Principles of control
6.9 First aid at work
6.9.1 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 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 requires employers to provide adequate and appropriate equipment, facilities and personnel to enable fi rst 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 fi rst-aid provision on any worksite is:
➤ a suitably stocked fi rst-aid box
➤ an appointed person to take charge of fi rst-aid arrangements.
It is also important to remember that accidents can hap- pen at any time. First-aid provision needs to be available at all times people are at work.
Many small fi rms will only need to make the minimum fi rst-aid provision. However, there are factors which might make greater provision necessary. The following checklist covers the points that should be considered.
6.9.2 Aspects to consider
The risk assessments carried out under the MHSW and COSHH regulations should show whether there any specifi c 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, type and location of incidents?
➤ what is the total number of persons likely to be on site?
Figure 6.12 (a) First aid and stretcher sign: (b) fi rst aid sign.
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➤ are there young people, pregnant or nursing mothers on site, employees with disabilities or special health problems?
➤ are the facilities widely dispersed with several build- ings or compact in a multi-storey 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?
6.9.3 Impact on fi rst-aid provision if risks are signifi cant
First aiders may need to be appointed if risks are signifi cant.
This will involve a number of factors which must be considered, including:
➤ training for fi rst aiders
➤ additional fi rst-aid equipment and the contents of the fi rst-aid box
➤ siting of fi rst-aid equipment to meet the various demands in the premises. For example, provision of equipment in each building or on several fl oors.
There needs to be fi rst-aid provision at all times dur- ing working hours
➤ informing local medical services of the site and its risks
➤ any special arrangements that may be needed with the local emergency services.
If employees travel away from the site the employer needs to consider:
➤ issuing personal fi rst-aid kits and providing training
➤ issuing mobile phones to employees
➤ making arrangements with employers on other sites.
Although there are no legal responsibilities for nonem- ployees, the HSE strongly recommends that they are included in any fi rst-aid provision.
6.9.4 Contents of the fi rst-aid box
There is no standard list of items to put in a fi rst-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 fi rst-aid items is listed in Table 6.1.
Tablets or medicines should not be kept in the fi rst-aid box. Table 6.1 is a suggested contents list only; equivalent but different items will be considered acceptable.
6.9.5 Appointed persons
An appointed person is someone that is appointed by management to:
➤ take charge when someone is injured or falls ill. This includes calling an ambulance if required
➤ look after the fi rst-aid equipment, for example, keeping the fi rst-aid box replenished
➤ keeping records of treatment given.
Appointed persons should never attempt to give fi rst aid for which they are not competent. Short emergency fi rst- aid training courses are available. Remember that an appointed person should be available at all times when people are at work on site – this may mean appointing more than one. The training should be repeated every three years to keep up to date.
6.9.6 A fi rst aider
A fi rst aider is someone who has undergone an HSE approved training course in administering fi rst aid at work and holds a current fi rst aid at work certifi cate.
Lists of local training organizations are available from the local environmental offi cer or HSE Offi ces. The training should be repeated every three years to maintain a valid certifi cate and keep the fi rst aider up to date.
Table 6.1 Contents of fi rst aid box – low risk
Stock for up to 50 persons:
A leafl et giving general guidance on fi rst aid, e.g. HSE leafl et Basic advice on fi rst aid at work.
• Medical adhesive plasters 40
• Sterile eye pads 4
• Individually wrapped triangular bandages 6
• Safety pins 6
• Individually wrapped: medium sterile unmedicated 8 wound dressings
• Individually wrapped: large sterile unmedicated 4 wound dressings
• Individually wrapped wipes 10
• Paramedic shears 1
• Pairs of latex gloves 2
• Sterile eyewash if no clean running water 2
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It is not possible to give hard and fast rules on when or how many fi rst aiders or appointed persons might be needed. This will depend on the circumstances of each particular organization or worksite. Table 6.2 offers suggestions on how many fi rst 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 defi nitive, nor are they a legal requirement.
Employees must be informed of the fi rst-aid arrangements. Putting up notices telling staff who and where the fi rst aiders or appointed persons are and where the fi rst-aid box is will usually be enough. Special arrangements will be needed for employees with reading or language diffi culties.
6.9.7 Suggested numbers of fi rst-aid personnel
To ensure cover at all times when people are at work and where there are special circumstances, such as remote- ness from emergency medical services, shiftwork, or sites with several separate buildings, there may need to be more fi rst-aid personnel than set out in Table 6.2.
6.9.8 Provision must be suffi cient to cover for absences.
In June 2006 the HSE indicated that upon their review of the First Aid Regulations they decided to retain approval of the training courses within the HSE but make changes to the structure of the course. The intention is that in Table 6.2 Number of fi rst-aid personnel
Category of risk Numbers employed at Suggested number of fi rst-aid personnel
any location
Lower risk
e.g. shops and offi ces, libraries Fewer than 50 At least one appointed person 50–100 At least one fi rst aider
More than 100 One additional fi rst aider for every 100 employed Medium risk
e.g. light engineering and assembly work, Fewer than 20 At least one appointed person food processing, warehousing 20–100 At least one fi rst aider for every
More than 100 50 employed (or part thereof)
One additional fi rst aider for every 100 employed Higher risk
e.g. most construction, slaughterhouses, Fewer than 5 At least one appointed person chemical manufacture, extensive work with 5–50 At least one fi rst aider
dangerous machinery or sharp instruments More than 50 One additional fi rst aider for every 50 employed
Source HSE
future, employers will be able to send suitable employ- ees on either a 6 hour (minimum) emergency fi rst aid at work (EFAW) or an 18 hour (minimum) FAW course, based on the fi ndings of their fi rst aid needs assess- ment (see Fig. 6.13). After 3 years, fi rst aiders will need to complete another course (either a 6 hour EFAW or 12 hour FAW requalifi cation course, as appropriate) to obtain a new certifi cate. Within any 3 year certifi cation period, fi rst aiders should complete two annual refresher courses, covering basic life support/skills updates, that will each last for at least 3 hours.
No date for the introduction of these courses has been set but HSE is aware that FAW training pro- viders require an adequate lead-in period. There are a number of additional issues to be clarifi ed before a date can be fi nalized. Firstly, whether the 3 day FAW course needs to be trialed in a pilot study prior to its introduction. Secondly, consideration will be given to any arrangements that need to be put in place for the approval and monitoring of those providers wishing to offer the EFAW course and whether these arrangements should be extended to those offering annual refresher training.
HSE will revise the guidance for employ- ers in its publication: First Aid at Work: The Health and Safety (First-Aid) Regulations 1981 Approved Code of Practice and Guidance (L74). This will help employers understand the new training regime and will provide more detailed informa- tion on how to conduct a fi rst aid needs assessment.
HSE recognizes this is crucial in ensuring employers send
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meets the needs of their workplace. The guidance will also strongly emphasize that HSE will consider it good practice for fi rst aiders to undertake annual refresher training.
Once the guidance has been drafted, it will be subject to a consultation process with stakeholders, as appropriate.
Summary of the HSE’s review is that:
➤ HSE recognizes the FWC as the lead industry body with representation from all sectors f the FAW train- ing provider industry
➤ HSE will not transfer FAAMS to the FWC and will retain it in-house
➤ HSE has made some modifi cations to the structure of FAW training courses since its Position Statement was published
➤ HSE needs to resolve a number of issues before a date for the introduction of the new courses is announced and an adequate lead-in period will be given for FAW training providers.
Any further signifi cant development will be published on the fi rst aid web pages of HSE’s website.