CHAPTER 13: FIRST AID MEDICAL PROCEDURES

CHAPTER 13: FIRST AID MEDICAL PROCEDURES

General Overview First aid cases include one-time treatment and subsequent observation of minor scratches, cuts, burns, splinters, and so forth, which do not ordinarily require medical care even though provided by a physician or registered professional personnel. Administration of a single dose of a prescription medication on the first visit for a minor injury is first aid. Retreatments constitute Medical Treatment cases. Repeated use of non-prescription medication, other than antiseptic, is a first aid case. First Aid training is to be provided by outside contractor who is certified in first aid training by the American Red Cross or equivalent organization. Examples of First Aid Treatments for Certain Types of Injuries and Illnesses Abrasions Limited to cleaning wound, soaking, applying antiseptic, medication, and bandaging on first visit. Follow-up visits are restricted to observation and changing bandages. Bruises Limited to a single soaking or applying cold compresses and any follow up visits for observation of the injury. Burns, thermal, and chemical (resulting in destruction of tissue by direct contact) Limited to cleaning or flushing, soaking, applying cold compresses, antiseptic, medication, and bandaging on first visit. Follow-up visits are restricted to observation, changing bandages, and non-prescription medication other than antiseptic. Cuts and Lacerations Limited to cleaning wound, soaking, applying antiseptic, medication, and bandaging on first visit. Follow up visits are restricted to observation and changing bandages. Eye Injuries Limited to irrigation, removal of foreign material not embedded in eye, and one time treatment of minor corneal scratches and abrasions. Administration of non-prescription medication and single doses of prescription medications. Inhalation of Toxic or Corrosive gases Limited to removing the employee to fresh air or the one time administration of oxygen for several minutes. Splinters and Puncture Wounds - limited to cleaning wound, removing foreign object(s) by tweezers or other simple technique, applying antiseptic, medication and bandaging on first visit. Follow up visits are restricted to observation and changing bandages. Sprains and strains Limited to soaking, applying cold compresses or use of elastic bandage on first visit. Follow up visits are restricted to observation or reapplying bandages. Examples of Diagnostic Procedures Considered First Aid Hospitalization for observation, where no medical treatment is rendered, other than first aid. However, if the employee misses his next scheduled shift, the case becomes a lost workday case. Visit to a physician or nurse (for observation only) is first aid. X-ray examination for fractures is diagnostic. Where the x-ray is negative, the case is first aid. Examples of Preventative Procedures and Treatments Considered First Aid Tetanus shots are preventative and are considered first aid cases, unless reaction to the shot necessitates treatment. Reaction to preventative medication such as flu shots (not administered because of an occupational injury or illness). FIRST AID AND EMPLOYEE HEALTH 240 Revised 7/13

Medical emergencies can occur without warning and can require immediate action. To respond to such emergencies, adequate first aid facilities and training are required. 1. The shop is equipped with a first aid kit that is highly visible, and that is inspected and replenished on a regular basis. The contents of each first aid kit will be checked before being sent out to each job. At the jobsite, the first aid kits will be checked at least weekly to ensure that expended items are replaced. 2. Each location has emergency phone numbers posted in prominent places. 3. Where chemical hazards exist, eye or eye/face wash stations must be available in areas where hazardous chemicals and materials are present. The facilities will be inspected on a monthly basis. 4. All injuries, no mater how slight, must be reported to your supervisor. 5. If employees are exposed to noise levels above 85 db at the company's location, then an audiometric hearing conservation program will be put into effect. 6. Some employees have been CPR-First Aid trained on a volunteer basis. EMERGENCY PROCEDURES Provisions shall be made prior to the start of a project for prompt medical attention in case of serious injury. The location and phone number of emergency service providers will be posted at each job site. Our customers will be the primary source of information concerning emergency services in their area. The following services should be included: HOSPITAL DOCTOR AMBULANCE FIRE DEPARTMENT POLICE/SHERIFF S DEPARTMENT Develop evacuation plans in case of fire or other disaster in or around the work area. Coordinate the evacuation plans with the customer. In most cases, our customer will already have written plans that they will share with us. In the event we are working in an area where a medical facility is not reasonably accessible or when medical assistance is not within 3-4 minutes of the work site a person with a valid certificate in FIRST-AID training from the American Red Cross or equivalent organization shall be available at the job site and responsible for rendering first aid. SERIOUS EMERGENCY SERIOUS EMERGENCIES are accidents that are life threatening or requiring more than routine first aid. Call the emergency medical service and transportation. In the Southern California area the number is 911. Tell them you have a SERIOUS ACCIDENT. Describe the nature of the accident (burn, fall, electrical shock, cut). Tell them the ACCIDENT LOCATION. Give them directions to the accident site, especially the location in the plant. If the accident location is difficult to find, send an employee to the plant main gate to direct the emergency vehicles. INSIST ON AN IMMEDIATE RESPONSE. Note the time you called and whom you talked to. Make sure transportation for the injured to a doctor or a hospital is immediately dispatched. Give the doctor and/or hospital notice that the injured is in transit to them. 241 Revised 7/13

ATTEND TO THE INJURED. Make sure that there is no chance of further injury to the injured or any other employee. Provide immediate first aid as necessary until the emergency personnel arrives. CLEAR AND SECURE THE AREA so that emergency treatment can be administered to the employee and there is clear access to the accident site for emergency vehicles and personnel. After the injured has been removed, rope off the area and do not allow access to anyone until completion of all investigations, and authorization to proceed by the J. T. THORPE Safety Manager. NON-SERIOUS ACCIDENTS Provide first aid for the injured employee. First aid supplies are available in the kits supplied in the toolboxes. The customer s first aid facilities may also be available to you-. Send the employee to a doctor if there is any question that the first aid treatment is not adequate. If the employee receives medical treatment he may not return to work unless he has a release from the doctor or treatment center. All non-serious accidents and injuries are warning signs that a serious accident may occur. Report all non-serious accidents (see ACCIDENT REPORTING Section 4.1) to the Safety Manager as soon as possible, but do not delay in taking corrective action on the job site. FIRST AID KITS First aid kits are to be provided on all projects. When not on the job, all first aid kits will be stored in the JTT warehouse away from possible sources of damage. Only weatherproof first aid kits are to be used. Items in the kits will be individually sealed. The kits will be inspected and maintained on a regular basis by an outside safety service to insure proper content. Warehouse persons pulling the jobs are required to inspect the kits for proper content and condition before sending them to job sites. A checklist of contents will be maintained at the storage area to assist with the review. Project management will also inspect the kits weekly to confirm content. 242 Revised 7/13

FIRST AID The first priority in treating an injured employee is to obtain proper medical attention. In an extreme emergency, immediate first aid may be necessary. ASPHYXIATION Nausea, dizziness, unconscious, lips, ear lobes blue, breathing stopped, bizarre behavior. Remove to fresh air, give rescue breathing. BLEEDING ARTERIES Bright red blood spurting from wound. Direct pressure over wound to control bleeding. BLEEDING VEINS Dark red blood flowing steadily. Apply sterile bandage firmly over wound. Do not break blood clot. BLEEDING INTERNAL Faintness, pale face, thirst, sighing, weak, rapid pulse. Lie down, keep warm and quiet. Call ambulance immediately. BURNS Caused by applications of heat, dry moist chemicals, acids or alkalis. Cold applications for minor burns. For liquid chemical burns, wash affected area with large amounts of water. For dry chemicals, brush away chemicals first, then wash. FRACTURED SKULL Bleeding from eyes, nose or mouth. Blood or serum from ears. Swelling of head wound. Elevate head. Lay bandage on injury, avoiding pressure on the wound. Never give a stimulant. Check victim periodically for a state of consciousness. 243 Revised 7/13

POISONING GAS/CHEMICALS Yawning, giddiness, fluttering hart, breathing stopped. Remove to fresh air. Give rescue breathing. HEAT EXHAUSTION Cold wet skin, dizziness, headache, nausea, weakness. Lie down, loosen clothing. Keep cool. Carefully give fluids. RUPTURE/HERNIA Sharp stinging pain. Faint feeling. Sick at stomach. Lump in groin. Place injured on back, elevate knees. Apply cold pack to lump. SHOCK Face pale, eyelids droopy, skin cold and clammy. Unconscious. Lie down, elevate feet, loosen clothing, keep warm and quiet. SNAKE BITE Pain, swelling, pinpoint wound. Apply restricting band above wound and not too tight. If alone, walk slowly for help. Remain calm. Do not squeeze or cut the wound. 244 Revised 7/13