1. First Aid Services and Practice
Dr Nik Nor Ronaidi bin Nik Mahdi

2. Content
• Introduction
• Definition
• Legal Provision
• Establishing first aid facilities and services
• Components of workplace first aid facilities
– First aiders
– First aid box
– First aid room
• Special first-aid requirements
• Worker Awareness

3. Introduction

4. Introduction
• In US, there were 5,703 work-related fatalities in
private industry in 2004.
• In that same year there were 4.3 million total
workplace injuries and illnesses, of which 1.3
million resulted in days away from work.
• Occupational illnesses, injuries and fatalities in 2004
cost the United States’ economy $142.2 billion. The
average cost per occupational fatality exceeded one
million dollars.

5. Introduction
• Sudden cardiac arrest (SCA) may occur at work.
• According to recent statistics from the American Heart
Association, there are 250,000 out-of-hospital SCAs annually.
• Possible causes of SCA at workplace:
– Electrocution
– Exposure to low oxygen environments
– Overexertion at work can also trigger SCA in those with underlying
heart disease.
• The outcome of occupational illnesses and injuries depends
on the severity of the injury, available first-aid care and
medical treatment.
• Prompt, properly administered first aid may mean the
difference between rapid or prolonged recovery, temporary
or permanent disability, and even life or death.

6. Introduction
• The aims of first aid are to:
– Preserve life;
– Prevent illness or injury from becoming worse;
– Reduce pain;
– Promote recovery; and
– Care of unconscious.
• First-aid is not just for serious injuries. It is also
important for minor injuries such as
burns, sprains, cuts, etc.

7. Definitions

8. Definitions
First aid:
• the assessment and interventions that can be
performed by a first aider during an emergency
with minimal equipment until appropriate medical
personnel arrive.
(DOSH Guidelines)
• emergency care provided for injury or sudden
illness before emergency medical treatment is
available.
(US OSHA)

9. Definitions
• First-aid in the workplace includes the provision of
first-aid facilities, services and personnel required
for the initial treatment of persons suffering from
injury or illness at a workplace.
• First-aid facilities includes:
– first-aid box;
– first-aid room; and
– first-aid equipment, e.g. oxygen tanks and stretchers.

10. Definitions
First-aider:
• a person who has successfully completed a first-aid
course and has been awarded with a certificate of
proficiency in first-aid by a recognized institution
(DOSH guidelines)

11. Legal Provision

12. Legal Provision
• An employer has a duty to provide
information, instruction, training and supervision about
first aid facilities and services for employees.
The Factories and Machinery Act 1967
• Section 25 (Parent Act) and Regulation 38
(Safety, Health and Welfare) state the scope of
responsibility of an occupier with regards to first-aid
provision:
– provide and maintain a readily accessible first-aid box or
cupboard
– assign responsibility who must be proficient in first aid
training if > 20 person employee
– providing and maintaining a first-aid room in a factory where
more than 150 person are employed.

15. Legal Provision
The Occupational Safety and Health Act 1994
• Section 15(1) of the OSHA 1994 (Act 514) provides
that every employer and the self-employed person
must ensure, so far as is practicable, the safety,
health and welfare at work of all his employees.
• The provision of first-aid facilities and first-aiders is
in compliance with the welfare component of this
general duty of employers and self-employed
persons.

16. Establishing first aid facilities and
services

17. Establishing first aid facilities and
services
• The provision of first aid facilities and services starts
with identifying all the hazards in the work
environment that could lead to injury or harm to
the health of people at the workplace.
• This should be done in consultation with workers
and their elected safety and health
representatives, where they exist.
• An assessment of the likelihood and consequences
of the hazard leading to injury or harm will assist in
identifying the means of reducing risk to the
employees and the first aid services and facilities
appropriate for the workplace.

18. Establishing first aid facilities and
services
• It is important to give consideration to high risk
environments, such as:
– Workplaces that use or manufacture hazardous substances
– Construction and demolition sites
– Timber harvesting sites
– Workplaces where hazardous processes may be used (e.g.
abrasive blasting)
– Where heat is used as part of any process (e.g. moulding or
casting, welding and cutting)
– Where people are required to work in any remote or isolated
areas (e.g. agricultural, fishing or transport industry)
– Workplaces that provide assistance and care to highly
dependant people

19. • The following matters need to be determined:
– The contents of first aid boxes
– The number of first aid boxes and where the boxes
should be located ensuring they will be readily available
– Any need for a simple oxygen supply
– The number of people to be trained in first aid and what
is approved training for the particular workplace
– The possible need for a first aid room and the
requirement it should contain
– A system for recording and reporting
– The availability of trained first aid personnel during
working hours
– The availability of professional medical care (e.g.
hospital, medical centre) and emergency service (e.g.
ambulance) response time

20. Components of workplace first aid facilities

21. Components of workplace first aid facilities
Major Components:
• first-aider
• first-aid box
• first-aid room
• first-aid equipment
Factors to be considered in implementation:
• type of industry / hazards
• number of workers
• number of work shifts
• location of workplace and status of infrastructure in
relation to the nearest medical clinic or hospital

22. First Aider
Provision of Information About First-Aiders
• An employer should display a notice, in a prominent
place in the work-site, of the names and locations of
first-aiders.
• First-aiders should also be provided with a form of
identification (e.g. badge, arm band) for easy
recognition.
Selection criteria:
• Mature, responsible
• physically fit
• free from blood borne infectious diseases, e.g.
Hepatitis B, HIV/AIDS
• Calm in emergency, free to leave their work
immediately to respond to an emergency

23. First Aider
Training
• Recognized first aid course:
– Basic life support
– First Aid / Basic Trauma Life Support
• Refresher Training → once every three (3) years.
• The skills and knowledge of First Aiders should include the ability to:
– undertake the initial treatment of injuries and illnesses occurring in the
workplace
– know when to call on the assistance of the emergency services or, where
available, workplace medical practitioners or workplace nurses
– follow the advice and direction of the emergency services
– undertake CPR
– utilize standard precautions to minimize the spread of infectious diseases when
treating wounds and disposing of clinical waste
– dispose of waste appropriately
– maintain first aid kits and first aid rooms (if applicable)
– record details of first aid treatment given
– make appropriate reports to management.

24. First Aider
Responsibilities
• Management of Casualty
– give immediate first-aid treatment
– arrange without delay for the injured worker(s) to be
sent to a doctor, hospital or home, according to the
seriousness of this condition.
– Apply the principle of Universal Precautions while
delivering the responsibility to protect the first-aiders
from acquiring blood borne pathogen e.g. Hepatitis B
and HIV.
• Maintenance of Treatment Record
• Responsibilities for Maintenance of First-Aid
Requirement

25. First Aider
• The number of First Aiders are depending on:
– the size and layout of the workplace
– the location of the workplace
– the number and distribution of employees including
casual and shift work arrangements
– the nature and specific hazards of the work
– known occurrences of accidents or illnesses
– the distance from the workplace to the nearest available
and appropriate medical services.

27. First Aid box
Design
• Sturdy, portable, and clearly marked.
Location
• clearly identifiable, well-illuminated and accessible
location.
• The box should be kept locked and the key thereto
kept by responsible person available during all
working hours.
• The employees should be informed of the location
of all first aid boxes.

28. First Aid box
Contents
• First-aid boxes should contain a sufficient quantity of
suitable first-aid materials.
• They should not contain oral medication of any kind
other than those required for first-aid treatment.
• Check frequently to make sure they are fully equipped
and all items are usable.
• Recommended contents of a first-aid box are listed in
DOSH guidelines.
• First aid boxes should not contain items likely to be
toxic or open to be misuse. Any first aid boxes
containing prescription drugs must be securely locked
and accessible only to properly trained personnel.

30. First Aid box
Number of First Aid Boxes
• At least one first aid box should be provided for
every 100 employees or part thereof.
• Extra first aid boxes should be provided for each
additional 50 employees at the workplace.
• In a large establishment, which covers a wide area,
or occupies several floors in a building, more than
one first aid kit will need to be provided.
• For mobile workplaces, a first aid box should be
located in each vehicle.
(ACT Public Service)

31. First Aid box
Accessibility of First Aid Boxes
• The first aid box must be readily accessible in case of
emergency.
• It should be located not more than 100 metres from the
furthest workplace and not more than one story above or
below the floor level of the workplace.
• The first aid box should be portable or mounted in such a way
as to allow it to be removed and carried to an injured person.
• There must be immediate access to appropriate treatment in
areas of specific hazards, such as:
– hazardous substances and dangerous goods
(corrosives, cyanide, hydrogen fluoride, pesticides)
– machinery or equipment (eg plant
maintenance, construction, warehousing, and logging).
(Australian Capital Territory Public Services)

32. First Aid Room
Design
• The room should be large enough to hold a couch
and still have space for people to move about.
• Emergency lighting
• Easily cleaned walls, floor, and ceiling
• Non slip floor
• Privacy
• Comfortable temperature and humidity
• Clearly identified as a first-aid room by means of a
sign

33. First Aid Room
Location
• proximity to shower, lifts and main passageways
• accessibility to work areas and car park
Items in First-Aid Room
• Recommended items listed in DOSH guidelines

35. SPECIAL FIRST-AID REQUIREMENTS

36. SPECIAL FIRST-AID REQUIREMENTS
Provision for Mass Casualties:
• In a workplace where there is a potential risk of mass
casualties → provide a safe place for evacuation and for
the availability of adequate equipment (e.g.
stretchers, wheelchairs, sheets, bandages, blankets, etc
).
Special Instructions:
• In any place of work where a chemical hazardous to
health is used → the current Chemical Safety Data
Sheet (CSDS) for that chemical must be available and
easily accessible to the employees
• Special training for first aider on early management in

37. SPECIAL FIRST-AID REQUIREMENTS
Protective Clothing and Equipment:
• Protective clothing and equipment should be
provided, properly stored and checked regularly
• Principle of Universal Precautions
• First-aiders are recommended to be immunized for
Hepatitis B.
Cleaning Up:
• Wash hands or any other body surfaces splashed
with blood or other body fluids as soon as possible
with soap and water.
• Contaminated surfaces should be cleansed and
disinfected.

38. Worker awareness

39. Worker awareness
• Every workers should be aware of:
– the nature of first aid facilities
– the location of the first aid boxes and first aid rooms
– the names and work locations (including telephone
numbers) of First Aiders
– the procedures to be followed when first aid is required
– Standards precaution for the control of infection
including blood-borne infections

40. Worker awareness
The information should be kept up to date and
provided:
• When an employee first becomes employed
• when there is significant change in the location of
the first aid facilities or services
• When there are changes in names, locations, or
contact numbers of trained first aiders.

41. THaNK YoU