OSHA Requirements for Medical Services and First Aid
Initial Response to Injury Situations
First Aid Refresher – Part 1
First Aid Refresher – Part 2
29 CFR 1910.151 Subpart K, Medical Services and First Aid including Appendix A
29 CFR 1910.269 Subpart R, Special Industries, Section (b) “Medical services and first aid.” (Utility General Industry)
1926.951 Medical Services and First aid (Utility Construction)
29 CFR 1926.50 Subpart D Medical Services and First Aid including Appendix A (Construction and General Industry Utility)
Note: Both 1910.260 and the 1926 rules are unified for utilities under 1926.50.
Identify the OSHA requirements for medical services and first aid as they relate to the electrical utility industry.
Identify the correct actions to take during an initial response to an accident or first aid situation.
Identify the correct actions to take when providing first aid for the following situations: examining the victim, bleeding, shock, and burns.
Identify the correct actions to take when providing first aid for the following situations: electric shock, head and spinal injuries, and fractures.
When a heart attack happens, if no First Aid is immediately applied, the chances for survival fall by 7% with each passing minute. The average ambulance response time is about 15 minutes.
Working in high-risk environments can be especially dangerous if employees don’t follow safety rules and procedures. Unfortunately, no matter how safely we work, accidents will happen, and people will be injured.
It is proven fact: knowing how to respond appropriately when an injury happens, with Basic First Aid, could be the difference between life and death. This is particularly true for the utility field, where First Aid for electrical shock victims is critical to securing positive incident outcomes.
In work situations at “fixed” facilities, such as generating stations, the Occupational Safety & Health Administration (OSHA) requires that enough persons are trained to ensure that an electrical shock victim is reached within four minutes of being discovered. If there are not enough trained employees at the facility to meet this requirement, such as a remote substation, for example, then all employees at the facility must be trained.
OSHA requires all electrical utility companies to maintain first aid kits. These kits must be inspected frequently enough to assure that expended items are replaced, but not less than once per year. Most companies inspect and maintain first aid kits more often than the required minimum.
When you respond to the scene of an accident:
Assess the situation carefully
Call for help
Look for sources of injury or entrapment
Look for source of electrical shock
Do not touch victim until they are clear of the source of electricity
De-energize, or use non-conducting equipment to remove person from contact with an energized circuit
If the victim is not breathing normally or making gasping sounds:
First, make sure that you request help.
Bring an Automated External Defibrillator (AED), if available, to the victim.
Begin CPR immediately and use the AED.
Using an AED
If an AED is present, attach it to the victim after the first set of compressions and ventilation.
If no AED is available, continue compression/ventilation cycle until an AED arrives or Emergency Medical Service providers arrive.
Performing Proper Chest Compressions
Administer high-quality chest compressions
Apply at least 100 compressions per minute to center of chest (sternum)
Depress at least two inches
Allow complete chest recoil after each compression
It is important not to miss anything when treating a victim, and to gather all of the available information. After ensuring the safety of the victim and yourself, check to see if the victim is conscious.
If the victim is conscious, attend to any life-threatening conditions (e.g., bleeding), first.
If the victim is unconscious:
check airway and breathing
clear airway, if required
attend to any life-threatening bleeding before proceeding to administer CPR
obtain a history from a conscious victim or from bystanders, if possible
If cardiopulmonary resuscitation (CPR) is not required, you now have more time to thoroughly examine the victim by conducting a head-to-toe '60 second check.’
Traumatic shock is a deteriorating condition, and one that does not allow a victim to recover without active medical intervention.
Care and Treatment for Traumatic Shock
Control any bleeding
If conscious, have the victim assume a prone position, with legs elevated 8 to 12 inches if there is no sign of chest, head, neck or spinal injury
Maintain body temperature
Obtain urgent medical help and ambulance transport
Treat any other injuries
Burns are usually caused by contact with flames, hot objects, chemicals, electricity, radiated heat, or frozen surfaces.
To treat a burn:
Cool or flush with water, 10 minutes for heat burns and 20 minutes for chemical burns
Cover with a clean, non-adherent dressing
Call for urgent ambulance transport if the burn is severe
Treat for shock if the burn is severe
Ensure that any chemicals are flushed from the skin, paying special attention to eyes
Do not over cool and cause shivering to compensate
Do not use creams or ointments unless prescribed
Do not attempt to remove material adhering to the burn
Do not prick blisters