First-aid at Work (EFAW)
(6 hours) Certificate valid
for 3 years
First-aid at Work (FAW)
(18 hours) Certificate valid
for 3 years
(6 hours – sameEFAW course as year 0) Certificate valid
for 3 years
FAW requalification (12 hours) Certificate valid
for 3 years Basic skills update
(3 hours)
Basic skills update (3 hours)
Figure 4.29 Flow chart showing courses to be completed over a 3-year certification period for EFAW and FAW. The dotted line indicates the route to be taken in subsequent years after completion of the relevant course at year 3
Detailed guidance for employers is available as a revision to the document produced by the HSE: First-aid at Work – The Health and Safety (First-Aid) Regulations 1981 – Approved Code of Practice and Guidance (L74). Within this, it is only the guidance that has been revised – the Regulations and Approved Code of Practice will remain the same. The HSE has revised its guidance for small- and medium-sized enterprises in First-aid at Work – Your Questions Answered (INDG214).
Detailed guidance for first-aid training organisations is available on the HSE website: First-aid training and qualifications for the purposes of the Health and Safety (First-Aid) Regulations 1981 www.hse.gov.uk/pubns/
web41.pdf.
Five Steps to Risk Assessment (INDG163, rev 3), HSE Books, ISBN 978-0-7176-6440-5 http://www.hse.gov.uk/
pubns/indg163.pdf
Young people and work experience, A brief guide to health and safety for employers, INDG364 (rev 1), HSE books, http://www.hse.gov.uk/pubns/indg364.pdf New and expectant mothers http://www.hse.gov.uk/
mothers/
Safe work in confined spaces; Confined Spaces Regulations 1997, ACoP regulations and guidance, (L101), second edition, HSE Books, ISBN 978-0-7176-6233-3 http://www.hse.gov.uk/pubns/priced/l101.pdf Guidance on permit-to-work systems. A guide for the petroleum, chemical and allied industries (HSG250), HSE Books, ISBN 978-0-7176-2943-5 http://www.hse.
gov.uk/pubns/priced/hsg250.pdf
First-aid at Work, The Health and Safety (First-Aid) Regulations 1981 (L74, third edition 2013), HSE Books, ISBN 978-0-7176-6560-0 http://www.hse.gov.uk/pubns/
priced/l74.pdf
Bird, F. E., 1974. Management guide to Loss Control, Institute Press, Atlanta, Georgia, USA