OHS Canada Magazine

Beyond Band-Aid

July 13, 2018
By Carmelle Wolfson

In every workplace, there is the potential for accidents to happen. As such, organizations must be prepared to re¬spond to incidents regardless of whether an injury or ill¬ness occurs in an office or a warehouse. “If somebody gets injured, it is the employer’s responsi¬bility to make sure that the person is provided with first-aid treatment,” says Claudio Dente, president of Dentec Safety Specialists Inc. in Newmarket, Ontario.

Philip Turmel, senior occupational health and safety special¬ist and team leader with SCN Industrial, a wholesaler of industrial first-aid products in Montreal, says employers today are investing more in the safety of their workers, thanks to more stringent regulations and enforcement. “People come first,” Turmel says. “It is one budget you can’t really cut into. You can repair a ladder, but you can’t repair a person sometimes.”

Legislation requires workplaces across Canada to have first-aid kits on hand. “Every provincial regula¬tion stipulates what an employer must do with regards to first aid. So it is clearly laid out as to the obliga-tions,” Dente says. “It even tells you what has to be in the kit and the number of pieces of that particular item in the kit.”

It is important to ensure that the kit is made specifical¬ly for the workplace, advises Tony Kourebeles, president of First Aid Central in Laval, Quebec. “It is not a case of one kit fits all,” Kourebeles says. “They have to en¬sure that the first-aid kit is intended for a business and not for home use.” If the medical products within the kit are manufactured overseas and not approved by Health Canada, it might not meet the obliga¬tions they have as an employer, he cautions.

Dente says it is important to conduct a hazard assessment to determine what additional supplies are needed beyond the basic requirements in a workplace first-aid kit. “General in¬dustry believes that if they provide a first-aid kit that meets the regulatory requirements, they are okay. But the general requirements in many cases do not have specific first-aid treatment for a particular type of hazard.”

Dentec offers an audit service for companies to help identify the hazards or poten¬tial injuries that would require additional first-aid supplies, which are not included in a general first-aid kit containing only basic items stipulated in provincial regulations. Workplaces that may need extra first-aid supplies include those involving hot applications like foundries and food ser¬vices, or jobs that require handling chemicals.

Each industry comes with its own unique hazards. “In the hospitality industry, you are subject to burns and eye in¬juries, splashes, cuts and punctures. In general industry, you are subject to cuts and lacerations, bruises and falls, eye inju¬ries, et cetera,” says Gerald Yaffe, president of specialty first-aid company Kit Care Corporation in Mississauga, Ontario.

For slips, trips and falls, Yaffe recommends obtaining proper bandaging materials and cold packs. For heavy man¬ufacturing, construction, woodworking or welding, first-aid supplies that treat deep cuts, punctures and abrasions may be needed. With regards to sheet-metal shops, Yaffe says tourni¬quets — bandages or strips of cloth that stop or slow bleeding by compressing blood vessels — are essential. “Sheet-metal working is inherently dangerous, and limbs can be severed simply because somebody slips during a cutting operation.”

In the oil and gas industry, emergency first responders are generally hired to attend to medical needs, and a full emer¬gency medical technician first-aid kit — rather than a simple workplace first-aid kit — is required. “One of the flaws in the system is that the first-aid kits or first-aid requirements [are] not industry-specific,” Yaffe says, noting that the needs of a restaurant kitchen are different from those of a muffler shop, a lumber yard or a factory producing metal objects.

For foodservices professionals, First Aid Central supplies bandages geared to the restaurant industry. The bandages come in blue, so that workers can easily see them to prevent contamination should it fall off during food preparation.

A defibrillator is another item that is increasingly found in workplaces nowadays. “A number of years ago, it was much more of a hard sell,” Brown says, adding that in the past, employers were hesitant to buy defibrillators as they were expensive, on top of concerns surrounding issues with liability.

As automatic external defibrillators (AEDs) are more commonly found in public areas, people are becoming more comfortable with using defibrillators. The Canadian Heart and Stroke Foundation notes that legislation in provinces across Canada protects individuals who use AEDs from liability when they are used in the context of saving a life. For instance, in Manitoba, The Good Samaritan Protection Act or Bill 214 protects lay rescuers from liability, as long as they are acting in good faith. Similarly, Ontario has the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, which protects people from civil liability when they attempt to save lives using public AEDs.

Brown recommends annual recertification of the AED training program. “I think one of the problems is, either people who are not trained or people who are trained close to three years ago still have a valid certificate, but may feel very uncomfortable because they might have forgotten most of what they learned.”

When the heart stops, an AED needs to be used within the first five minutes, Yaffe explains. For every minute after that, the chance of success decreases by 10 per cent..

Training is another key component of workplace first aid. Along with the kit itself, employers may be required to have one or more workers trained in administering first aid. Organizations that offer certification include St. John Ambulance, Canadian Red Cross and the Lifesaving Society of Canada. Companies like Kit Care also offer firstaid training.

Yaffe says the Canadian Heart and Stroke foundation sets guidelines for training on cardiopulmonary resuscitation (CPR). He adds that first-aid training courses comprise different teaching modules that include topics such as bandaging, CPR, defibrillation, broken bones, severe bleeding, choking, concussions, eye injuries and burns.

First-aid kits come in various sizes and are available in bags and plastic or metal cases. For cold environments, such as organizations operating in northern Canada, a first-aid kit encased in metal is more appropriate.A warehouse environment may also require the use of a metal case. If the kit falls onto concrete or hits something hard, it will not break, “as opposed to having something in plastic, which is a little more fragile,” Kourebeles says.

A first-aid kit must be located in a place that is visible and easy to access. It should also be marked as a first-aid kit on the outside of the box or bag. Workplaces may want to consider acquiring signs for first-aid stations or kits placed in locations that are not clearly visible.

“You don’t want to have it hidden in a drawer and no one knows it is there,” Kourebeles says. “If the kit itself is not exposed and it is enclosed somewhere, then there should be signage, a poster or a plastic sign, or even a paper that writes ‘first-aid kit here.’”

He points out that provincial legislation may require larger workplaces to have more than one kit. Kourebeles suggests that in a warehouse exceeding 100 feet in length, it is prudent to have one kit at the back and one at the front of the warehouse for easy access. If an office has multiple floors, one kit should be available on each floor, “so you are not necessarily running up to the third floor to go get the first-aid kit, when the injured employee is on the first floor.”

Aside from the hazards specific to each industry, cost is another factor to consider. First-aid kits can cost anywhere from about $5 to $300. A steel case will be more expensive than a plastic case, while a larger kit, which may include items like a sphygmometer to check blood pressure, heavy-duty sheers that can cut through a seatbelt or a stethoscope, will also run up the tab.

Choosing a trustworthy supplier is also key. “You need to have a reliable source that can deliver the products in a timely manner,” Dente says.

Another consideration is whether the supplier offers a diverse range of products. Dente recommends checking that the first-aid products have Medical Device Licences approved by Health Canada and that Health Canada has granted a Medical Device Establishment Licence to the company for the purpose of distributing, importing or manufacturing medical products like first-aid kits. This means that the product or company meets protocols relating to quality control, manufacturing process, standard operating procedures and recall established by Health Canada.

Kourebeles observes that regulators have been taking a more hands-on approach to compliance in this area. “Health Canada is definitely stepping up and ensuring that the people that are offering first aid are compliant,” he says. “They are doing their part to ensure that kits on the market — at least for businesses that are selling first-aid kits to the Canadian population — are registered, compliant and they are trying to offer an above-average product.”

Many suppliers now offer clients who have special requirements the option of customizing the standard workplace first-aid kits by adding items to the kit, while ensuring that it complies with provincial regulations. Meanwhile, Dentec provides hazard-specific kits. Some companies, like SOS Technologies in Toronto, track expiration dates and inform customers prior to those dates that they need to buy new items, asmost items in a first-aid kit have expiration dates.

Maintaining kits involves replacing items once they have been used, expired or compromised. Commonly, an employee will be responsible for doing this by going through a checklist provided along with the kit, followed by ordering the supplies that are needed. This person can be a designated safety representative, receptionist, nurse or even an employer.Recommendations on how often first-aid kits should be checked can vary anywhere from once a month to once a year. In Ontario, kits must be checked quarterly each year. It is also a good practice to check a kit immediately after a workplace injury, since supplies will likely be used and need to be replaced. A quality first-aid kit should hold items that do not expire within a year.

Yaffe recommends that the person checking the kit ensure that it is clean and free of blood-born pathogens. The first-aid kit should also be well-organized enough so that one can quickly see the products needed at a glance. Lastly, check that the items inside have not expired and are sealed and individually wrapped.

Carmelle Wolfson was the former assistant editor of OHS Canada.

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