One reason to work as hard as we do on safety and health is to get to zero accidents and eliminate the need to provide emergency injury care. However, even with an exceptional program, people still have need for emergency medical assistance. They may suffer an illness while at work. A pre-existing condition may result in additional trauma. An automobile accident may occur on the road in front of the plant or a natural disaster may cause injury to people.

In fact, the ability to assist people in need of medical attention is an important human consideration. The National Safety Council tells us that over 92 thousand people die from unintentional injuries annually and over 18 million suffer disabling injuries with a total cost to the economy exceeding $440 billion. Only a small percentage of these figures are a direct result of workplace injuries; but nearly all impact workers and their families in some way.

It is sometimes suggested that people should not get involved in assisting injured people. You'll do more damage, or you'll get sued. While that is a possibility, getting involved typically reduces severity and cuts costs and lost time significantly. There is considerable evidence to suggest that proper treatment at the time of an injury reduces further damage, prevents infection, avoids complications and has a significant positive psychological impact on the injured individual and on co-workers.

In a study of safety showers and emergency eye washes, it was found that rapid flushing at a properly designed and full-flowing emergency shower or eye station could often make the difference between major chemical burns and no apparent injury at all. To reap these benefits, however, the injured individual had to get immediately into the water stream and get totally drenched with a good flow of cool or cold water. Nearby hoses, personal showers, and squeeze bottles did not have the same positive effect.

In Canada, initiatives by St. John's Ambulance where all members of the community received first aid training interspersed with safety information resulted in dramatic reductions in injury frequency within the community. First aid knowledge, and the ability to use it, proved to have the side benefit of being an effective safety program.

As you might guess, provisions for competent medical aid are more than just good business. OSHA requires planning and effective performance in this area. If an infirmary, clinic, or hospital is not close by, then at least one of your people on each shift of work should be trained and competent to render first aid. Training in any certified community program is acceptable. As a general rule, OSHA looks for competence in CPR as well as the treatment of trauma injuries and such things as electrical shock. In many cases employers find that an employee is trained as an emergency medical technician or volunteer firefighter/first responder and that he/she will be happy to use their skills at the workplace.

The courts have ruled on some aspects of OSHA's first aid requirements. For example, the requirement that there be a clinic, infirmary, or hospital in "near proximity" has been interpreted to include a response by a competent emergency assistance. However, whether the person is taken to aid, or aid comes to the person, the courts have held that a response time of three to four minutes is necessary for suffocation, severe bleeding, or other life-threatening injury or illness. Where the injury is not life threatening, a fifteen minute response time is acceptable.

OSHA also requires that first aid supplies be sanitary and readily available for use by the trained personnel. If your people are working with chemicals or the potential for burns exists, then safety showers and eye baths are required near the areas of potential exposure. Everyone in the work area should be trained to use, or assist with, the emergency shower or eye bath. They should also be aware of the need for periodic testing of the equipment and the need to maintain clear access.