Setting up an effective first-aid program requires not only proper supplies but also adequate training. Here’s a look at OSHA requirements.

The first image that comes to mind when you think about first aid may be a kit stuffed with bandages, over-the-counter pain relievers and ointment.

Depending on your workplace, it may be mounted on a wall next to an AED, or automated external defibrillator, that delivers electric shocks during cardiac arrests.

Such supplies and equipment are only part of an effective first-aid program, however. Using them to treat co-workers’ injuries and, in some cases, provide lifesaving care until medical professionals arrive, requires proper training, says Mickey Parker, industrial account manager for Medique Products.

While such training is mandated under the U.S. Occupational Safety and Health Administration’s Standard 1910.151, the agency’s benchmark rule on first-aid programs, it isn’t thoroughly defined.

Nor is the type or quantity of first-aid supplies that businesses must provide, with the agency instead relying on employers to determine what’s appropriate for the level of risk in their workplaces.

That lack of specificity can leave employers with tough questions. When businesses ask Medique Products what they should be providing, the answer varies depending on what managers want to accomplish, Parker says.

“If they just want to check a box for basic regulatory compliance, then first-aid kits may help do that,” he says. “If their goal is keeping employees happy and sending them home safely at the end of their shift, the solutions become more complex.”

Founded in 1974, Medique provides a broad range of medical supplies, from single-dose over-the-counter drugs to fully stocked kits that comply with American National Standards Institute (ANSI) guideline Z308.1-2021 on first aid.

The ANSI standard, to which OSHA often refers industrial safety managers seeking guidance on first-aid program specifics, was updated in 2021 to include two types of kits.

First-Aid Kit Classifications

Class A first-aid kits are designed for minor workplace injuries such as small cuts and scrapes that might occur in an office or commercial business while Class B kits are meant for higher-risk work environments such as manufacturing plants and construction sites, says Paul Slot, Medique’s marketing director. They contain a broader range and larger quantities of first-aid supplies.

Neither the ANSI guideline nor OSHA specify how many first-aid kits a business should have, however.

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To determine what’s needed, employers are generally expected to evaluate the types and frequencies of on-the-job injuries using records such as OSHA’s Form 300 logs or reports from their workers’ compensation insurance provider.

“If you’ve been logging lots of burns,” for example, “then you would want to have adequate supplies for treating those burns,” Ray Chishti, workplace safety editor at safety consulting firm J.J. Keller & Associates, says in a webinar on the American Society of Safety Professionals site.

Ensuring first-aid programs match workplace needs is taking on heightened importance amid an increase in on-the-job injuries nationwide.

Nonfatal injuries rose 4.5 percent to 2.3 million in 2022, the most recent period for which data is available, according to the Bureau of Labor Statistics. Manufacturers alone reported a 3 percent jump in injuries and illnesses to 396,800.

Along with potentially devastating effects on workers and their families, such cases come with billions of dollars in expenses. In 2021, the most recent year for which data was available, workplace injuries cost the U.S. economy $167 billion, according to the National Safety Council.

“It’s unrealistic to expect accidents not to happen,” Mark Stromme, senior environmental health and safety editor at J.J. Keller, says in the ASSP webinar, which is why OSHA requires employers to “provide access to emergency care and first-aid supplies.”

One thing that agency regulations do specify is that businesses must have trained first-aid providers at all workplaces where there is no infirmary, clinic or hospital nearby to treat injured employees.

Along with first-aid requirements, a number of OSHA regulations also mandate training in CPR since workers may experience sudden and life-threatening cardiac arrests because of asphyxiation, electrocution or exertion.

If that happens, CPR can keep the victim’s blood flowing and oxygen circulating through the body until an AED can be used to restore a normal heartbeat.

Basics of First Aid

Using AEDs within three to four minutes of cardiac arrest can lead to a 60 percent survival rate, the agency notes in a guide to effective first-aid programs.

While OSHA doesn’t offer first-aid training itself, courses are available through nationally recognized organizations including the American Heart Association, the American Red Cross and the National Safety Council.

According to the agency, important elements of training include:

  • Teaching methods
    • Basing the curriculum on scientific evidence
    • Teaching “hands-on” skills through mannequins and partner practice
    • Having appropriate supplies and equipment available
    • Emphasizing quick responses to emergencies
  • Preparing for emergencies
    • Teaching the importance of accident prevention
    • Building relationships with local emergency medical service providers
    • Maintaining an easily accessible list of emergency phone numbers (police, fire, ambulance, poison control)
    • Learning how to protect providers from bloodborne pathogens and other infectious materials using personal protective equipment such as gloves, eye protection and masks
  • Responding to life-threatening emergencies
    • Determining an injured person’s responsiveness, or level of conscious awareness
    • Establishing and maintaining an open and clear airway
    • Performing rescue breathing
    • Performing CPR
    • Using an AED
    • Recognizing signs and symptoms of shock
    • Controlling bleeding with direct pressure
  • Responding to non-life-threatening emergencies
    • Assessing and providing first aid for wounds
    • Assessing burn severity; recognizing whether a burn is thermal, electrical or chemical and determining appropriate first aid
    • Treating exposure to effects of extreme cold or heat, from frostbite and hypothermia to heat cramps, heat exhaustion and heatstroke
    • Giving first aid for musculoskeletal and eye injuries as well as bites and stings

“First-aid training courses should include instruction in general and workplace hazard-specific knowledge and skills,” the agency says. Programs should be evaluated periodically to determine whether they’re still addressing the needs of a particular workplace and modified if necessary.

What are the biggest challenges you’ve encountered in providing first aid in the workplace? Tell us in the comments below.

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