Medical Services and First Aid

In emergency situations, prompt, properly-administered first aid can mean the difference between life and death, rapid versus prolonged recovery, or temporary versus permanent disability. Safety comes first, but when accidents do happen, it is important to have someone who knows how to handle the situation effectively. You may be that person. In that case, knowing what to do, and not to is important. If you aren’t qualified, quickly get someone who is. Also, know where the first aid kits and emergency eyewash stations are before an incident occurs. And, understand and follow the universal precautions when dealing with blood.

The following lays out some basic first aid information:

Call for Help
If you are not alone, have someone go for help immediately. If you are alone, immediate care is a priority. However, that immediate care may be going for help.

Analyze the situation
Don’t become a victim yourself. If you can be safe while doing it, get the victim away from any danger source such as water, fire, or downed power lines. Be sure to turn off all power sources before touching an electrocuted victim.

Don’t move the victim
If there is any chance of spine or neck injury do not move the victim unless he or she is in a life threatening situation.

Look for signs of life
Look for signs of life and give artificial respiration or CPR if necessary but only if you have been trained. Be sure help is on the way before starting CPR. Do not tilt the victims head back if you suspect a neck injury.

Control heavy bleeding
Stop the flow of blood by direct pressure, elevating the injury above the heart or pressure points. Do not use a tourniquet unless the person is in danger of bleeding to death and you’ve been trained to apply one.

Treat for shock
Signs of shock include cold, pale skin; a rapid, faint pulse; nausea; rapid breathing; and weakness. To treat for shock, keep the victim lying down; cover him/her only enough to maintain body heat; don’t move the victim unless absolutely necessary; and get medical help immediately.

Treat for choking
A person can choke to death in a few minutes. You can tell if a person is choking if he/she can’t speak, cough, or breathe. If the person is choking, use the Heimlich Maneuver.

Treat for burns
For small burns, gently soak burn in cold water or pour cold water on burn. Do not treat large burns with water unless they are chemical burns. Cover burn with a dry, sterile bandage. Provide artificial respiration as needed. Seek medical attention. Some chemicals should not be flushed with water, but neutralized by other means—see chemical label.

Treat for chemical burn in eye
Quickly flush the eyes with lots of water for at least 15 minutes (for best results, do so at an eyewash station, emergency shower, or hose). Try to force the eyes open to wash chemical out. Do not bandage eyes. Seek medical attention.

Treat for Fracture
Do not move the victim unless you absolutely have to. This is especially important if you suspect a neck or back injury. Get medical help.

This information is provided by: Assurance Agency http://www.assuranceagency.com

Stairway Safety for Construction

Stairways, like ladders, are a source of accidents at construction sites. They are also a source for numerous OSHA citations. In September 2003, the following stairway violations were in the top 75 OSHA rules to receive citations:
- Stairways with four or more risers or rising more than 30", whichever is less, must have at least one handrail and one stairrail system along each unprotected side or edge.
- A stairway or ladder must be provided at all employee access points where there is a break in elevation of 19" or more, and no ramp, runway, sloped embankment, or personnel hoist is provided.
- Your employer must provide a training program, as necessary, for stairway use. The program must enable you to recognize hazards related to stairways, and must train you in the procedures to be followed to minimize these hazards.
- Unprotected sides and edges of stairway landings must be provided with guardrails.

OSHA has many rules that address design, stairrails, handrails, and maintenance. The following examples (of the many rules for stairways) point out some of these areas.

General
- Temporary stairways must have landings of not less than 30" in the direction of travel, and extend at least 22" wide at every 12' or less of vertical rise.
- Where doors or gates open directly on a stairway, a platform must be provided. The door swing must leave 20" of effective width.
- Proper housekeeping procedures eliminate stairway slip, trip, and fall hazards. Keep stairs free from debris and clutter.

Good lighting will help avoid stairway hazards. Like any other walking/working surface, it is difficult to avoid what you cannot see.

Stairrails and handrails
- Stairrails must not be less than 36 inches high from the tread to the top of the stairrail.
- Handrails must be between 30 and 37 inches high measured from the tread surface.
- Handrails must provide an adequate handhold to avoid falling. If the handrails are not permanent, there must be at least a three inch clearance between the handrail and wall.

Temporary stairs have their own issues
- Treads for temporary service must be made of wood or other solid material, and must be installed the full width and depth of the stair.

This information is provided by: Assurance Agency  http://www.assuranceagency.com

Housekeeping

HOUSEKEEPING – WHAT IS GOOD HOUSEKEEPING?

WALKING AREAS:

• Three-foot-wide access paths to work area
• Cut-offs and scrap material out of work area – toss them into a corner or box
• Building material stored in a way that does not require climbing over piles of
lumber or other material to gain access
• Keeping hoses/cords off the middle of the stairway
• Keeping hoses/cords out of the work area and avoiding snarls
• Keeping mud off stairs, ramps and ladder rungs
• Keeping accumulation of snow and ice and mud of off stairways and landings
• PULL nails from reusable lumber, do not bend them over
• Pull brace blocks from floor when you remove wall bracing

METAL BANDS:

- Cut at bottom of lumber pile with snips and remove. If you cannot remove the band, bend over the sharp edge
- Treat plastic bands as trip hazards- remove them from the lumber pile immediately.

GUSSET PLATES:
- Roof crew- note if any gusset plates stick above the top chord- if they do, make other crew members are aware. First man close to the stick up needs to pound it down.

This information is provided by: Assurance Agency http://www.assuranceagency.com

Handle the Heat

Overview
Working in the heat puts an extra strain on your body. With some understanding of how the body reacts to heat, you can prevent heat-related disorders.

What are the risk factors?
Personal:
Age, weight, degree of physical fitness, metabolism, medications, use of alcohol or drugs, water consumption, caffeine consumption, and a variety of medical conditions, such as hypertension, all affect a person's sensitivity to heat. It is difficult to predict who will be affected by the heat, or when someone will be affected.

Environmental:
Air temperature; humidity; radiant heat from the sun and other sources; conductive heat sources, such as the ground, air movement, workload severity and duration; protective clothing; and PPE are all other factors to consider.

Another factor is whether or not you are accustomed to the heat. By gradually being exposed to working in hot conditions, your body develops a greater tolerance for the heat.

Can personal protective equipment add to the hazard?
Yes, sometimes heavy or impermeable chemical protective clothing can contribute to a worker's exposure to the heat. However, there are specialized types of PPE that can be worn under other types of protective clothing to cool workers, such as Ice vests, water-cooled garments, and air supply systems.

Work practices can help control heat hazards
A more common technique that might be considered PPE is to wear wet clothing, headbands, or bandanas. This could also be considered a type of work practice control. Other work practices that help control exposure to the heat include:
- Using intermittent rest periods to recover from the heat.
- Drinking about 5 to 7 ounces of fluids every 15 to 20 minutes to replenish body fluids.
- Using relief workers.
- Using the buddy system (work in pairs) when working in hot conditions.
- Pacing the work, or reducing the physical demands of the work.
- Providing cool recovery or shaded rest areas.
- Scheduling work for cooler times of the day or when heat producing equipment isn't being operated.
- Wearing light, loose-fitting, breathable (like cotton) clothing.

This information is provided by: Assurance Agency http://www.assuranceagency.com

Happy Fourth of July

Share the love and spread the joy on this Independence Day.

Happy Fourth of July!

Cathy Kirin
RCEC / RHBA

Bloodborne Pathogens (BBP)

Individuals who are infected with Hepatitis B Virus (HBV) or Human Immunodeficiency Virus (HIV) may not show symptoms and may not know they are infectious. For this reason, all human blood and body fluids should be considered as if infectious, and all precautions should be taken to avoid contact. This simple rule is known as "universal precautions."

In the workplace, bloodborne pathogens (BBP) may be transmitted when blood or other infectious body fluids come in contact with mucous membranes (your eyes, nose, mouth); non-intact skin (due to cuts, abrasions, burns, rashes, paper cuts); or by handling or touching contaminated materials or surfaces. Bloodborne pathogens are also transmitted by "injection" under the skin via an contaminated sharp object puncturing or cutting the skin causing a wound.

Hepatitis B Virus versus Human Immunodeficiency Virus:
- Hepatitis B Virus is more persistent than HIV and is able to survive for at least one week in dried blood on environmental surfaces. However, HIV will not survive for more than a few minutes when exposed to room temperature air, and will usually die within seconds.
- A teaspoon of infected blood may contain over one billion HBV particles, while a teaspoon of infected HIV blood contains about 15 HIV particles.
- Hepatitis B Virus usually has mild symptoms which makes diagnosis difficult. HIV infections usually are not diagnosed for years and symptoms may not appear for many months or years.
- Hepatitis B can be prevented with a vaccine. At the present time there is no preventive vaccine for HIV.
- No cure is presently available for HBV or HIV.

If you administer first aid to an injured person in the workplace and there is a potential for contacting any body fluids, you should adhere to the following "universal precaution" guidelines:
- Wear impervious gloves when there is a chance of exposure to blood or body fluids.
- Wear a face shield to protect your entire face, and safety goggles to provide the most complete eye protection.
- Use resuscitation devices when performing cardiopulmonary resuscitation (CPR).
- Report all BBP exposures, or potential exposures to your supervisor immediately.
- Immediately wash your hands and affected areas with soap and warm water.
- Flush your eyes, nose or other mucous membrane areas with water, if exposed.
- Wash down areas which body fluids may have been contacted with the use of a mild solution of household water and bleach (10:1).

This information is provided by: Assurance Agency  http://www.assuranceagency.com

Automated External Defibrillators (AEDs)

Overview
Nearly 350,000 people die of sudden cardiac arrest each year. Currently, the chances of surviving sudden cardiac arrest (SCA) without the aid of an automatic external defibrillator (AED) are one in twenty.

However, with an AED, chances of survival improve to one in three. The use of AEDs could save 100,000 lives per year!

What is SCA?
The heart normally has a rhythmic beat which causes the blood to move in a consistent, predictable way. When someone has an SCA event, the heart begins to pump irregularly and ineffectively. This is called ventricular fibrillation (VF). VF is not to be confused with the heart attack where blood flow to the heart muscle is blocked. With VF, the blood stops circulating adequately, breathing stops, and eventually the victim will die.

Another SCA event is ventricular tachycardia (VT), when the heart muscles start to “quiver” instead of working together to push blood through the system.

CPR alone does not replace defibrillation in an SCA incident. CPR can only assist the victim for a short time until medical help arrives. However, medical assistance can be many minutes away. According to the American Heart Association, the chances of survival decrease 10 percent with each passing minute that the heart beat is not returned to normal. Very few people have survived SCA after 10 minutes with no medical treatment.

Unfortunately, we don’t know why SCAs occur, nor how to prevent them. We do know, however, how to fix them if they occur—AEDs.

What is an AED?
You’ve seen full-sized defibrillators on television. When the doctor shouts “Clear” and shocks the victim, they are using a defibrillator. The AED works the same—it shocks the heart back into a normal rhythm to restore a pulse.

Manufacturers have developed lighter, smaller, battery-operated, computer-controlled models which nearly anyone can use.

Signs and symptoms of SCA
Symptoms of SCA are very sudden and dramatic. Typically, the victim will collapse, and show no sign of a pulse. At this point, emergency medical help must be summoned, and the AED used.

The victim’s chest is bared, all visible jewelry or medicine patches are removed, and the electrode pads are attached. Once the electrical pads are attached, the AED is turned on. Many AEDs will prompt the operator through the necessary steps to use it. If the AED does not sense a shockable event, no shock is given. Others will function automatically, applying a shock to the victim after sounding a warning alarm.

Laws and liability
In May 2000, Congress passed the Cardiac Arrest Survival Act to establish a national standard that provides Good Samaritan immunity for cardiac arrest care providers, trainers, and owners of property where AEDs are kept.

A legal trend is starting to appear which suggests that failing to provide AEDs to respond to an SCA incident may be deemed as negligent.

Training Tips
Review the employee handout, and the user’s guide which comes with the AED. Point out the location of AEDs in your facility.

Review with the employees the signs and symptoms of sudden cardiac arrest and heart attack. Explain that in either case, early contact with emergency medical personnel is critical.

Explain how to summon emergency medical help, and the identities of the emergency medical responders at your facility. Explain to the participants how the company trains first aid responders to use the AEDs.

Where To Go For More Information
29 CFR 1910.151—First Aid.
OSHA CPL 2-2.53—Guidelines for first aid programs.
AED User’s Guide
Cardiac Arrest Survival Act (CASA)
Airline Passenger Safety Act
Applicable state regulations

This information was provided by: Assurance Agency  http://www.assuranceagency.com