First Aid and

Requirements for OHC

Agenda

„ When to get help

„ How to get help
„ How to help
„ First aid
„ Requirements of OHC
„ Blood borne pathogens & Controls
Know when to get help
When to get help
„ Any life threatening or injury situation
„ If you are light headed and think you may
lose consciousness
„ Alone in the facility and seriously injured
„ When someone is injured seriously
When To Call Designated First Aider

„ Any time there is an injury or when someone

may need First Aid or CPR
„ Any time someone is feeling ill or needs to
use the First Aid room
„ If you notice any type of irregular behavior in
your coworker
„ If any non Trained employee
changes behavior dramatically
Know how to get help
Get help as quickly as possible
Be aware of your own condition
„ Are you dizzy ?
„ Light headed?
„ Chilled and sweating?
„ Blurred vision?
„ Shortness of breath ?
„ Pain in center of chest spreading to neck, shoulder or arms?
„ Something gets caught in your throat
„ Sudden weakness/numbness of the face
„ Loss of speech / trouble talking or understanding speech
„ Sudden severe headache
„ Are you allergic to certain things / been stung by a bee before?
Time is critical – Do What
YOU Can Do Before The
Unexpected Happens
We Recommend
„ Maintain your medical Record
„ Make a list of:
Your basic fitness history
List of medications you are taking
Any allergic condition(s)
Summery of your last illness
Name of the chemicals your are working with
Any previous work related injury or illness
YOUR DIABETIC CONDITIONS
Last First aid treatment taken for
Any Special need for your condition
Contact detail of your family doctor
We Recommend (Cont…)

„ Make this list department/plant wise

„ A department/ plant wise file containing
record should be readily available
„ Assign responsibility for up gradation
„ Attend Safety & Health Trainings

This is for you and your family

Help First Aider
„ If a designated First Aider asks for your help -
listen, and do what is asked
„ Call Emergency - it is OK to call more than
once
„ If you aren’t needed - stay out of the way
„ Keep others away - keep area clear
„ Help direct emergency personnel
„ Respect the privacy of others
ASK BEFORE ITS TOO LATE
How to help
Emergency First Aid
„ If you are the first on the scene of accident
you may be the ONLY link between a victim
and emergency medical care

„ Your Roll is to TAKE ACTION by

Providing first aid
Seeking medical help
Calling emergency
 Your actions
may improve the
victims chance
of recovery
General Considerations
„ Are you trained?
„ Are you equipped?
„ If “no”
Notify Occupational Health Center
„ Observations
„ Activate appropriate resources
Secure area
Do not become involved
Do not become a victim
General Considerations (cont.)
„ Are you trained?
„ Are you equipped?
„ If “yes”
Respond
Monitor the situation
Inform Occupational Health Center
Record all that transpires
Activate appropriate resources
 General Considerations (cont.) Personal
Protection Equipment
Gloves should be worn with any patient contact.
Task Protective Mask Gown
Eyewear

Taking vital signs No No No

Bleeding control with Yes Yes Yes
heavy bleeding or
spurting blood
Airway Yes If splashing If splashing
blood blood
maneuvers

Disinfecting If splashing If splashing If splashing

blood blood blood
General Considerations (cont.)
Personal Protection Equipment
Gloves Disposal
(When used alone)
Dispose of gloves in biohazard waste bag
Basic first Aid
First Aid Start up

Doing what must be done to:

„ Stabilize (before medically trained
personnel with equal or higher training are
available)
„ Transport (to an appropriate medical
facility)
First Aid
„ Focused examination
Primary Problem
Seriousness (Priority)
Additional problems
„ Communication
„ Transportation
„ Documentation
First Aid
„ Patient Assessment
Responsiveness
Airway
Breathing
Circulation
Communication
„ Provide information
„ Activate appropriate resources
„ Receive advice for care
Information to provide
„ Position „ Medical history
„ Name of victim (s) „ Vital signs
„ Age „ State of
„ Sex consciousness
„ Description of injury, „ Eyes
illness, or incident „ Breathing
„ Treatment given „ Signs of shock
„ Nearest relative
„ Phone number
 Basic First Aid Kit
Adhesive bandage compress Oral airway
Adhesive tape 1 in. Antibiotic ointment
Bandage compress 2 in. Plastic strips (various sizes)
Bandage compress 4 in. Latex gloves (Nitrile if allergic to
Triangular bandage latex)
Absorbent gauze compresses Bandage scissors
Gauze roller bandage 4 in. Non-adherent pads 2in. X 3 in.
Aluminum splint Tweezers
Tourniquet Sunscreen (SPF 30 or higher)
Eye dressing packet (pads and Burn Treatment Compound
strips) Aspirin, 324 mg.
Eye wash solution Ammonium Inhalants
Antiseptic swabs First Aid book
According to ANSI Z308.1-2003 items that
should also be included in the workplace
First Aid Kits
„ Item Size & Quantity
Analgesic (pain reliever) aspirin, tylenol, etc 16
Antibiotic Treatment 1/32 oz. (application) 6
Bandage Compress 2" x 36" 4
Bandage Compress 3" x 60" 2
Bandage Compress 4" x 72" 1
Breathing Barrier 2
Burn Dressing 4" x 4" 1
Cold Pack 4" x 5" 1
Eye Covering 2.9 sq. in per eye 2
Eye Wash 1 fl. oz. 1
Roller Bandage 4" x 6 yds. 1
Roller Bandage 2" x 6 yds. 2
Securing the scene
Before performing any First Aid,
Check for:

„ 1. Electrical hazards
„ 2. Chemical hazards
„ 3. Noxious & Toxic gases
„ 4. Ground hazards
„ 5. Fire
„ 6. Unstable equipment
Chain of Survival
In order for a person to survive:

Early Early CPR Early Early

or First Defibrillation Advanced
Access
Aid Call Care
You emergency on Hospital
Pay attention to: scene
HISTORY; what happened; from the casualty or bystanders
SYMPTOMS; what only the casualty can tell you
SIGNS; what you can see for yourself
DURING TREATMENT
•avoid coughing, breathing, or speaking over the
wound
•avoid contact with body fluids
•use a face shield or mask with one-way-valve
when doing active resuscitation
•use only clean bandages and dressings
•avoid treating more than one casualty without
washing hands and changing gloves
AFTER TREATMENT
•clean up both casualty and yourself
•clean up the immediate vicinity
•dispose of dressings, bandages, gloves and
soiled clothing correctly
•wash hands with soap and water
Fundamentals of First Aid

„ 1. ABC (airway-breathing-circulation)
„ 2. Control bleeding
„ 3. Treat for Shock(medical
emergencies)
„ 4. Open wounds & Burns
„ 5. Fractures & Dislocations
„ 6. Transportation
ABC’s
„ Causes of Respiratory/Cardiac Arrest

Electrical
Toxic -
Noxious
gases

Drowning Suffocation

Heart Attack Trauma

Drugs Allergic reactions

Recovery rate of victim if has
artificial respiration done
immediately
„ Establish responsiveness
A-B-C’s

„ Use chin lift/head tilt

„ Look.-listen-feel for breathing

„ Attempt to Ventilate
Ventilate Every 5 seconds

Check pulse Recovery position

Cardio Pulmonary Resuscitation

„ Should be certified to perform

this procedure

„ If done improperly, could

harm victim
CARDIOPULMONARY RESUSCITATION
CPR ABC’s
 AIRWAY - Open the
airway with the tilt-
chin method.
 Breath - give two
breaths.
 Check circulation.

 If there is no pulse or
breathing…..(next slide)
CPR (Cont.)
 … Perform chest compressions.
q 15 compressions and two breaths.
 Count = 1&2&3&4&5…&15
 Call emergency
RESCUE BREATHING

Ê1breath every 5 seconds - 12 per

minute.

ÊCompressions : ventilations = 15:2

Heimlich Maneuver
Or

Conscious airway obstruction

Types of Bleeding
Artery
Spurting

•Veins Steady flow

•Capillary Oozing

Internal Injuries
Types of Wounds
Control of Bleeding
Elevation

Direct Pressure

Pressure bandage
Cold Applications
Pressure Points
Temporal
Where the artery
passes over a bone Facial

close to the skin Carotid

Sub-clavian
Brachial
Radial
Ulnar

Femoral
Popliteal
Pedal
Tourniquet
Absolute last resort
in controlling
bleeding,Remember
Life or the limb

Once a tourniquet is
applied, it is not to be
removed , only by a
doctor
Shock
Shock affects are major
functions of the body
loss of blood flow to the
tissues and organs

Shock must be treated for

in all accident cases
 Shock Symptoms

„ Restless „ Frightened
„ Faint „ Weak
„ Thirsty „ Anxious
„ Nauseated „ Dizzy
Shock Signs
„ State of consciousness: alert (may be
deceiving) to unconscious
„ Breathing: shallow, rapid, irregular
„ Pulse: weak and rapid
„ Skin: cold, clammy (sweating)
„ Pupils: dilated
Treatment for Shock

•Lie victim down if possible

•Face is pale-raise the tail
•Face is red-raise the head
•Loosen tight clothing
•Keep victim warm and dry
•Do not give anything by mouth
•No stimulants
Heat Exhaustion
HEAT EXHAUSTION is caused by exertion accompanied by heat and
high humidity. It particularly affects the very young and the elderly.
SIGNS AND SYMPTOMS
•pale, clammy skin
•profuse and prolonged sweating
•cramps in the limbs and/or abdomen
•nausea and/or vomiting
•headache
•lethargy
CARE AND TREATMENT
•complete rest in the shade, no further exertion
•cool casualty by sponging with tepid water
•when nausea passes, give cool water to drink
(cautiously)
•ensure casualty has assistance when recovered
Heat Stroke
Heat stroke is potentially fatal. In this condition, the body's temperature regulation
center in the brain has been rendered inoperable, and the temperature continually
rises, causing eventual brain damage. Immediate active intervention is necessary to
avoid coma and death.

SIGNS AND SYMPTOMS

flushed, hot, dry skin the casualty has ceased sweating
rapid, strong pulse (sometimes irregular)
irrational or aggressive behavior staggering gait
visual disturbances vomiting
collapse and seizures coma - death
CARE AND TREATMENT
urgent ambulance transport complete rest in shade
remove casualty's clothing
cool casualty with any means possible
be prepared to resuscitate as required
nothing by mouth - dehydration is required by intravenous
fluids administered by a doctor or ambulance crew
Hypothermia
HYPOTHERMIA is a potentially fatal condition that especially affects the elderly. The
body's core temperature has been lowered to the extent that the brain function is impaired
and the heart's activity is about to be compromised. Urgent first aid intervention is
required.
SIGNS AND SYMPTOMS
pale, cold skin - no capillary return when fingernails are pressed
slow pulse, sometimes skipping a beat
slow, shallow respirations blurred, or double, vision
casualty is silent, appears asleep, difficult to rouse; may be unconscious
casualty experiences a sense of 'wellbeing' absence of shivering
If very cold, may have non-reacting pupils and appear 'death-like'
CARE AND TREATMENT
urgent ambulance transport
warm casualty slowly, wrap in 'space blanket' or similar
if wet, leave less bulky clothing on and warm slowly
once casualty commences shivering, reassess heating
nothing by mouth until fully recovered
be prepared for sudden collapse and resuscitation
Burns
Thermal burns
Cool application
Cool application Dry sterile dressing,
Don’t break treat for shock
blisters
Chemical Burn Treatment
„ Flood the area with slowly running water for
at least ten minutes.
„ Gently remove contaminated clothing while
flooding injured area, taking care not to
contaminate yourself.
„ Continue treatment for SEVERE BURNS
„ Remove to hospital.
Minor Burns and Scalds
Treatment
„ Place the injured part under slowly running water, or
soak in cold water for 10 minutes or as long as pain
persists.
„ Gently remove any rings, watches, belts, and shoes
from the injured area before it starts to swell.
„ Dress with clean, sterile, non fluffy material.
„ Don't use adhesive dressings.
„ Don't apply lotions, ointments or fat to burn/ scald.
„ Don't break blisters or otherwise interfere.
„ If in doubt, seek medical aid.
Severe Burns and Scalds
Treatment:
„ Cool the burn area with water for 10 to 20 minutes. Or use Burn Jel.
„ Lay the casualty down and make him as comfortable as possible,
protecting burn area from ground contact.
„ Gently remove any rings, watches, belts or constricting clothing from
the injured area before it begins to swell.
„ Cover the injured area loosely with sterile unmediated dressing or
similar non fluffy material and bandage.
„ Don't remove anything that is sticking to the burn.
„ Don't apply lotions, ointments, butter or fat to the injury.
„ Don't break blisters or otherwise interfere with the injured area.
„ Don't over-cool the patient and cause shivering.
„ If breathing and heartbeat stop, begin resuscitation immediately.
„ If casualty is unconscious but breathing normally, place in the
recovery position.
„ Treat for shock.
„ Send for medical attention.
 Serious Burns

„ Monitor airway
„ Reassess vital signs every 5 minutes
„ Do not give fluids by mouth
„ Do not place ice on any burn
 Burns
Special Situations
„ Eyes
Flush with water for 5 minutes
Cover both eyes
„ Respiratory track
Always a medical emergency
Singeing of nasal hairs
Cough
Hoarseness
Difficulty breathing
Fractures and Dislocations
Must treat for bleeding first
Don’t straighten break
Treat the way you found it

Do not push
bones back
into place
Fractures
Signs and Symptoms
„ Pain „ Tenderness
„ Swelling „ Exposed
„ Bruise fragment
„ Deformity „ Locked joint

„ False Motion „ Guarding

„ Crepitus „ Unable to support

weight
 Fracture Classification
„ Greenstick
„ Simple
„ Comminuted
„ Compound
„ Impacted
Fracture – Greenstick
„ Incomplete
separation of bone
fragments
Fracture - Simple

„ Two distinct bone

fragments
Fractures Comminuted

„ Multiple bone
fragments
„ Fractures
Comminuted
Fracture - Compound

„ Bone penetrates
through skin
Fractures Impacted

„ One bone fragment

telescopes into the
other
Dislocations
The most common dislocations occur in the shoulder, elbow,
finger, or thumb.

LOOK FOR THESE SIGNS:

1. swelling
2. deformed look
3. pain and tenderness
4. possible discoloration of the affected area

IF A DISLOCATION IS SUSPECTED...
1. Apply a splint to the joint to keep it from moving.
2. Try to keep joint elevated to slow bloodflow to the area
3. A doctor should be contacted to have the bone set back
into its socket.
 Fractures - Treatment
„ Remove clothing from area
„ Check ability to move and feel below fracture
„ Check circulation below fracture
„ Cover open wound
„ Splint
Immobilize joints above and below fracture
Reduces pain
Prevents additional damage
Pad all rigid splints
Fractures – Treatment (cont..)
„ When in doubt, SPLINT
„ Ice – not directly to skin
„ Position injured limb slightly above level
of heart if easily possible
„ Immobilize all suspected spinal injuries
„ Shock - treat
„ Report
„ Transport
 Fractures
Splinting and Immobilizing Sling
ƒ Triangle bandage under injured arm;
over uninjured shoulder
ƒ Tie ends of sling at side of neck – pad
under knot
ƒ Secure arm with cravat under good
arm
 Fractures
Splinting and Immobilizing Sling (Cont.)

Splints Magazine

Shirt Flap Shirttail

 Splinting and Immobilizing (cont.)
Must be a straight line break Can be formed to shape of
deformity

Be careful of temperature
change
Head Injuries
A sharp blow to the head could result in a concussion, a jostling of the
brain inside its protective, bony covering. A more serious head injury
may result in contusions, or bruises to the brain.

OTHER SYMPTOMS TO LOOK FOR IF YOU SUSPECT A VICTIM MAY

HAVE A BRAIN INJURY:
1. clear or reddish fluid draining from the ears, nose, or mouth
2. difficulty in speaking
3. headache
4. unequal size of pupils
5. pale skin
6. paralysis of an arm or leg (opposite side of the injury) or face (same
side of the injury)

PROPER CARE:
1. While waiting on help to arrive, keep the victim lying down in the
recovery position
2. Control any bleeding, and be sure that he is breathing properly.
3. Do not give the victim any liquids to drink.
4. If the victim becomes unconscious for any amount of time, keep track of
this information so that you can report it when medical help arrives.
Neck and Spinal Injury Causes

„ Improper Postures
„ Falls
„ Blunt trauma
„ Penetrating trauma to head, neck, or torso
„ Springboard or platform diving accidents
Neck or Spinal Injuries
Signs and Symptoms
„ Tenderness and/or pain at injury site
„ Soft tissue injuries with spinal injury
„ Numbness, tingling or weakness in arms
or legs
„ Difficulty breathing
„ Paralysis
Neck or Spinal Injuries
Protect Spine
Manual Stabilization
„ Hold patient’s head still
„ Maintain head in position found
Do not turn to either side
Do not tilt forward or backward
Neck or Spinal Injuries
Protect Spine
Manual Stabilization
„ Kneel behind the patient
„ Spread your fingers and thumbs around
the sides of the head
„ Hold the head steady
Neck and Spinal Injuries
CARE AND TREATMENT
•ABC
•extreme care in initial
examination — minimal
movement
•urgent ambulance transport
•apply cervical collar
•treat for shock
•treat any other injuries
•maintain body heat
•if movement required, 'log
roll' and use assistants
•always maintain casualty's
head in line with the shoulders
Lifting Techniques
Two person carry

Lift & roll

4 person straddle
Snake and Spider Bites
Rattlesnake Copperhead Black Widow Brown Recluse

Limit activity
Constricting bandage above
Cold application
Advanced medical attention
Poisoning
U Assess the scene for clues
and safety.
U Get victim away from poison if
necessary.
U Provide care for any life
threatening conditions.
U Check Material Safety Data
Sheet (MSDS).
U Notify medical staff or on-call
Doctor.
U Call the Poison Control Center
Anaphylaxis

Definition:
An immediate*, life threatening systemic
allergic* reaction
Anaphylaxis
Triggers (examples)

„ Foods: peanuts, tree nuts, shellfish, fish,

milk, eggs, food additives
„ Medications: antibiotics, muscle relaxants,
seizure medications, beta-blockers
„ Insect stings: bees, wasps, hornets, yellow
jackets, fire ants
„ Exercise and cold
 Anaphylaxis Symptoms

Onset
„ Seconds
„ Up to 2 hours after incident
„ Reaction may recur up to 24 hours after
first reaction (biphasic reaction)
Anaphylaxis Symptoms (General)

„ Headache
„ Sense of impending doom
„ Loss of consciousness
Anaphylaxis
Epithelial Reactions

„ Hives: Itch, Swell

„ Skin
„ Lips
„ Tongue
„ Throat
„ Hands
„ Feet
Anaphylaxis
Respiratory Tract Reactions
„ Sneezing
„ Nasal congestion
„ Runny nose
„ Wheezing
„ Coughing
„ Shortness of breath
Anaphylaxis
Gastrointestinal Tract Reactions

ƒ Nausea
ƒ Abdominal cramps
ƒ Vomiting
ƒ Diarrhea
 Anaphylaxis
„ Do NOT minimize an allergic reaction
„ DEATH can occur within minutes
Anaphylaxis Treatment
„ Obtain medical attention regardless of
response
„ Treat shock
„ Oxygen
„ Ice pack locally if applicable
„ Tourniquet
„ Antihistamines (only by Dr.)
 REMEMBER!!!
UNIVERSAL PRECAUTIONS:
à The routine use of appropriate
barrier precautions to prevent skin
and mucous membrane exposure
when contact with blood or other
body fluids of any individual may
occur or is anticipated.
à Universal Precautions apply to
blood and to all other body fluids
with potential for spreading any
infections.
Requirements for OHC
What Law says?
„ According to Indian factories Act, 1948
OHC is must for every factory having more
than 500, and additional one per 1000
Qualified M.B.B.S. doctor, with having
minimum three months training in
occupational health
Other qualified paramedical staff
 General Requirements
„ Qualified &Trained Medical and Paramedical
Staff
„ Well equipped medical center
„ Well ventilated & equipped treatment room(s)
„ Emergency Response kit
„ Complete First Aid kit
„ Portable oxygen unit
„ Color blindness test
„ Medicine inventory as per the requirement
„ Communication with nearest city/town medical
center
Industry specific requirements
„ Spirometer
„ Audiogram
„ Chemical specific antidote kit
OHC Accessories
„ Well equipped OHC should have at minimum:
One 4-wheeled, multi-level ambulance cot, Standard
cot mattress with waterproof cover
One (1) hand-operated bag/mask ventilation unit with
adult mask(s), capable of use with oxygen supplies
(disposable, single use units recommended).
Portable oxygen unit
Padded board splints
Axillary/ foldable stretcher
Poison Antidote kit (depending on chemical toxicity)
Burn sheets
Microsoft Word
Document
Ambulance Vehicle Requirement
Warning Lights Emergency warning beacon, visible 360
degrees
Audible Warning A siren, audible 500 feet to the front.
Devices
Maps Street directories and road maps
Fire Extinguishers Two (2) adequately charged fire extinguishers, five
(5) pound C02 or dry powder, approved, one of
which shall be mounted in the patient compartment
Hand lights Two (2) 6-volt hand lights, bulb type, or two bulb
type hand lights with rechargeable battery of 4.5
volts minimum.
Chock Blocks Two (2) vehicle chock block.
Ambulance Vehicle Requirement
(Cont.)
Hazardous Material One (1) National Institute of Occupational Health
Guidebooks and Safety (NIOSH) Pocket Guide to Chemical
Hazards, current edition.
Protective Equipment Personal protective equipment adequate to
safeguard crew from anticipated exposures

Road reflectors Six (6) DOT approved triangular reflectors, or

equivalent

Protective Masks Two (2) respirators, conforming to OSHA Blood

borne Pathogens Standard 29 CFR 1910.1030
(HEPA ).
Mock drills

„ Regular Mock drills

„ Transportation of causality to OHC in three
minutes
„ Assign responsibility
 OHC Activities
„ Pre employment medical examination
„ Periodic medical examination
„ Exit medical examination
„ Medical Surveillance Program
„ Respiratory Protection Program
„ Hearing Conservation Program
„ Immunization Program
„ Health Awareness training programs
„ Health record maintenance
Blood borne pathogens and control
What is Bloodborn Pathogen
(BBP)?
„ Microorganisms carried in blood that can cause
disease in humans
Transmission of BBP
„ Contact with another person’s blood or
bodily fluid that may contain blood
„ Mucous membranes - eyes, mouth,
nose
„ Non-intact skin
„ Contaminated sharps/needles
The Fact of BBP
Exposure Determination
In which job classifications here are ...
• Employees occupationally exposed?
– Nurses and Physicians in Medical
centers
− Emergency response team, first
aiders
Equipment and Safer Medical
Devices
„ Sharps disposal containers
Closable
Puncture-resistant
Leak-proof
Labeled or color-coded
Upright, conveniently placed in
area where sharps used
Do not overfill
Exposure Controls –
Safe Work Practices
• Don’t bend, recap, remove, shear or
break needles or other sharps
• Place contaminated reusable sharps
immediately in appropriate containers
until properly decontaminated
• Wash hands after each glove use and
immediately or ASAP after exposure.
• Remove PPE before leaving work
area.
Exposure Controls –
Blood or OPIM Spill Clean Up
• Remove glass and other sharps materials using
brush and dust pan, forceps, hemostat, etc.
• Do not use your hands.
• Properly discard all materials into sharps or
puncture-resistant bio-hazardous waste container
• Use absorbent material to soak up spilled materials
• Clean area with 10% bleach
• Saturate the spill area with disinfectant. Leave for
10 minutes (or as specified by product
manufacturer) or allow to air dry
• Dispose of paper towels and cleaning materials into
bio-hazardous waste containers
Remove Contaminated Gloves
Safely.
„ Grasp near cuff of glove
and turn it inside out.
Hold in gloved hand.
„ Place fingers of bare
hand inside cuff of gloved
hand and also turn inside
out and over first glove.
„ Dispose gloves into
proper waste container.
„ Clean hands thoroughly
with soap and water.
Exposure Control - Personal
Protective Equipments.
• Gloves
• Masks and eye protection
• Resuscitation devices
• PPE Rules:
– Always check PPE for defects or
tears before using
– Remove defective PPE

– Remove PPE before leaving a

contaminated area
– Do not reuse disposable PPE
Questions ? ? ?
Thank You