CITY OF PHILADELPHIA RISK MANAGEMENT DIVISION Safety Directive # A-14 Revision #1 February 20, 2006

Transcription

1 CITY OF PHILADELPHIA RISK MANAGEMENT DIVISION Safety Directive # A-14 Revisin #1 February 20, 2006 Title: First Aid, Cardipulmnary Resuscitatin (CPR), and Other Emergency Care Purpse This dcument prvides prcedures t make immediate medical assistance available t emplyees r visitrs wh are injured r becme suddenly ill in the wrkplace. Additinal guidelines will prvide a general framewrk fr initiating a design prcess fr respnding t medical emergencies at City f Philadelphia wrk sites where there is a need r desire fr internal care via n-site services. The key elements cited in these guidelines are intended t prvide a fundatin upn which individually tailred prgrams are develped and implemented. Intrductin In the event f a medical emergency in the wrkplace, a Citywide prgram is in place designed t prvide apprpriate medical care. Medical facilities are present and within clse prximity t many City f Philadelphia wrk sites [refer t the Designated Health Care Prvider Panel fr yur area]. The City can facilitate the transprt f emplyees t a medical facility and/r utside emergency assistance can arrive within three t five minutes frm the mment f initial incident ccurrence t the administratin f emergency care at mst facilities. Therefre, the City is nt required t train emplyees in first aid at mst facilities and wrk sites. Hwever, thse wrk sites nt meeting this level f respnse shuld create a prgram t prvide immediate emergency assistance t the victim such as first aid, CPR, r ther emergency care, if necessary. Citywide Injury Respnse Prcedures fr all Departments Nn- Emergencies 1. Emplyees, wh incur an injury r illness as a direct result f their jb respnsibilities, must reprt the injury t their immediate supervisr. 2. Emplyees wh need treatment must btain a referral slip fr evaluatin frm their supervisr r Safety Office and treat at ne f the City s designated medical prvider sites. 3. When an injury r illness is determined t be wrk related, fllw up treatment must be prvided at the City s designated prvider site. 4. Emplyees, wh are treated and nt hspitalized, must btain a cpy f an encunter frm (prvided by the City s designated prvider site) and prvide it t their Department. This prvides the physician s recmmendatins and any restrictins n wrk duty status. 5. Emplyees shuld nt prvide their private insurance infrmatin t the City s designated prvider site while being treated fr a wrk-related injury. First Aid, CPR, & Other Emergency Care Revisin #1 - February 20, 2006 Page 1 f 2

2 Emergencies In serius emergencies, the injured emplyee shall be taken t the nearest hspital fr treatment r emergency medical services (EMS) shuld be called. The fllwing prcedures shuld then be fllwed as sn as medically pssible: 1. The immediate supervisr must be ntified as sn as pssible. 2. If an emplyee is treated at a hspital that des nt appear n the City s panel listing, and has been released with restrictins, he r she must reprt directly t a City prvider site, with a referral, the next scheduled business day. 3. The emplyee and supervisr must cmplete an injury reprt within 48 hurs even if an emplyee des nt require fllw-up treatment. Departmental Medical Emergency Respnse Prgram Departments may need r additinally want t prvide n-site services fr the administratin f emergency medical care until advanced medical services are prvided fr sme lcatins. It is imprtant t nte that utcmes f medical emergencies in the wrkplace depend nt nly n the severity f the injury r illness, but als the rendering f immediate first aid, CPR, r ther emergency care (i.e. AEDs). Prmpt prperly administered first aid care can mean the difference between life and death, rapid vs. prlnged recvery, r temprary vs. permanent disability. Given the ptential psitive impact additinal immediate care can prvide, there are significant advantages t having a detailed medical emergency respnse prgram in place. Thse departments with such prgrams shuld include the fllwing majr elements: 1. Evaluate the need r desire t prvide first aid/cpr/r ther emergency care n site; then identify and cmmunicate t emplyees hw n-site and/r utside emergency medical care will be prvided. On-site services may be necessary if respnse frm utside emergency medical assistance is anticipated t be lnger than 3 t 5 minutes. Alternatively, n-site care may als be instituted as a desire t imprve the utcme f medical emergencies. 2. Prvide written and active supprt f the Prgram by department leadership. 3. Obtain medical directin and versight ver the prgrams. 4. Develp departmental/facility standard perating prcedures (SOPs) and prtcls fr an emergency respnse plan, including a ntificatin system t activate respnders. (i.e. ne persn at the scene shuld cntact a central cmmand center, if available, t alert them f an incident and subsequently cntact fully trained medical respnders t cme t the scene) 5. Outline integratin with facility security and emergency medical services (EMS) systems. 6. Determine what persnnel will be designated and trained t respnd t medical emergencies, if any. Vlunteers r assigned persnnel shuld prvide adequate cverage fr the wrk site and wrk shifts. 7. Train/certify and retrain designated persnnel in first aid, cardipulmnary resuscitatin (CPR), and use f any emergency medical treatments available (i.e. autmated external defibrillatrs [AED]). 8. Develp a dcumentatin/reprting system fr incidents and peridic review f the prgram during which revisins can be made where apprpriate t assure quality and perfrmance. 9. Ntify emplyees f the Citywide wrkplace Medical Emergency Actin Plan (See Appendix 1) via distributin, psting, r training. First Aid, CPR, & Other Emergency Care Revisin #1 - February 20, 2006 Page 2 f 2

3 Appendix 1 ( Citywide Wrkplace Medical Emergency Actin Plan )

4 CITY OF PHILADELPHIA OFFICE OF THE DIRECTOR OF FINANCE RISK MANAGEMENT DIVISION CITYWIDE WORKPLACE MEDICAL EMERGENCY ACTION PLAN IF SOMEONE BECOMES SERIOUSLY ILL OR INJURED AT WORK In the case f wrkplace medical emergencies such as emplyee burns, seizures r uncnsciusness, untrained individuals may unintentinally endanger themselves and thse wh they are trying t help. Fr this reasn, it is generally wise t leave medical rescue wrk t thse wh are trained, equipped and certified in the medical field. Hwever, a Wrkplace Medical Emergency Actin Plan is helpful fr knwing what t d in the event f a medical emergency in yur wrkplace. Because medical facilities are present and within a clse prximity t many City f Philadelphia wrksites, the City can facilitate the transprt f emplyees t an infirmary, clinic, r hspital, and/r utside emergency assistance can arrive within the alltted times (3- t 4-minute respnse time frm an incident s ccurrence t the administratin f first aid) fr mst wrk sites, and therefre, the City is nt required t train emplyees in first aid at thse wrk sites. In general, shuld an emplyee be injured r becme ill at wrk r during the curse f wrkrelated events, r when in dubt, call (r specified 911 sequence frm City phne lines). 1. Stay calm. D nt put yurself in danger. 2. Get Help. Yell fr smene t help yu. 3. Call fr help (1-911 frm City wned facilities r frm leased facilities). Smene shuld stay with the victim and smene else shuld call 911. Nte: If alne, yu may have t leave the victim t call fr help, but the victim will benefit frm yu ging if n ne else can call. 4. Prvide the fllwing infrmatin t the 911 dispatcher: a. Yur name b. Yur phne number c. Lcatin f the persn needing help. Give detailed directins (i.e., building, flr, rm #) d. Describe what happened e. Describe the injuries and the cnditin f the victim. f. In sme situatins, stay n the phne s the persn can tell yu what t d while help is n the way. D nt hang up until tld t d s by the dispatcher. 5. Immediately utilize yur department/facility s emergency respnse prtcl t crdinate care until Emergency Medical Services (EMS) arrives. Otherwise, ask if anyne nearby is trained in first aid r CPR. See if they can prvide assistance. 6. D nt mve the victim unless he/she is in danger f further serius injury (e.g., fire, imminent structural failure, etc.). If yu must, mve the victim t a safer area because f dangerus physical cnditins: Pull n the cllar f the shirt r pull the victim frm underneath bth shulders with neck cradled in yur arms. Lg rll if yu need t turn the victim ver. Supprt the neck in case f a spinal crd injury. D nt pull the bdy sideways D nt twist the bdy when turning the victim ver. 7. If trained in first aid, prvide apprpriate care; cardipulmnary resuscitatin (CPR), start resuscitatin when needed; r ther emergency care, prvide necessary assistance. 8. Stay with the victim until help arrives.

5 AFTER CALLING FOR HELP BLEEDING External bleeding frm an pen wund ccurs frm the rupture f capillaries, arteries r veins. After calling 9-1-1, the caller shuld await instructins frm the dispatcher and nt hang up until the dispatcher says t d s. The persn wh remains with the victim may perfrm simple tasks that culd prevent the victim frm serius bld lss, pain and/r future cnsequences frm the injury/illness. The fllwing are a few specific injuries/illnesses that can be aided until further instructin is given by the 911- dispatcher, and/r trained medical help arrives. BURNS In the event f a skin burn, the fllwing simple tips culd decrease the victim s immediate pain and prevent further damage t the skin. Run cl water ver a small burn. D nt apply ice, intment/cream r butter. D nt remve clthing stuck t the skin. SEIZURE A seizure is the result f an abnrmal activity f the brain s cells. The victim will prbably shake and be unable t speak. Assist persn t lie dwn and cushin the victim s head (a rlled twel r jacket wrks well). Remve any bjects arund r frm the victim that culd injure the shaking persn. If the persn vmits, rll them nt their side t prevent chking. D nt try t hld the persn dwn t stp the shaking. D nt put any bjects in the persn s muth (e.g., liquid, fd, r inanimate bject). Capillary bleeding The mst cmmn type in which bld cmes frm capillaries clse t the skin Usually clts and stps by itself The least serius and mst easily cntrlled Arterial and Venus bleeding These are the mst serius types and must be cntrlled. Arterial is the mst dangerus because bld is lst at a fast rate. The key is t stp r slw dwn the bleeding by: If pssible, the bdy part that is bleeding shuld be elevated abve chest level. Apply pressure t the wund with a piece f clean clthing, gauze r a glved hand. Avid cntact with bld and/r bdily fluids, especially t the eyes, muth and nn-intact skin r pen wunds. D nt use direct pressure n an eye injury, a wund with an embedded bject, r a skull fracture. D nt remve an impaled bject. D nt remve a bld-saked cmpress material. Apply anther cmpress n tp and keep pressing. References: 1. US Department f Labr, Occupatinal Safety and Health Administratin (OSHA), 29 CFR , Subpart K, Medical Services and First Aid 2. US Department f Labr, OSHA 3088, Hw t Plan fr Wrkplace Emergencies, 2001 (revised) 3. Natinal AG Safety Database, First Aid/First Respnder, d000200/d000155/firstaid.html 4. Natinal Safety Cuncil, First Aid and CPR Standard, 4 th Editin, 2001

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