We have been asked by a number of our clients in the construction industry about providing first aid during the current COVID-19 outbreak.
Our First Aid trainers have pulled together some First Aid advice for Contractors undertaking key or essential works at this time.
Our advice is provided to support you in risk mitigation and provide some guidance for your nominated first aiders.
The Health and Safety (First Aid) Regulations 1981 require all construction sites to have a first aid box on site and an appointed and trained person to take charge of first aid arrangements. This obligation continues notwithstanding these times of social distancing.
Because of social distancing, contractors need to be aware that a first aider might refuse to provide first aid in the normal way because of the risk of contracting coronavirus. This could result in the injured person remaining unsupported. Equally, liability could attach if a first-aider was to contract COVID-19 whilst giving first aid.
We would expect that most first aiders may consider that checking somebody’s airway, or carrying out mouth to mouth resuscitation, is too a high risk. On that basis they may refuse to do it. The Resuscitation Council UK (RCUK) is in fact advising against mouth to mouth during the COVID-19 pandemic.
The RCUK offers this advice:
- Recognise cardiac arrest by looking for the absence of signs of life and the absence of normal breathing;
- Do not listen or feel for breathing by placing your ear and cheek close to the patient’s mouth. If you are in any doubt about confirming cardiac arrest. The default position is to start chest compressions until help arrives;
- Make sure an ambulance is on its way. If COVID-19 is suspected, tell emergency service when you call 999;
- If there is a perceived risk of infection, rescuers should place a cloth/towel over the victims mouth and nose. Then attempt compression only CPR and early defibrillation until the ambulance arrives;
- Put hands together in the middle of the chest and push hard and fast;
- Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of infection;
- If the rescuer has access to personal protective equipment (PPE) e.g. FFP3 face mask, disposable gloves, eye protection), these should be worn;
- After performing compression only CPR. All rescuers should wash their hands thoroughly with soap and water with alcohol-based hand gel being a convenient alternative; and
- They should also seek advice from the NHS 111 coronavirus advice service or medical adviser.
Administering first aid is simple. The steps to take in an emergency can be easily described to an injured or ill person so they can help themselves. For example, if they are bleeding heavily, you can ask them to apply pressure to the wound with whatever they have available.
This would be the same for burns – you could ask them to cool the burn under water for 20 minutes without you having to touch them.
If you do need to provide assistance to an individual who you are concerned may have coronavirus, wherever possible place the person in a location away from others.
Where there is no separate room, instruct bystanders who are not involved in providing assistance to stay at least 2 metres away from the casualty.
If barrier screens are available, these should be used.
It is important to remember first aid has always had to consider the risk of infection, not from coronavirus (COVID-19) but from other infections such as HIV, hepatitis and other viruses or infections which have the potential to harm.
Always follow the safety guidelines in relation to hygiene and personal protection when administering first aid, wash hands thoroughly before and after, wear disposable gloves and any other protective personal equipment you have access to e.g. aprons and masks.
Calling the Emergency Services
At the present the NHS and ambulance service are under tremendous strain. Consider whether you need to call 999 – this service is for life threatening emergencies such as unresponsive people, those with chest pain, breathing difficulties, severe allergic reactions or catastrophic bleeding.
If someone has to go to A&E remember the first aider should never be the one to transport them. If you suspect the person has coronavirus and needs to go to A&E contact NHS 111 first. Anyone attending A&E should, wherever possible, attend alone.
In general terms, construction companies should proceed on a risk based approach and, if the risk of limited first aid exists, control measures should be put in place.
For example, businesses should, amongst other things, give consideration to:
- Providing NHS style personal protective equipment (full face-fitted masks, eye protection, and medical gloves) to first aiders on site;
- Reducing the volume and type of work being conducted during this time (perhaps low risk operations only will continue);
- Checking that first aiders are comfortable to continue to act as first aiders in the current climate, and
- Making sure first aid equipment such as first aid kits, PPE, defibrillators, etc are available on site.
These and other measures may reduce the risk rating to an acceptable level on some projects and allow work to continue (perhaps at reduced volume). However, there may well be some projects where the risk of a first aider refusing to assist is too great, and a decision may need to be taken to suspend those projects accordingly.
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