First-Aid Readiness and the Opioid Crisis

As World First Aid Day, an annual campaign to highlight the importance of first-aid training in preventing injuries and saving lives, takes place on September 8 this year, the findings of a 2016 Ipsos poll has raised the question of just how ready Canadians are to render first aid. According to the survey that Ipsos conducted between August 30 and September 1, 2016 on behalf of the Canadian Red Cross, not all Canadian households are adequately prepared with first-aid training in the event of an emergency.

The poll surveyed a sample of 1,005 Canadians online. Results indicate that 36 per cent of Canadians have no one living in their household who is trained in first aid. Despite that finding, 75 per cent of Canadians say they are confident that they would know what to do about the emergency situation if they saw someone fall off a ladder or slip on some ice. Only 12 per cent of respondents feel very confident that a child in their life could help them if they collapsed, and 92 per cent think that children should start learning about first aid and how to help people in their community as early as nine years old.

One emerging trend that might compel Canadians to enhance their first-aid readiness is the increasing use of opioids and the rising incidence of opioid overdose. As a result, some provinces are making naloxone kits that can be used in the event of an opioid overdose more readily available.

For example, a spike in opioid-related deaths in Ontario prompted the province to make Narcan nasal spray available — free of charge — in pharmacies by the end of March. There were 1,053 opioid-related deaths from January to October 2017, compared with 694 during the same time period in 2016. Saskatchewan is also making naloxone more accessible by allowing take-home naloxone kits to be distributed without the involvement of a pharmacist and in locations other than a pharmacy.

For those whose jobs require them to be on the frontline, such as first responders like police officers, paramedics and healthcare workers, the risk of inadvertent exposure to strong opioids that could endanger their health is very real. In May, a peace officer was hospitalized after he picked up a vial with gloves on while on patrol on Seba beach in Alberta. He returned to office and started having breathing problems and an increased heart rate. Investigation later found traces of fentanyl on the dashboard of the peace officer’s car and on his ticket books.

As opioid use and overdose becomes more prevalent, employees may find themselves or their co-workers exposed to opioid while on the job, or increasingly encounter situations that may require them to intervene by administering naloxone kits as a form of first aid in situations involving opioid overdose. In a statement the Canadian Union of Public Employees issued in March last year, the union outlines several considerations that must be addressed before workers are reasonably expected to act.

Firstly, employers who expect their employees to respond to suspected overdose incidents must develop clear policies, protocols and procedures in consultation with the workplace health and safety committee or representative and provide training to all staff on how to respond.

As there is a risk of exposure to opioids when responding to a person who is overdosing, such as through contact with vomit, the employer must provide adequate and appropriate personal protection equipment. Workers must also be assured that they will be free from any form of reprisal if they attempt to respond to a suspected opioid overdose, as some workers’ compensation boards may consider administration of treatment that is not specifically described by an employer’s policy or a collective agreement as “volunteering.” As such, claims for injuries or conditions sustained while performing these activities, both at or outside of work hours, may not be covered by the worker’s compensation board.

A person who is overdosing may be unpredictable, aggressive and even potentially violent. Employers also need to take this risk into account and perform a violence-hazard assessment to determine the proper controls to keep employees safe, the CUPE statement notes.

Jean Lian is editor of OHS Canada.