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What should not be in a medical box?

Tablets and medication It is recommended that tablets and medicines should not be kept in the first-aid box. Some workers carry their own medication that has been prescribed by their doctor (eg an inhaler for asthma).

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These FAQs are aimed at employers, dutyholders, first-aiders and training organisations.

Please note that FAW refers to 'first aid at work' and EFAW to 'emergency first aid at work'. What is an appointed person? When an employer's first-aid needs assessment indicates that a first-aider is unnecessary, the minimum requirement is to appoint a person to take charge of first-aid arrangements. The roles of this appointed person include looking after the first-aid equipment and facilities and calling the emergency services when required. They can also provide emergency cover, within their role and competence, where a first-aider is absent due to unforeseen circumstances (annual leave does not count). Do appointed persons need to undertake first-aid training? To fulfil their role, appointed persons do not need first-aid training. However, emergency first-aid training courses are available. What training is required for using a defibrillator? Health and safety legislation does not require you to have an automated external defibrillator (AED) in your workplace. Where an employer has identified through their needs assessment that they wish to provide an AED in the workplace, then the Provision and Use of Workplace Equipment Regulations 1998 (PUWER) apply. For the purpose of complying with PUWER in these situations, the employer should provide information and written instructions, for example from the AED's manufacturer, on how to use it. However, fuller training is likely to make the user more confident and is now an integral part of the syllabus for FAW and EFAW courses. What is the first-aid treatment for an electric shock? See HSE's poster: Electric shock: first-aid procedures What should a first-aid box in the workplace contain? The decision on what to provide will be influenced by the findings of the first-aid needs assessment. As a guide, where work activities involve low hazards, a minimum stock of first-aid items might be: a leaflet giving general guidance on first aid (for example, HSE's leaflet Basic advice on first aid at work); individually wrapped sterile plasters (assorted sizes), appropriate to the type of work (hypoallergenic plasters can be provided if necessary);

sterile eye pads;

individually wrapped triangular bandages, preferably sterile;

safety pins;

large sterile individually wrapped unmedicated wound dressings;

medium-sized sterile individually wrapped unmedicated wound dressings;

disposable gloves (for advice on latex gloves please see Selecting latex gloves) This is only a suggested contents list. Employers may wish to refer to British Standard BS 8599-1 which provides further information on the contents of workplace first-aid kits. Whether using a first-aid kit complying with BS 8599-1 or an alternative kit, the contents should reflect the outcome of the first-aid needs assessment. It is recommended that you don't keep tablets and medicines in the first-aid box. More advice is given in HSE's free leaflet: First aid at work: your questions answered. How often should the contents of first-aid boxes be replaced? Although there is no specified review timetable, many items, particularly sterile ones, are marked with expiry dates. They should be replaced by the dates given and expired items disposed of safely. In cases where sterile items have no dates, it would be advisable to check with the manufacturers to find out how long they can be kept. For non-sterile items without dates, it is a matter of judgement, based on whether they are fit for purpose. What first-aid equipment should be provided? Once an assessment of first-aid needs has been carried out, the findings can be used to decide what first-aid equipment should be provided in the workplace. The minimum requirement is a suitably stocked first-aid box, see FAQ 'First-aid box'. The assessment may indicate that additional materials and equipment are required such as scissors, hypoallergenic microporous adhesive tape, disposable aprons and individually wrapped, moist wipes. They may be put in the first-aid box or stored separately. If 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. When the seal has been broken, containers should not be kept for reuse. Containers should also not be used beyond their expiry date. Do I need to make first-aid provision for members of the public? The Health and Safety (First-Aid) Regulations 1981 do not require employers to provide first aid for members of the public. However, many organisations such as schools, places of entertainment, fairgrounds and shops provide a service for others. HSE strongly recommends that employers include the public in their first-aid needs assessment and make provision for them. Do the Health and Safety (First-Aid) Regulations 1981 cover large events such as concerts? Only in so far as employers are responsible for providing first aid for their employees. At events such as concerts, it is the event organiser's responsibility to ensure the availability of medical, ambulance and first-aid assistance as appropriate for all those involved.

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I have employees who travel regularly or work elsewhere, what should I do about first-aid provision for them? Employers are responsible for meeting the first-aid needs of their employees working away from the main site. The assessment of first-aid needs should determine whether: those who travel long distances or are continuously mobile should carry a personal first-aid box; and

employees should be issued with personal communicators/mobile phones.

How do the Health and Safety (First-Aid) Regulations 1981 relate to first-aid provision in schools? Employers are responsible for the provision of appropriate first-aid equipment, facilities and first-aid personnel in respect of their employees – this includes schools, as they are workplaces. Although the Regulations do not require employers to provide first aid for anyone else, HSE strongly encourages employers to consider non-employees when carrying out their first-aid needs assessment and to make provision for them. There is a British Standard BS 8599-1 for first aid kits, it is not a regulatory requirement under the Health and Safety (First-Aid) Regulations 1981 to purchase kits that comply with this standard. Instead the contents of a first aid box is dependent on an employers first aid needs assessment. This means for employers following a needs assessment the options are: 1. Within your workplace you have access to a first aid kit whose contents complies with BS 8599-1 and matches or exceeds the findings from your needs assessment; or 2. Within your workplace you have access to a first aid kit whose contents matches the findings from your needs assessment but does not comply with the requirements of BS 8599-1. Do I need to provide a room for first aid? You should provide a suitable first-aid room(s) where your first-aid needs assessment identifies this as necessary. What should be kept in the first-aid room? Typical examples of the equipment and facilities a first-aid room may contain are: a sink with hot and cold running water;

drinking water and disposable cups;

soap and paper towels;

a store for first-aid materials;

foot-operated refuse containers, lined with yellow, disposable clinical waste bags or a container suitable for the safe disposal of clinical waste;

an examination/medical couch with waterproof protection and clean pillows and blankets;

a chair;

a telephone or other communication equipment; and

a record book for recording incidents attended by a first-aider or appointed person. Who should have access to the first-aid room? If possible, the room should be reserved specifically for providing first aid and a designated person (first-aider or appointed person) should be given responsibility for supervising it. The room should be easily accessible to stretchers and be clearly signposted and identified. What signs should I have? All first-aid boxes should have a white cross on a green background. Similarly, first-aid rooms should be easily identifiable by white lettering or a white cross on a green background. Where should I put them? Signs should be placed where they can be seen (not obstructed from view) and easily identified. How many first-aiders do I need? The findings of your first-aid needs assessment will help you decide how many first-aiders are required. There are no hard and fast rules on exact numbers and you will need to take into account all the relevant circumstances of your particular workplace. See the table in the leaflet First aid at work assessment tool Can legal action be taken against first-aiders? It is very unlikely that any action would be taken against a first-aider using the first-aid training they have received. HSE cannot give any specific advice on this issue as it does not fall within HSE's statutory powers. It is recommended that you seek legal advice, or advice from your employer's insurance brokers on whether their policies cover first-aiders' liability. When dealing with a casualty, how can the risk of cross-infection be minimised? Training courses for first-aiders in the workplace highlight the importance of preventing cross-infection in first-aid procedures. Particular concerns have been raised about the possibility of first-aiders becoming infected by a blood-borne virus (including HIV, hepatitis B virus and hepatitis C virus) while performing first aid. Blood-borne viruses addresses this issue and advises on steps that can be taken to reduce the risk of infection.

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Do I need to record incidents requiring the attention of a first-aider? It is good practice to provide your first-aiders and appointed persons with a book in which to record incidents they attend. The information can help you identify accident trends and possible areas for improvement in the control of health and safety risks. It can be used for reference in future first-aid needs assessments. The record book is not the same as the statutory accident book though the two might be combined. Employers, self-employed people and those in control of premises have a duty to report some accidents and incidents at work under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR). Further information is given at RIDDOR. What information should be recorded? Useful information to record includes: the date, time and place of the incident;

the name and job of the injured or ill person;

details of the injury/illness and what first aid was given;

details about what happened to the person immediately afterwards (eg went back to work, went home, went to hospital); and the name and signature of the first-aider or person dealing with the incident. Who is responsible for keeping the records? It is usually the first-aider or appointed person who looks after the book. However, employers have overall responsibility. Are first-aiders allowed to give tablets and medication to casualties? First aid at work does not include giving tablets or medicines to treat illness. The only exception to this 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 should not be kept in the first-aid box. Some workers carry their own medication that has been prescribed by their doctor (eg an inhaler for asthma). If an individual needs to take their own prescribed medication, the first-aider's role is generally limited to helping them to do so and contacting the emergency services as appropriate. However, this does not apply to the administration of prescription only medication specified in Schedule 19 of the Medicines Regulations 2012, where this is for the purpose of saving life in an emergency. Adrenaline 1:1000 up to 1 mg for intramuscular use in anaphylaxis is an example. Where a first aid needs assessment identifies that Schedule 19 medication may be required to be administered in an emergency, the employer should consider providing workplace first aiders with additional training in their use. What about the offshore industry? The use of tablets and medication in the context of first-aid provision in the offshore industry is dealt with separately (see sections on offshore work under 'Training').

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