EMERGENCY CONTACTS

Fire - In a fire situation, an ambulance will be sent as part of the emergency response, once the fire warden has informed the fire brigade of the threat on:

000

Poisons Information - There is a national telephone advice service on poisons and emergency treatment of victims of poisoning. Poisons Information is contactable from anywhere in Australia on:

13 11 26

Mobile Phone Access - If an emergency arises and a digital mobile phone is locked, the SIM card removed, or is out of local range (and hence the routine 000 number is not useable) it may still be possible to contact emergency services by dialling:

112

Contents

SCOPE

1.      The first aid services provided by the Australian National University are an important element of the University’s occupational health and safety program, facilitating first aid treatment for both:

• Injuries that may occur in the workplace (including fieldwork); and
• Acute personal sickness that may impact on staff members or students while at the ANU.
• University Sporting Activities are not covered by the procedure, but consideration should be given to having a first aid attendant and first aid kit at these events.

2.      First aid services are to be organised by Budget Unit management within managerial\geographic domains of the University and with first aid attendants trained at advanced and senior levels of proficiency within each domain.

3.      These procedures are consistent with the terms of the "Approved Code of Practice for First Aid in Commonwealth Workplaces", Comcare Australia, 1999, and "ACT First Aid in the Workplace - Code of Practice", ACT Workcover, May 2006.

RESPONSIBILITY OF BUDGET UNITS

4.      Budget Unit management refers to a School, Faculty, Division, Department, Cost Centre or Unit designated by the Vice-Chancellor as responsible for an activity of the University.

5.      Budget Unit management is responsible for the organising of first aid attendants, their training, and the provision of first aid kits, oxygen resuscitation equipment, and (when required) the first aid room within a domain.

6.      Where an ambulance is required to transport ill or injured staff members, the cost will be borne by the University.  Costs may be recoverable from workers compensation or insurances (fieldwork\overseas travel).

FIRST AID DOMAIN

7.      A first aid domain is defined with the object of providing first aid services for staff located within a Budget Unit or a group of Budget Units. A list of first aid domains is given in Appendix A.

8.      There shall be a minimum of four first aid attendants (senior\level 2) and two first aid attendants (advanced\occupational level 3) in each first aid domain.  This should provide good first aid service coverage considering staff absences and locations.  Additional first aid personnel may need to be considered (see item 16).

9.      Those Budget Units not included in a first aid domain should provide first aid services at a reasonable level and within the spirit established by these procedures. The minimum level of service would be a first aid attendant (senior\level 2) and a first aid kit for each 50 employees or part thereof.

SPECIFIC STAFF AND LOCATIONS

University Security, Facilities & Services

10.  All University Security staff shall be trained first aid attendants.

11.  If first aid is required after hours, Security can be contacted on ext. 52249.  In an emergency, a 000 call to the Ambulance service should be made.  If a second call is possible, please contact ANU Security - they can provide additional assistance and are able to direct the emergency services.

Fieldwork

12.   Each fieldwork party should carry an occupational first aid kit.

13.   All fieldwork parties must have at least one currently certified first aid attendant.  For fieldwork in remote areas, first aid attendants should be trained in remote area first aid.  Additional first aid attendants may be required when considering the risk associated with the fieldwork and numbers of people (such as with undergraduate field classes).  The Budget Unit should encourage regular participants in fieldwork to undertake certification in first aid and training in cardiopulmonary resuscitation.

14.   Additional details for remote area and fieldwork first aid can be found in Appendix C.

15.   A home-based workplace is not considered to be a remote or isolated workplace for the purpose of this procedure.

FIRST AID ATTENDANTS

16.   First aid attendants are those staff, approved by Budget Unit management for that role in the workplace, holding current first aid qualifications from an accredited first aid provider such as Parasol, St John Ambulance or Australian Red Cross.

17.   Additional first aid personnel may need to be considered depending on -

• the size and layout of the workplace,
• the number and distribution of employees including shift work arrangements,
• nature and specific hazards
• location of the workplace and its distance to the nearest available medical services.

When the number of staff within a budget unit or domain exceeds 250 employees, a minimum of one additional first aid attendant is required for each additional 50 employees, or part thereof.  Eg. 305 staff would require 8 first aid attendants.

18.   First aid attendants shall, at minimum, be trained to First aid attendant (Senior\Level 2) proficiency.  A budget unit or domain with research laboratories, workshops, kitchens (as a workplace, not an amenity) and other hazardous workplaces or with in excess of 200 employees require additional attendants to be trained to an advanced\level 3 proficiency (Advanced\Occupational Level 3) which includes qualification in the provision of oxygen resuscitation techniques.

19.   Budget Unit management may delegate first aid attendants (advanced\occupational level 3) to be responsible for the administration and maintenance of the first aid room and its contents, including appropriate equipment for oxygen resuscitation techniques and Automatic External Defibrillators.

20.   A first aid attendant is responsible for:

• Familiarising themselves with the location and responsibility for first aid kits in their workplace,
• Responding to requests for first aid assistance and to render assistance within their level of training and where appropriate, arrange for additional ambulance or medical assistance,
• Maintaining the first aid kit in a clean and tidy state, and stocked according to the budget units arrangements,
• Disposing of contaminated clinical wastes (eg. Discarded sharps, human tissue waste etc) in an appropriate manner.  This may involve the use of the biological spill kit (see kit contents), sharps container or other as per the Hazardous Waste Disposal Guidelines,
• Where a specific first aid treatment is anticipated within a budget unit or domain (eg hydrofluoric acid skin burns) the first aid attendants should be informed and be aware of the appropriate response.

FIRST AID TREATMENT

21.   Informed Consent - Before treating an injured person, their consent should be asked for and received prior to beginning care.   If the injured person is unconscious, or is unable to give consent due to their injuries, consent can be assumed and treatment commenced.   If the injured person is under 18 years old, consent from a parent or guardian should be sought.   If a parent\guardian is not present, treatment can be commenced.

22.   Treatment should NOT be commenced on an adult who declines an offer of help and appears to be of sound mind and able to make decisions.  If first aid treatment is declined, obtain signed documentation of refusal and enter into the first aid treatment book.  Inform local management of any refusal for treatment.

23.   For specific legal issues in first aid, go to;  http://www.parasolemt.com.au/legalissues.asp

Specific Techniques

24.   Electric Shock First Aid response - Any person who receives an electric shock, regardless of the voltage (if known), should have a medical assessment by a doctor as soon as possible.  Transport should be supported for the injured person to attend this medical assessment.  When a person receives an electric shock, the electricity is conducted through the whole body.  The injured person may receive significant burns or, without their knowing, the electric shock may interfere with the heart's electrical system.

25.   Oxygen resuscitation techniques- First aid attendants (advanced\level 3) shall be trained in the provision of oxygen resuscitation techniques.

26.   Defibrillation - the delivery of an electrical charge or ‘shock’ to the heart from a purpose designed device - Automatic External Defibrillator (AED).   Defibrillation is the only method of correcting ventricular fibrillation.  Defibrillation may be undertaken by persons with any basic first aid or CPR training who have completed the recommended training in the use of the defibrillation equipment.

27.   If a defibrillator is immediately at hand, its use takes precedence over cardiopulmonary resuscitation for patients in cardiac arrest.

28.   It is encouraged for First Aid Domains to have an Automatic External Defibrillator and appropriately trained staff.

RECORD KEEPING

29.   First Aid treatment information must be kept confidential and access restricted in accordance with the Privacy Act.

30.   Any staff administering first aid should record the details of treatment given to individuals in their First Aid treatment book, ensuring that records or notes are accurate, factual, contain relevant information, and are based on observations rather than opinions.

31.  Details should include:

• The name of the injured person
• The date, time, and place of the accident\incident
• The nature of the injury
• A brief description of the treatment given
• The name of the person administering treatment
• Where possible—details of how the incident\accident occurred and what the injured person was doing at the time the accident\incident occurred
• An injury\illness form (for example http://www.parasolemt.com.au/downloads/Injury%20Document.pdf) may also be beneficial.

32.   When recording information, follow these guidelines:

• Only use blue\black ink pen;
• Any corrections should be crossed out and initialled (do not use correction fluid e.g. ‘white out’ to correct any mistakes);
• Sign and date record;
• The treatment book must have non-removable pages.
• Completed\full books should be sent to OHSIM for keeping under appropriate archival arrangements.

33.   First aid attendants must ensure that University’s incident notification report form is completed.  The form is at: http://info.anu.edu.au/policies/Procedures/Human_Resources/OHS/Incident_Reporting.asp.  A copy of the treatment record for serious injuries, exposure to hazardous substances, and related to worker’s compensation cases should be sent to OHSIM for keeping with the injured staff’s personnel file and\or worker’s compensation record.

FIRST AID ROOM

34.  In high risk workplaces (with large workshops, research laboratories etc) a first aid room is required.  Recommendations for a first aid room can be found in Appendix B.  A first aid room is required for low-risk workplaces with more than 200 employees.

35.  Some low risk budget units may wish to maintain a ‘sick room’ or ‘treatment room’ for providing first aid services.  These rooms should comply with as many of the requirements of Appendix B as practical.

36. Within each first aid domain, procedures should be established for the operation of each first aid room, including whether the room is to be kept locked. If the room is to be kept locked, keys shall be provided to all first aid attendants approved for the domain.

37. The size of the first aid room provided should be sufficient for its purpose. The first aid room should be well illuminated and ventilated. The access door to the first aid room should provide easy access to injured people who may need to be supported or moved by stretcher or wheelchair. The first aid room should be located within easy access to toilets and should be marked with appropriate signage (refer Appendix B).

38.  Each first aid room and its contents should be under the administrative responsibility and control of a first aid attendant (advanced\level 3).  Appropriate contents are listed at Appendix B.

39.  A first aid room should not be used for other purposes.

FIRST AID KIT

40.  All first aid attendants shall have access to a first aid kit. The number of first aid kits required in each Budget Unit is related to the number of staff and first aid attendants.  Additional kits are required for isolated workplaces, fieldwork parties, and motor vehicles.  An assessment of the workplace and first aid code of practice [1] can provide additional clarification.  As a general guide, a minimum of 2 first aid kits is required for the first 50 staff and one additional kit for each additional 50 staff or part thereof.

41.  First aid kits should be appropriately located and accessible to all staff. First aid kits should not be kept locked, but kept under the supervision of first aid attendants.

42.  First aid kits should be green or white in colour and have a first aid sticker with the words "FIRST AID" visible on the kit.

43.  First aid attendants should be responsible for ensuring first aid kits are properly maintained and the contents replenished as necessary. A list of recommended contents for a first aid kit is given in Appendix B. Additional contents should be added to a first aid kit where specific hazards exist.

EMERGENCY MEDICAL SERVICES

44.  Obtaining Medical or Ambulance assistance—.  The first aid attendant should consider the relevant circumstances, injuries, potential for shock and other deterioration of the patient etc. when considering the medical or ambulance assistance required and method of transport to medical facilities. 

45.  The preferred method of transporting an injured person to hospital is in an ambulance.  Where an ambulance is required to transport ill or injured staff members , the cost will be borne by the University.

46.  Serious or Life-threatening Illness or Injury—First Aid attendants should not hesitate to call an ambulance if indicated.  Upon arrival of an ambulance, responsibility for the injured person is transferred to the attending ambulance officer(s).  The decision to transport the injured person to hospital rests between the ambulance officer(s) and the injured person.

47.  Unless there is no alternative, a first aid attendant is responsible for, and must not leave, the injured person until medical assistance arrives. Where possible, instruct another person (bystander) to:

• Dial 000
• Ask for the Ambulance Service
• When connected, describe the nature of the illness\injury
• State the number of casualties
• Describe the location of the injured person or a place to meet the ambulance
• Where required, arrange for another person to meet the ambulance
• Return and inform the first aid attendant of the expected arrival time of the ambulance.

48.  Minor Injury or illness—Where, due to a minor injury or illness, a person is unable to continue with their normal duties they may:
a.      Arrange for a family member or friend to collect them, or
b.      Choose to transport themselves home or to medical aid. (Note that any person receiving an electrical shock, however minor, must receive a medical assessment on the same day of the incident – see item 24).
c.      Where the first aid attendant believes that the injured person is unfit to make this decision, they are to advise the injured person to consider alternative arrangements.  The first aid attendant can advise suitable transport arrangements, but is not responsible for the transportation (costs or otherwise) of injured persons.
d.      If the injured person insists in declining treatment or following advice, they cannot be prevented from doing so.  The injured person should then be informed that this would be against first aid advice and at his or her own risk.  The injured person’ s intentions must be noted in writing, and if possible, signed by the injured person.  In the event an injured person refuses to sign, their intentions must wherever possible be witnessed and signed by a third person.

MEMORANDUM OF UNDERSTANDING

49.  The ANU has entered into a Memorandum of Understanding (MoU)with Calvary Hospital (Bruce, ACT) to assist in the appropriate treatment and outcomes for staff and students affected by accidents, especially those hazards that pose a high risk to exposed individuals (e.g. cyanide, arsine, hydrofluoric acid, risk group 3 biological agents, etc).

50. The MoU requires the following procedure for high hazard operations to be followed:
a.      ANU staff fully consider the implications of exposure\injury through the risk management process;
b.      hospital staff are made familiar with the major hazards of the University, the potential effect on health from exposure to such hazards, and the appropriate emergency medical treatments for exposed individuals;
c.      the hospital has, and will maintain or develop appropriate antidotes, antibiotics and emergency medical services for the hazards and their medical effects;
d.      the hospital will provide feedback for the incident investigations and assisting improvements.

51. The MoU and expected requirements of this process will be incorporated into the First Aid training for the ANU.

HIGH HAZARD OPERATIONS

52.  The Research Group Leader and associated Budget Unit must complete the following before high hazard operations can be conducted:
a.      Undertake a risk assessment on all hazardous operations.  Where the risks indicate special treatments (first aid, medical intervention, antivenene, antidotes etc) a thorough set of supporting documentation must be generated. The documentation must include relevant Material Safety Data Sheets, and “advice to doctor” information.  Documentation is available for:

• hydrofluoric acid:(http://info.anu.edu.au/hr/OHS/Hazard_Alerts/_Hydrofluoric_Acid.asp)

b.      Notify the ANU Occupational Health Safety and Injury Management Branch (OHSIM), and local first aid attendants of treatment documentation and risk assessment to allow its addition to the MoU list (Email: ohs.officer@anu.edu.au; cc. local first aid attendant\s).

53.  OHSIM will update the University high hazard operations list (see Appendix D) regularly with Calvary (or other medical services).  This assists in notification of special needs (anti-venom, antidotes etc) and aids preparedness.

54.  Upon incident\exposure –
a.      Give prior warning of arrival at Calvary hospital
(mobile phone contact # 0413 611 306 or 6201 6777 )
b.      Ensure that supporting documentation, including relevant Material Safety Data Sheets, ‘advice to doctor’ section, accompanies the injured person to hospital.

55.  The University is responsible for the medical expenses associated with such incidents.

STAFF AWARENESS

56.  As a part of the local Budget Unit induction program, all staff should be made aware of the following:

• location of first aid kits
• location of first aid room
• the procedures to follow if first aid is required
• any specialised treatments for unusual injuries or exposures (eg hydrofluoric acid skin burns)
• names and contact numbers of local first aid attendants
• arrangements for fieldwork
• arrangements for emergency medical services.

57.  Staff should complete the University’s Incident Notification Report form when an injury or exposure to a hazard occurs.   First Aid attendants may assist in the form’s completion.

TRAINING

58.  First aid training should be provided to staff to ensure an appropriate number of qualified first aid attendants are maintained.   These staff will be registered by the ANU to perform these duties.  These are recorded on ESPHR and on a web register located at:   http://info.anu.edu.au/hr/OHS/OHS_Networks/First_Aid_Attendants.asp)

59.  All first aid training must include the basic self-protective measures and appropriate response action plan (e.g. DRABCD).

60.  The options for first aid training, coordinated by OHSIM and provided by an accredited first aid provider, are as follows:
a)     Senior\Level 2 First Aid Certificate - for staff approved by Budget Unit management for rendering first aid.
b)     Advanced\Occupational Level 3 First Aid Certificate - for staff approved and additionally trained for the provision of oxygen resuscitation techniques.
(i)    Advanced/Occupational Level 3 training should be undertaken annually to maintain oxygen certification - unless otherwise notified.
c)     Remote Area First Aid Course - for staff approved for rendering first aid during remote area fieldwork.
d)    Cardiopulmonary Resuscitation training, as part of first aid courses or electrical safety training.
e)    Automatic External Defibrillator training, which may be combined with first aid training.

SIGNAGE

61.  Where appropriate, the Budget Unit should provide safety signs to identify and locate first aid facilities. The appropriate first aid sign is a white cross on a green background. All signs should comply with Australian Standard AS 1319 Safety Signs for the Occupational Environment.

PROVISION OF PHARMACEUTICALS

62.  As pharmaceuticals and medicines have the potential to cause harm, neither first aid attendants nor any staff member of the University are to provide any medications to staff - including analgesics such as ‘Panadol’.  In accordance with the ‘Approved Code of Practice for First Aid in Commonwealth Workplaces 1999, Section 9’, first aid kits must not contain any analgesic medications.

63.  People who wish to avail themselves of over-the-counter pharmaceuticals need to purchase their own supply.

64.  Persons who require medications for treating symptoms (eg asthma) should purchase, hold and use their individual medications for their medical conditions (eg Ventolin for asthma, EpiPens for anaphylaxis).   A first aid attendant may assist with administration of medications.  (However, it is not the role of a first aid attendant to medically diagnose disease and recommend treatments (other than for asthma and diabetes).)

VACCINATIONS

65.  It is recommended that First Aid attendants are vaccinated against Tetanus and Hepatitis A & B [4].  The University vaccination procedure can be found at: http://info.anu.edu.au/policies/Procedures/Human_Resources/OHS/Immunisation.asp.

DOCUMENT HISTORY

66.  The Provision of First Aid Services hazard management procedures were first reviewed by representatives of staff, reviewed and ratified by the Occupational Health and Safety Policy Committee and approved by Director, Human Resources on 3 July 2000.   This issue includes updates associated with current practice, Automatic External Defibrillators and improvements with the University-Calvary Hospital MoU.

First issued  July 2000
Second issue August 2006

REFERENCES

1.  “Approved Code of Practice for first Aid in Commonwealth Workplaces” Comcare Australia, 1999. http://www.comcare.gov.au/__data/assets/pdf_file/0019/658/OHS_16_first_aid_code_jun04_v1.pdf

2. PARASOL EMT Pty Limited,  http://www.parasolemt.com.au/legalissues.asp

3. Australian Resuscitation Council, Guideline 10.1.3Public Access Defibrillation (PAD) Nov 2004 Australian Resuscitation Council, Policy Statement11.7.1 Early Defibrillation, July 1997

4. Commonwealth of Australia, The Australian Immunisation Handbook—8th Edition, 2003, National Capital Printers, Canberra

5. ACT First Aid in the Workplace – Code of Practice, ACT WorkCover May 2006, http://www.workcover.act.gov.au/pdfs/guides_cop/first-aid_cofp.pdf
 

APPENDIX A

FIRST AID DOMAINS

Institute of Advanced Studies
JCSMR
RSBS
RSC
RSES
RSPhysSE
RSSS\RSPAS
Mt Stromlo
Siding Spring

The Faculties
Arts\Economics (Crisp, Copland, Dedman, Hanna Neumann, Haydon Allen, Manning Clark)
AD Hope, Crawford, Baldessin
BaMBi, Medical School
BoZo
SREM (Forestry, Geography, Geology)
Law
Physics\Psychology
School of Art

Administrative Divisions and The Library
Facilities & Services, University Maintenance, (John Yencken Building)
Administrative Divisions (Chancelry)
CRES, Hancock Library
Chifley Library
Menzies Library

 
APPENDIX B

RECOMMENDED FIRST AID ROOM CONTENTS

• sink and wash basin with hot and cold water mixer supplied;
• work bench or dressing trolley;
• cupboard for storage of linen, dressings, disinfectants;
• sharps container (0.6 litre - tall)
• soiled dressing waste bags;
• electric power points;
• bed with blanket, pillow and disposable linen;
• chair;
• telephone;
• portable stretcher;
• first aid kit;
• liquid soap, disposable paper towels;
• Treatment book with non-removable pages for recording treatment of injuries;
• helmet - green with a white cross;
• map of ANU campus and environs;
• resuscitation mask;
• oxygen resuscitation equipment and facilities for trained personnel; and
• Automatic External Defibrillator (AED).

RECOMMENDED FIRST AID KIT CONTENTS

 
APPENDIX C

REMOTE AREA FIRST AID

Risk Assessment
1.      There are additional risks associated with fieldwork in remote areas, including:
a)     The time taken for medical aid to reach the injured worker.  The time is generally more significant than distances; and
b)     A wider range of hazards that may require specialized training, treatments, and facilities.
2.      As part of the risk assessment for fieldwork in remote areas (see Fieldwork Procedure, consideration should be given to preparedness to deal with foreseeable accidents and incidents and the requirement for first aid (http://info.anu.edu.au/policies/Procedures/Human_Resources/ohs/Fieldwork_Safety.asp).
3.      To determine the level (or severity) of risk you need to consider all of the following when setting priorities for implementing risk controls:
a) Consequence: for each hazard, ask "What is the extent of the injury or ill health if it were to occur?";
b) Likelihood: ask what is the likelihood of harm occurring if a person is exposed to the hazard; and
c) Exposure: ask how many people would be exposed to the hazard and for how long.
4.      The budget area management should record the first aid risk assessment processes undertaken, the outcomes of any assessments and the decisions made.  This will be beneficial in supporting the risk assessment outcomes when reviewing first aid arrangements.

Specific considerations for remote area work
5.      First aid attendants should be trained in remote area first aid.
6.      In remote areas, where poor roads and adverse weather conditions may limit access, operational planning and training should include the potential requirement for (aerial) evacuation of injured or ill people.
7.      Efficient communications systems (e.g. a satellite phone, mobile phone, CB radio, or EPIRB) should be available for the provision of interim medical advice.  These should be carried with you when travelling a distance away from your vehicle.
8.      Details of local ambulance, hospital and medical centres (with the capacity to deal with occupational health matters).
9.      An appropriately stocked first aid kit, taking into account the risks involved.  The risk is the potential for the hazard to cause actual harm. For example special first aid kits for eye injuries, burns, fauna bites and vehicle accidents.
10.  A remote area first aid kit may also include the following additional items:

• emergency reference manual
• broad crepe bandages (for snake bites)
• cervical collar (for spinaleck injuries)
• large clean sheeting (for covering burns)
• whistle (for attracting attention)
• torch\flashlight
• specialized medical treatments for asthma, snake bites, etc.

Note: Most first aid kits will be too large to be carried with you in the field beyond your vehicle transport.  If working away from your vehicle then you will need to consider smaller kits that contain the essentials (eg. Treatments for snake bite) that are compact and light enough to be carried with you at all times.  Emergency communication should also be carried with you.

11.  The affected person should purchase, hold and use their individual medications for their medical conditions (eg Ventolin for asthma, EpiPens for anaphylaxis).   A first aid attendant should only assist with administration of medications.  It is not the role of a first aid attendant to medically diagnose disease and recommend treatments (other than for asthma and diabetes).

12.  In a remote location, contact should be made with appropriate medical facilities for advice. 
 

APPENDIX D

MEMORANDUM OF UNDERSTANDING

THIS MEMORANDUM OF UNDERSTANDING is made on the 8th day of August 2005
BETWEEN
CALVARY HEALTH CARE ACT LIMITED, ABN 74 105 304 989, of Bruce, in the Australian Capital Territory, 2617, (‘Calvary’)
AND
THE AUSTRALIAN NATIONAL UNIVERSITY, ABN 52 234 063 906, of Acton, in the Australian Capital Territory, 0200, Australia (‘the University’)
TO
Improve the expected treatment outcomes of ANU Staff and Students affected by accidents especially injuries or exposures that arise from high hazard operations and chemical related incidents.

The full MoU can  be found at http://info.anu.edu.au/hr/OHS/_Procedure_Attachments/MoU_Calvary_ANU_2005.pdf