What is a First Aid Case

9/28/2020

The mantra in the world of S&H is “ALL ACCIDENTS ARE PREVENTABLE.” And after so many years in this profession, I can say that this statement does hold considerable merit; yet there are examples where experts in the field of accident investigation have had to admit, that there are few – that is, very few – exceptions.  Probably the most notable occurred in recent times; this is the incident of Flight 1549; the US Airlines flight from New York’s LaGuardia Airport in January 2009. This story was made famous in the movie, “Sully” (starring Tom Hanks), where moments after the plane took off from LaGuardia, a flock of birds flew into one of the engines, causing the aircraft to lose its ability to remain in fight and as a consequence, Sully felt it necessary to land the aircraft into New York’s Hudson River.  Outside of eliminating all birds from flying within the airspace of an airport (not a very feasible suggestion), many in the safety profession doubt this event could have been prevented.

So, with some very few and noteworthy exceptions, the axiom, “all accidents are preventable,” is a slogan that we should consider with feasibility. At the same time, when an accident does occur, it is important to control and maintain the event – whether it’s a hazardous material spill or an injury. We have an obligation to minimize the occurrence. 

What is an accident? The S&H profession typically describes an accident as an event that is/was unplanned and unwanted that has resulted in personal injury or illness or damage to property (i.e. materials or equipment).  When one of our coworkers gets injured, our primary concern is to ensure this employee will receive proper treatment. And by applying first aid measures, we can begin to initiate an effective method to help minimize an injury/illness. Should our field efforts prove to be successful, we not only controlled a medical condition from becoming a more serious case, we also may have prevented the injury from needing a more aggressive form of treatment. When this occurs, we have maintained an injury to be classified as a “First Aid Event.”

Determining how an injury or illness should be classified can get a little tricky. OSHA, through the regulation “RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES,” (29 CFR 1904), provides a list of descriptions that can be used to determine when an event may be classified as a first aid case.  According to this regulation first aid is defined as any one of the following scenarios:

• Using a non-prescription medication at nonprescription strength (for medications available in both prescription and non-prescription form, a recommendation by a physician or other licensed health care professional to use a non-prescription medication at prescription strength is considered medical treatment for recordkeeping purposes);
• Administering tetanus immunizations (other immunizations, such as Hepatitis B vaccine or rabies vaccine, are considered medical treatment);
• Cleaning, flushing or soaking wounds on the surface of the skin;
• Using wound coverings such as bandages, Band-Aids^TM, gauze pads, etc.; or using butterfly bandages or Steri-Strips^TM (other wound closing devices such as sutures, staples, etc., are considered medical treatment);
• Using hot or cold therapy;
• Using any non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc. (devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment for recordkeeping purposes);
• Using temporary immobilization devices while transporting an accident victim (e.g., splints, slings, neck collars, back boards, etc.).
• Drilling of a fingernail or toenail to relieve pressure, or draining fluid from a blister;
• Using eye patches;
• Removing foreign bodies from the eye using only irrigation or a cotton swab;
• Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs or other simple means;
• Using finger guards;
• Using massages (physical therapy or chiropractic treatment are considered medical treatment for recordkeeping purposes); or
• Drinking fluids for relief of heat stress.

When an employee receives medical treatment, there is an obligation to record the incident on the OSHA 300 and 300A logs as a “recordable incident” (these forms are a company’s listing of occupational recordable events for a specific calendar year and summary sheet, respectively).  OSHA has specified that medical treatment (per 29 1904) does NOT include a visit to a physician or other licensed health care professional solely for observation or counseling or for such diagnostic procedures as x-rays and blood tests including the administration of prescription medications used solely for diagnostic purposes (e.g. eye drops to dilate pupils).  

Through quick treatment via first aid measures and immediate contact with our incident intervention contractor, WorkCare, we have the opportunity to minimize a work-related incident; possibly even reducing an injury or illness from being a potential recordable event to merely a first aid case. However, should a fellow worker need medical treatment, regardless of how the incident may be classified, we should always proceed with the proper course of action: be that first aid measures or having the affected worker visit a medical clinic or hospital emergency room. Typically, WorkCare will assist us in our decision process and even calling ahead to the medical facility while the affected employee is driven to the facility by a superviros.

Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time

Thomas A. Edison