First Aid. Introduction. What is first-aid at work? The minimum first-aid provision. What is an appointed person? What is a first-aider?

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1 First Aid Introduction The Health and Safety (First-Aid) Regulations (NI) 1982 require that adequate and appropriate equipment, facilities and personnel are provided to enable first-aid to be given to employees who are injured or become ill at work. Although these Regulations apply to the provision of first-aid for employees, schools should consider carefully the likely risks to pupils and visitors and make allowance for them when drawing up policies and deciding on the numbers of first-aid personnel. What is first-aid at work? People at work can suffer injuries or fall ill. It doesn t matter whether the injury or the illness is caused by the work they do or not. What is important is that they receive immediate attention and that an ambulance is called in serious cases. First-aid at work covers the arrangements you must make to ensure that this happens. It can save lives and prevent minor injuries becoming major ones. The minimum first-aid provision 1 A suitable stocked first-aid box. 2 An appointed person to take charge of first-aid arrangements. 3 Provision of information to employees on first-aid arrangements. What is an appointed person? An appointed person is someone who: Takes charge when someone is injured or becomes ill, including calling an ambulance if required; and Looks after the first-aid equipment, e.g. restocking the first-aid box. To fulfil their role appointed persons do not need first-aid training, though emergency first-aid courses are available. Appointed persons are not first-aiders and should not attempt to give first-aid for which they have not been trained. Remember an appointed person should be available at all times that people are on school premises, and also off the premises whilst on school trips. This may mean appointing more than one, (see Educational Visits-Policy Practice and Procedure). What is a first-aider? A first-aider is someone who has undergone a HSENI approved training course in either first-aid at work or emergency first-aid at work and holds a valid certificate of competence. Both certificates are valid for a period of three years and it is a requirement that a two-day refresher course must be successfully completed for the first-aid at work course and a one day refresher for the emergency first-aid at work course within the three year period. If not the full first-aid course must be retaken.

2 A first-aider can undertake the duties of an appointed person. A non-teaching trained first-aider is entitled to an additional payment for undertaking first-aid duties. Information on current rates can be obtained from the Board s salaries and wages section. Following an assessment you may decide that one or more first-aiders are required. Points to consider? What size is the school and is it on a split site? Additional provision may be required if there is more than one building. The location of school in relation to emergency services? The time that it may take the emergency services to arrive must be considered. Consider any specific risks, for example, hazardous substances, dangerous tools and machinery. Adequate provision should be in place for practical departments such as science, technology, home economics and physical education. Specific needs. Are there members of staff or pupils with special health needs or disabilities? What age range does the school cater for? Accident statistics. Accident statistics can indicate the most common injuries, times, locations, and activities at a particular site. School trips. If a first-aider accompanies pupils off site, will there be adequate first-aid provision in the school? Out of school hours activities. There should be adequate provision for sports activities, clubs, etc. If the risks are significant, you may need to have one or more first-aiders. How many first-aiders or appointed persons do I need? The regulations do not specify the exact number of first-aid personnel required. Governing bodies and Principals should make a decision based on their own circumstances and a suitable and sufficient risk assessment. The following table is issued as a guide. For further advice please contact the Board s Health and Safety Adviser. Establishment Number of pupils Number of first-aiders Nursery/Primary pupils 1 first-aider and one relief (to provide cover in the case of absence) schools thereafter 1 additional person for every 200 pupils Secondary/High Schools/colleges Special schools pupils 1 first-aider for each practical department i.e. Technology, PE, Home Economics and Science Contact the Board s Health and Safety Adviser for advice First-aid training The Board may arrange first-aid at work training (qualified first-aider) for non-teaching staff designated as the school s first-aider.

3 What should I put in the first-aid box? First-aid boxes should contain only those items which a first-aider has been trained to use. There is no mandatory list of items to be included in a first-aid container. As a guide a minimum stock of first-aid items would be: One guidance card; Twenty individually wrapped sterile adhesive dressings (assorted sizes) appropriate to the work environment; Two sterile eye pads; Four individually wrapped triangular bandages, preferably sterile; Six safety pins; Six medium individually wrapped sterile unmedicated wound dressings; Two large sterile individually wrapped unmedicated wound dressings; and A pair of disposable gloves. The means assessment may indicate that additional materials and equipment are required, for example, scissors, adhesive tape, disposable aprons and individually wrapped moist wipes. Where mains tap water is not readily available for eye irrigation, at least one litre of sterile water or sterile normal saline (0.9%) in sealed disposable containers should be provided. Once the seal has been broken, the containers should not be kept for re-use. Sterile eye irrigation liquids should not be used beyond their expiry date. The administration of tablets and other types of medicine is not a provision under first-aid at work. The only exception is where aspirin is used when giving first-aid to a casualty with a suspected heart attack in accordance with currently accepted first-aid practice. It is recommended that tablets and medicines are not kept in the first-aid container. Travelling first-aid containers Before undertaking any off site activities an assessment should be made of what level of first-aid provision is needed. There is no mandatory list of items to be included in a travelling first-aid kit. They might typically contain: A leaflet giving general advice on first aid; Six individually wrapped sterile adhesive dressings; One large sterile unmedicated dressing; Two triangular bandages; Two safety pins; Individually wrapped moist cleansing wipes; and One pair of disposable gloves. Additional items may be necessary for specialised activities. How many first-aid boxes do I need? Every school should provide at least one fully stocked first-aid container. It is important that first-aid boxes are checked on a weekly basis and restocked as required. The assessment of a school s first-aid needs should include the number of first-aid containers. Additional first-aid containers will be needed for split-sites, distant sports fields or playgrounds, any other high-risk areas and off site activities. All firstaid containers must be marked with a white cross on a green background.

4 Personal liability The Board will legally indemnify their staff in the event of a claim arising due to alleged negligence in the administration of first-aid in the course of their duties. Automated External Defibrillator (AED) An AED is a safe, easy to use, very effective, compact, portable device which is designed to be used by lay persons to deliver a high energy electric shock to a victim of Sudden Cardiac Arrest (SCA). It automatically diagnoses the heart rhythm, and determines if a shock is needed. The machine guides the operator through the process by verbal instructions and visual prompts, which are helpful for responders who are hard of hearing or are operating in noisy environments. They are safe and will not allow a shock to be given unless the heart s rhythm requires it. Procurement of an AED The information gathered from the school s risk assessments on the identifiable hazards present, and the possible harmful consequences for staff and pupils, can help the school carry out their assessment of first-aid needs, which would ascertain what equipment (including AEDs) would be required to provide adequate first-aid provision in your school. To help in deciding if you require an AED, and if yes, how many, you may wish to consider the following questions: What type of school-primary, Post-Primary, Special? It may take the emergency services several minutes from arrival at the main entrance to locate the victim on a large school site with several buildings or if the casualty is located on the upper floor of a building with no lift. Cardiac arrest can be triggered by a hard blow to the chest and can occur when playing contact sports. The emergency response time of your nearest emergency services. Consider effects which might lengthen normal response time e.g. snow A rapid response is vital if a victim of SCA is to have a chance of survival. How many pupils and members of staff are there in school? The higher the number of people there are, the greater potential risk of SCA. Have any of your pupils or staff been diagnosed with a heart condition? People with underlying heart disease are particularly vulnerable to SCA. Do you facilitate community use of your school, and how often? Adults are more likely to suffer SCA. Does the school have a lot of after-school activities, e.g. school shows, parents meetings, sports days, open evenings? There is a greater risk of SCA when there are large volumes of people concentrated in one area. The school should contact their board s procurement section if they decide to proceed with the purchase of an AED, as a five board contract is in place for the supply, delivery, and initial commissioning of AEDs. Placement The Resuscitation Council (UK), (RC(UK)), state that as a practical guide, an AED should be no further than two minutes brisk walk from the places where they are likely to be used. In order to achieve a good response time, priority should be given to areas of higher risk such as gymnasiums, sports fields, dining halls, cafeterias, assembly halls, and areas that are harder for the emergency services to reach. They should be easily accessible to both employees and also community users of the building in an emergency.

5 AED procedure It is important that everyone knows what they need to do in a SCA incident. The school should have put written procedures in place for staff. An example format is given below. When responding to SCA incidents and intervening with an AED the following steps should be taken: 1. Assess scene safety. Rescuers are volunteers and are not expected to place themselves at risk in order to provide aid to others. 2. Confirm unresponsiveness. 3. Activate system: a. At any public phone or mobile call 999. b. At any school phone call main office and alert them to the emergency and location of unconscious person. c. Main office staff will assign someone to retrieve AED and meet responder at scene of emergency. d. The office staff will assign someone to wait at school entrance to direct emergency services to the victim s location. 4. Responder will immediately commence CPR prior to the arrival of the AED. 5. Follow operating instructions for AED. 6. Continue with CPR and AED until either victim regains consciousness or the emergency services arrive. Care and management of the AED AEDs require minimal maintenance. Most perform regular self- checks, and will indicate with a visual or audible prompt if there is a malfunction or low battery charge. It is important to identify at least two persons within the school who will act as AED Co-ordinators, and who will be responsible for checking the AED on a regular basis, to ensure that it is ready for use at any time. Consideration should be given to ensure checks are carried out during school holidays. Training An AED can be used safely and effectively without previous training, and there may be times when trained members of staff are not immediately available to respond to a SCA. Provided a person is willing to use the AED they should not be prohibited from doing so. However, both the guidance to the first-aid regulations and RC(UK) state that users of AEDs should be appropriately trained. An AED information and awareness demonstration provided by a supplier would not be regarded as appropriate training. Regular refresher training should be carried out and a record kept of AED operator training. The number of people you will want to train to use an AED will be determined by the size and layout of your school and its operating hours. Consider: Staff members who are trained first-aiders; Those present when pupils are exercising such as physical education teachers, and coaches; People who can respond immediately (teachers may not be able to leave a classroom right away); Members of staff who are on site during after school events such as plays; Members of staff who are present during community use e.g. building supervisor; and Cover during periods of staff absences. There is a five board contract in place for the provision of AED training, and the school should contact their board s procurement section for details.

6 Post incident procedure and review There should be procedures in place detailing the actions to take after an incident such as: Downloading and transferring data from the AED; Replenishing supplies; Returning the AED to service; and Recording details of the incident on the employing authority s accident report form. It is also important after deployment of the AED to conduct a review of the event to learn from the experience. The post-event review should include an identification of actions that went well and the collection of opportunities for improvement. Further information can be found in the five board/ccms publication AED Guidelines for Schools.

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