29 CFR § 1915.87 - Medical services and first aid.

§ 1915.87 Medical services and first aid.

(a) General requirement. The employer shall ensure that emergency medical services and first aid are readily accessible.

(b) Advice and consultation. The employer shall ensure that healthcare professionals are readily available for advice and consultation on matters of workplace health.

(c) First aid providers.

(1) The employer shall ensure that there is an adequate number of employees trained as first aid providers at each worksite during each workshift unless:

(i) There is an on-site clinic or infirmary with first aid providers during each workshift; or

(ii) The employer can demonstrate that outside first aid providers (i.e., emergency medical services) can reach the worksite within five (5) minutes of a report of injury or illness. The employer must take appropriate steps to ascertain that emergency medical assistance will be readily available promptly if an injury or illness occurs.

(2) The employer shall ensure that a first aid provider is able to reach an injured/ill employee within five (5) minutes of a report of a serious injury, illness, or accident such as one involving cardiac arrest, acute breathing problems, uncontrolled bleeding, suffocation, electrocution, or amputation.

(3) The employer shall use the following factors in determining the number and location of employees who must have first aid training: size and location of each worksite; the number of employees at each worksite; the hazards present at each worksite; and the distance of each worksite from hospitals, clinics, and rescue squads.

(4) The employer shall ensure that first aid providers are trained to render first aid, including cardiopulmonary resuscitation (CPR).

(5) The employer shall ensure that each first aid provider maintains current first aid and CPR certifications, such as issued by the Red Cross, American Heart Association, or other equivalent organization.

(d) First aid supplies.

(1) The employer shall provide and maintain adequate first aid supplies that are readily accessible to each worksite. An employer's on-site infirmary or clinic containing first aid supplies that are readily accessible to each worksite complies with this requirement.

(2) The employer shall ensure that the placement, content, and amount of first aid supplies are adequate for the size and location of each worksite, the number of employees at each worksite, the hazards present at each worksite, and the distance of each worksite from hospitals, clinics, and rescue squads.

(3) The employer shall ensure that first aid supplies are placed in a weatherproof container.

(4) The employer shall maintain first aid supplies in a dry, sterile, and serviceable condition.

(5) The employer shall replenish first aid supplies as necessary to ensure that there is an adequate supply when needed.

(6) The employer shall inspect first aid supplies at sufficient intervals to ensure that they are adequate and in a serviceable condition.

(e) Quick-drenching and flushing facilities. Where the potential exists for an employee to be splashed with a substance that may result in an acute or serious injury, the employer shall provide facilities for quick-drenching or flushing the eyes and body. The employer shall ensure that such a facility is located for immediate emergency use within close proximity to operations where such substances are being used.

(f) Basket stretchers.

(1) The employer shall provide an adequate number of basket stretchers, or the equivalent, readily accessible to where work is being performed on a vessel or vessel section. The employer is not required to provide basket stretchers or the equivalent where emergency response services have basket stretchers or the equivalent that meet the requirements of this paragraph.

(2) The employer shall ensure each basket stretcher, or the equivalent, is equipped with:

(i) Permanent lifting bridles that enable the basket stretcher, or the equivalent, to be attached to hoisting gear capable of lifting at least 5,000 pounds (2,270 kg);

(ii) Restraints that are capable of securely holding the injured/ill employee while the basket stretcher, or the equivalent, is lifted or moved; and

(iii) A blanket or other suitable covering for the injured/ill employee.

(3) The employer shall store basket stretchers, or the equivalent, and related equipment (i.e., restraints, blankets) in a clearly marked location in a manner that prevents damage and protects the equipment from environmental conditions.

(4) The employer shall inspect stretchers, or the equivalent, and related equipment at intervals that ensure the equipment remains in a safe and serviceable condition, but at least once a year.

Appendix A to § 1915.87—First Aid Kits and Automated External Defibrillators (Non-Mandatory)

1. First aid supplies are required to be adequate and readily accessible under paragraphs § 1915.87(a) and (d). An example of the minimal contents of a generic first aid kit for workplace settings is described in ANSI/ISEA Z308.1–2009, “Minimum Requirements for Workplace First Aid Kits and Supplies” (incorporated by reference as specified in § 1915.5). The contents of the kit listed in this ANSI standard should be adequate for small worksites. When larger operations or multiple operations are being conducted at the same worksite, employers should determine the need for additional first aid kits, additional types of first aid equipment and supplies, and additional quantities and types of supplies and equipment in the first aid kits.

2. In a similar fashion, employers that have unique or changing first aid needs at their worksite may need to enhance their first aid kits. The employer can use the OSHA 300 Log, OSHA 301 Incident Report form, or other reports to identify these unique problems. Consultation from the local fire or rescue department, appropriate healthcare professional or local emergency room may be helpful to employers in these circumstances. By assessing the specific needs of their worksite, employers can ensure that reasonably anticipated supplies are available. Employers should assess the specific needs of their worksite periodically, and augment first aid kits appropriately.

3. If it is reasonably anticipated that employees will be exposed to blood or other potentially infectious materials while using first aid supplies, employers must provide appropriate personal protective equipment (PPE) in compliance with the provisions of the Occupational Exposure to Bloodborne Pathogens standard, § 1910.1030(d)(3). This standard lists appropriate PPE for this type of exposure, such as gloves, gowns, face shields, masks, and eye protection.

4. Employers who provide automated external defibrillators (AEDs) at their workplaces should designate who will use AEDs and train those employees so they know how to correctly use the AEDs. Although a growing number of AEDs are now designed to be used by any person, even without training, training reinforces proper use and promotes the usefulness of AEDs as part of an effective cardiopulmonary resuscitation plan. For AEDs to be effective, employers should:

a. Ensure that AEDs are located so they can be utilized within three to five minutes of a report of an accident or injury;

b. Ensure that employees use AEDs in accordance with manufacturers' specifications; and

c. Inspect, test, and maintain AEDs in accordance with manufacturers' specifications.