This document outlines the key elements of establishing a workplace first aid program according to OSHA regulations. It discusses defining first aid and the roles of first aiders. The four essential program elements are identified as management leadership, worksite analysis, hazard prevention and control, and safety training. Basic program requirements around assessing risks, complying with OSHA, and stocking appropriate first aid supplies are also covered. Employer responsibilities in training first aiders, documenting the program, and evaluating it are summarized. Common workplace injuries and their costs are briefly mentioned.

1. First Aid Awareness
Recognizing first aid needs and
requirements for establishing a
first aid kit per
29 CFR 1910.151 - Subpart K-
Medical and First Aid
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Bureau of Workers’ Compensation
PA Training for Health & Safety
(PATHS)

2. First Aid Defined
First aid: emergency care provided for
injury or sudden illness before
emergency medical treatment is
available.
The First-Aider: one trained in the
delivery of initial medical emergency
procedures, using a limited amount of
equipment to perform a primary
assessment and intervention while
awaiting arrival of emergency medical
service (EMS) personnel.
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3. Workplace First Aid Program
Four essential program
elements:
 Management Leadership
and Employee
involvement
 Worksite Analysis
 Hazard Prevention and
Control
 Safety and Health
Training
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4. Basic Program Elements
 Identifying/assessing injury risks
 Designing/implementing a first-aid program
that:
o Aims to minimize the outcome of
accidents or exposures
o Complies with OSHA requirements
relating to first aid
o Sufficient/appropriate quantities of
supplies and first-aid equipment, i.e.
bandages and automated external
defibrillators
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5. Employer Responsibilities
Those assigned are trained as first-aid
providers:
 With training suitable to the specific
workplace
 Periodic refresher courses
 Instruct all workers about the
first-aid program and actions
for ill or injured coworkers
 Put policies and program in writing
 Schedule evaluation and changing of
program
 Keep program current
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6. The Risks
On average, there are 23,000 on-
the-job injuries in the United
States daily.
This amounts to 8.5 million injuries
per year and a huge cost to
workers, their families, and our
economy, approximately $192
billion. Workers deal with more
than just injuries. Hundreds of
thousands of them develop
illnesses on the job, costing $58
billion a year.
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7. OSHA’s Top 10 Hazards
2015
 Fall Protection
 Hazard Communication
 Scaffolding
 Respiratory protection
 Lockout/tagout
 Powered Industrial Trucks
 Ladders
 Electrical-Wiring Methods
 Machine Guarding
 Electrical-General Requirements
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8. Other Workplace Events
 Electrocution
 Exposure to low oxygen environments can lead
to sudden cardiac arrest (SCA)
 Exposure to chemicals
 Overexertion at work can also trigger SCA in
those with underlying heart disease
 Temperature extremes
Prompt, proper first aid may mean
the difference between rapid or
prolonged recovery, temporary
or permanent disability, and even
life or death
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9. Assessing Risks
Designing a First-Aid Program Specific for the
Worksite
 Evaluate injuries, illnesses and fatalities at a
worksite are essential first steps in planning
a first-aid program.
 Use OSHA 300 log,
 OSHA 301 forms,
 Workers’ Compensation insurance carrier reports
 National data for injuries, illnesses and fatalities
may be obtained from the Bureau of Labor
Statistics (BLS) website at www.bls.gov/iif.
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10. 1910.151-Medical/First Aid
The employer shall ensure the ready availability
of medical personnel for advice and consultation
on matters of plant health.
In the absence of an infirmary, clinic, or hospital
in near proximity to the workplace which is used
for the treatment of all injured employees, a
person or persons shall be adequately trained to
render first aid. Adequate first aid supplies shall
be readily available.
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11. 1910.151-Medical/First Aid
Where the eyes or body of any person may be
exposed to injurious corrosive materials, suitable
facilities for quick drenching or flushing of the
eyes and body shall be provided within the work
area for immediate emergency use.
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12. Appendix A to 1910.151
First aid kits (Non-Mandatory)
First aid supplies are required to be readily
available under paragraph §1910.151(b). An
example of the minimal contents:
Generic first aid kit is described in American
National Standard (ANSI) Z308.1-1998 “Minimum
Requirements for Workplace First-aid Kits.” The
contents of the kit listed in the ANSI standard
should be adequate for small worksites.
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13. Appendix A to 1910.151
When larger operations or multiple
operations are being conducted at the same
location, employers should determine the need
for additional first aid kits at the worksite,
additional types of first aid equipment and
supplies and additional quantities and types of
supplies and equipment in the first aid kits.
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14. Appendix A to 1910.151
Employers with unique or changing first-aid
needs in their workplace may need to enhance
their first-aid kits.
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15. BBP Exposure
If it is reasonably anticipated
that employees will be exposed to
blood or other potentially
infectious materials (OPIM) while
using first aid supplies, employers
are required to provide
appropriate personal protective
equipment (PPE) in compliance
with the provisions of the
Occupational Exposure to Blood
borne Pathogens standard,
§1910.1030(d)(3) (56 FR 64175).
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16. Developing a Program
 Consult with the local fire and
rescue service or emergency
medical professionals
 SCA should be considered when
planning
 Get estimates of EMS response
times for all permanent and
temporary locations and for all
times of the day and night when
workers are on duty,
 Use information when planning
their first-aid program
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17. Program Policies
 In writing
 Communicated to all employees, including
those workers who may not read or speak
English
 Language barriers should be addressed in
instruction and in your procedures
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18. OSHA Requirements
OSHA First Aid Standard (29 CFR 1910.151)
Requires trained first-aid providers at all
workplaces of any size if there is no “infirmary,
clinic, or hospital in near proximity to the
workplace which is used for the treatment of all
injured employees.”
OSHA standards also require training in CPR
where sudden cardiac arrest from asphyxiation,
electrocution, or exertion may occur.
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19. Required CPR Training
 1910.146 Permit-required Confined
Spaces
 1910.266 Appendix B: Logging
Operations – First-Aid and CPR
 Training
 1910.269 Electric Power
Generation, Transmission, and
Distribution
 1910.410 Qualifications of Dive
Team
 1926.950 Construction Subpart V,
Power Transmission and Distribution
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20. First Aid Supplies
 Assign a person to choose types and
amounts of first aid supplies and for
maintaining same.
 The supplies must be adequate,
 Reflect the kinds of injuries that
occur, and
 Must be stored readily available for
emergency use.
 Automated external defibrillator
(AED) should be considered when
selecting first-aid supplies and
equipment.
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21. Kit Sizes
Small businesses, ANSI Z308.1 - 2003, Minimum
Requirements for Workplace First Aid Kits.
For large operations, determine how many kits
are needed and is other specialty equipment
needed.
Unique or changing needs: consider upgrading
kits.
 Consult with the local fire and rescue service or
emergency medical professionals
 Assess specific workplace needs
 Periodically reassess supply needs and
inventories.
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22. Kit Maintenance
Inspect:
 At assigned location?
 Contents complete and undamaged?
 Contents condition.
 Non-required items removed from kit?
 Contents out-of-date? Replace.
 First Aid Manual included?
 Sign to call 911?
Establish a periodic inspection schedule.
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23. Situationals
 Welder: burns, electrolyte, cuts
 Nursing
 Manufacturing
 Mining
 Transportation
 Real estate
 Education
 Administration
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24. Welding
Injuries:
 Burns
 Cuts
 Dehydration
 Eye injuries
Consider:
 Electrolytes
 Burn Spray & Compounds
 Eye pads
 Calling 911
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25. Nursing
Injuries:
 Finger
 Dental
 Strains & Sprains
 Specific to patient
condition
Consider:
 Patient needs which arise
 Calling a special Code
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26. Manufacturing
Injuries:
 Vary with type of manufacturing
 Punctures/impalement
 Cuts
 Crushing
 Broken bones
Consider:
 CPR
 AED
 Calling 911
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27. Mining
Injuries:
 Silica exposure
 Crushing
 Amputation
 Carbon monoxide
exposure
Consider:
 CPR, AED
 Oxygen
 Calling 911
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28. Transportation
Injuries:
 Carbon Monoxide poisoning
 Struck-by/Crushing
 Heat exhaustion
 HazMat Exposure
Consider:
 Oxygen cylinder
 CPR
 AED
 Call 911
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29. Real Estate
Injuries to self and Client:
 Chest pain, stroke
 Heart attack, Seizures
 Anaphylactic reaction
Consider:
 CPR
 AED
 Calling 911
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30. Retail Trade
Injuries to self and Client:
 Chest pain, stroke
 Heart attack, Seizures
 Anaphylactic reaction
 Pregnancy complications
Consider:
 CPR
 AED
 Special kit to counter reactions
 Calling 911
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31. Education
Injuries:
 Falls
 Eye injuries
 Ingestion
Consider:
 CPR
 AED
 Calling 911
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32. Administration
Injuries:
 High Blood Pressure
 Insulin Problems
 Heart Attack
Consider:
 CPR
 AED
 Calling 911
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33. AEDs
Automated External
Defibrillators
 (AEDs) treat sudden cardiac
arrest (SCA) caused by
ventricular fibrillation
 Using AEDs within 3-4 minutes,
can lead to a 60% survival rate.3
 All worksites are potential
candidates for AED programs
 Assess an AED program as part
of your first-aid response
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34. AED Program
 Physician oversight;
 Compliance with local,
state and federal
regulations;
 Coordination with local
EMS;
 Quality assurance
program;
 Periodic program review
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35. First Aid Courses
Training is offered by:
 American Heart Association
 American Red Cross
 National Safety Council
 Other nationally recognized
and private educational
organizations.
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36. Training Programs
 Individualize to workplace needs
 Consider unique conditions at a specific
worksite and customize your program
Training Elements Considered
1. Teaching Methods
2. Preparing to Respond to a Health Emergency
3. Assessing the Scene and the Victims
4. Responding to Life-Threatening Emergencies
5. Responding to Non-Life Threatening
Emergencies
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37. 1. Teaching Methods
 Curriculum based on a
consensus of scientific
evidence where available;
 “Hands-on” skills and
partner practice;
 Appropriate supplies and
equipment available;
 Stress acute injury and
illness settings as well as
appropriate response by
using visual aids;
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38. 1. Teaching Methods
 Course information resource
for reference both during
and after training;
 Allow emphasis on
commonly occurring
situations;
 Emphasize skills training and
confidence-building over
classroom lectures;
 Emphasize quick response to
first-aid situations.
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39. 2. Preparing to Respond
Instruction/discussion in:
 Prevention to reducing fatalities, illnesses and
injuries;
 Interacting with local EMS;
 Current emergency telephone numbers (police,
fire, ambulance, poison control) accessible by
all employees;
 Understand legal aspects of providing first-aid
care, including Good Samaritan legislation,
consent, abandonment, negligence, assault and
battery, State laws and regulations;
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40. 2. Preparing to Respond
 Understand effects of stress, fear of infection,
panic; how they interfere with performance;
and what to do to overcome these barriers to
action;
 Universal precautions and body substance
isolation;
 Personal protective equipment (PPE);
 Appropriate management and disposal of
blood-contaminated sharps and surfaces; and
 OSHA’s Bloodborne Pathogens standard
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41. 3. Assessment
 Assess scene for safety, number
injured, nature of event;
 Assess the toxic potential and
the need for respiratory
protection;
 Establish the presence of a
confined space and the need for
respiratory protection and
specialized training to perform a
rescue;
 Prioritize care, treat for shock
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42. 3. Assessment
 Assess each victim for responsiveness, airway
blockage, breathing, circulation, and medical
alert tags;
 Take a victim’s history determining the
mechanism of injury;
 Perform a logical head-to-toe check for injuries;
 Continuously monitor the victim;
 Emphasize early activation of EMS;
 Indications for and methods of safely moving
and rescuing victims;
 Repositioning ill/injured victims to prevent
further injury.
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43. 4. Life-Threatening Events
 Adapt program to specific
worksite:
 Establishing responsiveness;
 Establishing and maintaining
an open and clear airway;
 Performing rescue breathing;
 Treating airway obstruction
in a conscious victim;
 Performing CPR;
 Using an AED;
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44. 4. Life-Threatening Events
 Recognizing the signs and
symptoms of shock and
providing first aid for shock
due to illness or injury;
 Assessing and treating a
victim who has an
unexplained change in level
of consciousness or sudden
illness;
 Controlling bleeding with
direct pressure;
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45. 4. Life-Threatening Events
Poisoning
 Ingested poisons: alkali, acid, and systemic
poisons. Role of the Poison Control Center (1-
800-222-1222)
 Inhaled poisons: carbon monoxide; hydrogen
sulfide; smoke; and other chemical fumes,
vapors, and gases
 Assessing the toxic potential of the
environment and the need for respirators
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46. 4. Life-Threatening Events
 Knowledge of the worksite chemicals and first aid
and treatment for inhalation or ingestion;
 Effects of alcohol and illicit drugs to recognize
physiologic and behavioral effects;
 Recognizing asphyxiation and confined space
dangers;
 Responding to Medical Emergencies
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47. 5. Non-Life Threatening
Wounds
 Assessment and first aid for wounds
including abrasions, cuts, lacerations,
punctures, avulsions, amputations
and crush injuries
 Principles of wound care, including
infection precautions
 Principles of body substance isolation,
universal precautions
 Use of personal protective equipment
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48. 5. Non-Life Threatening
Burns
 Assess severity
 Is burn thermal, electrical, or chemical
and the appropriate first aid;
 Review your corrosive chemicals and
appropriate first aid.
Temperature Extremes
 Exposure to cold: frostbite and
hypothermia;
 Exposure to heat: heat cramps, heat
exhaustion and heat stroke.
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49. 5. Non-Life Threatening
Musculoskeletal Injuries
 Fractures;
 Sprains, strains, contusions and cramps;
 Head, neck, back and spinal injuries;
 Appropriate handling of amputated body parts.
Eye injuries
 First aid for eye injuries;
 First aid for chemical burns.
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50. 5. Non-Life Threatening
Mouth and Teeth Injuries
 Oral injuries; lip and tongue injuries; broken
and missing teeth;
 The importance of preventing aspiration of
blood and/or teeth.
Bites and Stings
 Human and animal bites;
 Bites and stings from insects;
instruction in first-aid treatment
of anaphylactic shock.
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51. Trainee Assessment
Assessment of successful completion of the first-
aid training program should include:
 Instructor observation of acquired skills and
 Written performance assessments.
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52. Skills Update
 Retention rate of 6-12 months
of these critical skills.
 Skills review and practice
sessions at least every 6
months for CPR and AED
skills.
 Instructor-led retraining for
life-threatening emergencies
should occur at least annually.
 Retraining for non-life-
threatening response should
occur periodically.
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53. Program Update
 Review program periodically
 Does it continue to address the needs of the
specific workplace?
 Add or modify training, supplies, equipment
and first-aid policies to account for changes in
workplace safety and health hazards, worksite
locations and worker schedules since the last
program review.
 Keep program up-to-date with current
techniques and knowledge. Replace/remove
outdated training and reference materials.
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54. Summary
 Employers are required by 29 CFR 1910.151 to
have a person(s) adequately trained to render
first aid for worksites not near an infirmary,
clinic, or hospital.
 Design a program for a workplace reflecting
known and anticipated risks.
 Consult local emergency medical experts and
providers of first-aid training when developing a
program.
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55. Summary
 Program must comply with all applicable OSHA
standards and regulations.
 OSHA requires certain employers to have CPR-
trained rescuers on site.
 Seriously consider establishing a workplace
AED program.
 First-aid supplies must be available in adequate
quantities and readily accessible.
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56. Summary
 First-aid training courses
should include instruction in
general and workplace hazard-
specific knowledge and skills.
 CPR training should incorporate
AED training if an AED is at the
worksite.
 Repeat first-aid training
periodically to update
knowledge and skills.
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57. Summary
Management commitment and worker
involvement is vital in developing, implementing
and assessing a workplace first-aid program.
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58. Questions
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59. Contact Information
Health & Safety Training Specialists
1171 South Cameron Street, Room 324
Harrisburg, PA 17104-2501
(717) 772-1635
RA-LI-BWC-PATHS@pa.gov
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60. Bibliography
Best Practices Guide: Fundamentals of a Workplace
First Aid Program, OSHA 3317-06N 2006
Virginia school emergencies
www.doe.virginia.gov/.../health_emergencies/fir
st_aid_emergencies.pdf
The Cost of Debilitating Workplace Injuries
Tuesday, May 24, 2016 by Chelsie King Garza
research.lawyers.com
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61. Bibliography
www.bls.gov/iif
American National Standard (ANSI) Z308.1-1998
“Minimum Requirements for Workplace First-aid
Kits.”
OSHA First Aid Standard, 29 CFR 1910.151,
Appendix A
29 CFR 1910.1030, Bloodborne Pathogen Standard
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62. Bibliography
OSHA Recording and Reporting Occupational
Injuries and Illnesses regulation (29 CFR 1904)
provides specific definitions of first aid and
medical treatment.
American Heart Association in collaboration with
International Liaison Committee on Resuscitation.
Guidelines 2000 for Cardiopulmonary
Resuscitation and Emergency Cardiovascular
Care: International Consensus on Science, Part 4:
The Automated External Defibrillator. Circulation.
2000; Vol. 102, Supplement: I 61.
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63. Bibliography
Additional Resources on First Aid, CPR and
AEDs
American Association of Occupational Health
Nursing at www.aaohn.org
National Safety Council at www.nsc.org
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64. Bibliography
Segal, Eileen B, “First Aid for a Unique Acid: HF,”
Chemical Health and Safety, September/October
1998, Vol. 5, No. 5, p.25, Bronstein, A.C. and
Currance, P.L. “Emergency Care for Hazardous
Materials Exposures, “ Mosby Company, 1988.
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65. Other Suggested Programs
The following may aid your in-house program:
 Bloodborne Pathogen Standard
 Fall Protection
 Heat-related injuries
 Cold weather injuries
 Infectious Diseases
 Struck-by Hazards
Please contact us for a full list of other free
programs available to you.
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PATHS – PA Training
for Health & Safety