Requirements for a First Aider
The Occupational Health and Safety Act in South Africa applies to all workplaces across different companies and industries in the countries, including those who employ fewer than five employees and those employers who are self-employed.
Employers in South Africa must:
- Ensure that they provide adequate, appropriate first-Aid personnel, First Aid Products, and facilities to ensure that all employees can receive immediate attention if they fall ill, or are injured in the workplace during working hours.
- Ensure that non-employees are considered when they assess their first-Aid While employers are not legally obliged to provide first aid to non-employees, employers are strongly urged to include these individuals.
Employers in South Africa can take several approaches towards ensuring that they provide adequate first aid to their employees. One of the most common approaches relates to a prescribed approach, where there is detailed guidance on compliance, including:
- The number of first aiders
- The duties and training of the first aiders
- The number of first aid kits and their contents
- The number of first aid rooms and their specific requirements, where necessary depending on the industry and the company’s nature of business.
The second approach is more systematic and methodological, involving a risk assessment to determine the specific needs. This is a flexible approach, and it involves the employer, first aiders, safety representatives, and the workers coming together to determine what the first aid needs of the organisation are.
Employers in South Africa are required to ensure that they provide adequate facilities to ensure the health, safety, and welfare of employees in the workplace. When there are more than 10 employees in a workplace, the employer must provide first aid equipment and first aid training to employees who are to be appointed as a first aider.
The importance of a first aider cannot be emphasised enough, especially when considering the type of injuries that can occur in any workplace, the nature of activities, and the number of employees who are employed.
For every group of 100 employees, at least one appointed first aider must be readily available during working hours.
This first aider must possess a valid first aid certificate of competency in first aid. Where there are areas of work considered as high-risk or where there are toxic, corrosive, or dangerous substances are processed, manufactured, or handled, the first aider must be trained in the procedures to treat injuries that could result from these activities.
Workplaces must contain first aid signage that is conspicuously placed, indicating the location of the first aid box or boxes in addition to the name of the first aider in the area.
First aiders are considered as the first responders when there are emergencies, injuries, and illnesses before medical services arrive.
The minimum requirements for any first aider are that they must have attended first aid training and they must hold a valid first-Aid certificate. The issuer must be a valid first aid training provider in South Africa and the certificate serves as proof that the first aider has completed training in the following topics:
- The roles, functions, and responsibilities for the first aider
- Management of the emergency scene
- The assessment of the patient in a primary and secondary assessment
- Basic anatomy and physiology including body functions relating to respiratory, circulatory, musculoskeletal, neurological, and integumentary
- Obstructed airways and any other breathing emergencies
- Cardiovascular emergencies including heart attacks and strokes
- The controlling of bleeding, both internally and externally
- The signs and symptoms of shock
- Cardiopulmonary resuscitation (CPR), adult and single rescue
- Trauma and any additional acute medical situations relating to bones, joints, head, spine, skin disruption, and poisoning
- General precautions that can prevent blood and body fluid exposure
- Basic infection control
Skills that are beneficial to First Aiders
A first aider has a series of responsibilities that they must carry out in their position. In addition to this, there are some qualities and character traits that can benefit first aiders to perform their duties to the best of their ability, these are:
- First aiders must have strong communication skills and they must be able to ask questions, listen carefully, and relay information accurately.
- The first aider must be people-orientated, have confidence, be well-spoken, and be comfortable with interacting with a range of people in unideal situations such as emergencies.
- First aiders must possess the ability to work under pressure and to react quickly and remain in control, without succumbing to their emotions.
- First aiders must be able to work in a team and they must have effective leadership skills, especially during times when they work under pressure.
- First aiders must have the ability to cooperate with others and to coordinate well, especially under stressful situations.
- A first aider must know their limits and know what their level of competence is. In addition, a first aider must know when they should call or ask for help.
Four-Layered Framework for Providing First aid in the Workplace
This provides employers with a solid framework according to which they can ensure compliance with the regulations that surround the provision of first aid. The four components include:
- Appointed persons
- Emergency first aid at Work
- First-Aid At Work
- Additional Training
Appointed Persons (AP)
Appointed persons in the workplace should not be confused with first aiders. These individuals are typically in charge of the z equipment, facilities, and notifying emergency services of an incident or an accident.
However, these individuals can receive the same training to provide backup support if an appointed first aider is not available when there is an emergency. Most legal minimum requirements require that an appointed person be present in every workplace. This will be according to the first aid needs assessment of the specific workplace.
While appointed persons do not legally require first aid training, they should have enough information and instruction regarding their roles and responsibilities. Emergency first at work training is a useful option for APs, but it is not considered mandatory.
First aiders can attend different levels of first aid trading, including, but not limited to:
- Emergency first at work which is typically for first aiders who work in lower-risk workplaces. This type of training allows them to provide emergency first-Aid if another employee is injured or they have become ill while at work.
- First aid at work is typically for first aiders who work in high-risk workplaces, and this allows them to offer first-Aid to a variety of injuries and illnesses.
- Additional training that first aiders can attend, according to the first aid needs of the workplace and the employer’s discretion, relate to training on safe defibrillator use, mental health first-Aid, delivery oxygen, paediatric first-Aid, and so on.
Low-risk areas or workplaces are often offices, retail shops, libraries, and any work area where exposure to hazards and risks will not result in serious, life-threatening illness or injury. In addition, these workplaces are also near medical assistance or health facilities such as hospitals.
High-risk workplaces refer to manufacturing plants, restaurant kitchens, automotive factories, repair workshops, and other operations. In these working environments, the potential exposure could result in serious injury that may require immediate and intensive medical attention.
In addition, workplaces are also considered a higher risk when they are more remote and some distance away from medical assistance or services.
Responsibilities of a First Aider
First-Aid is the immediate assistance that is given to an injured or ill individual. The first aider’s primary role is to provide this assistance to safeguard the individual and to prevent further harm until professional medical services arrive on the scene.
The typical assistance that a first aider can provide can range from dressing a wound to performing life-saving techniques. According to health, safety, and environmental regulations, a first aider is a person who voluntarily undertakes training according to specific workplace circumstances according to first-Aid needs assessments.
The first aid needs assessment is carried out by an employer and the following must be considered:
- The nature of work that is carried out in the workplace
- The inherent workplace hazards and risks, including any special or specific hazards that need special arrangements
- The nature and the size of the workforce
- The work patterns and working schedules of employees
- Absences and schedules of first aiders and appointed persons
- The company’s history of accidents
- The needs that remote or lone workers may have
- Distribution of the employees
- The site or work location remoteness from medical facilities
- Whether employees work on any shared or multi-occupancy sites where other companies operate
- The first aid provision for non-employees
Assessing the situation
The first aider must first evaluate the situation to identify if there is any danger to them or the injured person. The first aider must ensure that it is safe to approach the scene and the injured or ill person, determine the cause of the accident and the number of casualties.
The first aider must ensure that they gain more insight into the incident or accident such as what happened, how many people are affected, their ages, and so on.
Protecting themselves and the individual
The first aider must ensure that they safeguard their health and safety and that they never put themselves at risk. The first aider can only move an injured or ill individual if there is no risk of causing harm to the injured individual.
If the scene of the accident or incident cannot be made safe by the first aider, the first aider must contact emergency services and notify the relevant key personnel.
The first aider must ensure that they practise high standards of personal hygiene before they engage an ill or injured individual. The first aider must wear gloves that are latex-free or appropriate coverings that will prevent contact with bodily fluid or other substances.
The first aider must avoid breathing, sneezing, or coughing over the injured or ill individual or their wounds. The first aider must ensure that they do not touch open wounds without the proper protective equipment.
The first aider must ensure that they take the necessary precautions to tend to the individual in such a way that the risk of Covid-19 and any other infectious diseases is minimized.
Comfort and reassurance
The first aider must remain calm and take charge of the situation, introduce themselves to the individual (if they are conscious), explain what is happening and what the first aider will do before they do it. The individual must always be treated with respect and dignity regardless of the situation.
Assessing the individual
If there are multiple casualties, the individuals with life-threatening conditions must be assisted first. The primary survey must be used to identify such conditions and once these situations have been dealt with the first aider can continue with the secondary survey.
If the first aider is alone and there are multiple casualties, they must arrange for help from other trained and first aid certified personnel.
Summoning help if needed
If the emergency, incident, or accident is of such a nature that professional medical service is necessary, the first aider must alert key management and emergency services after they have carried out the primary survey.
Additional non-emergency responsibilities
There are additional responsibilities for first aiders outside of emergencies, these are:
- Assisting the employer with their first aid needs assessments
- Maintaining first aid equipment including first aid kits, facilities, and so on.
- Assist with accident and incident reports and investigations
- If the first aider is trained in mental health first aid, they can carry out these responsibilities.
One of the reasons why employees in the workplace are reluctant to volunteer as a first aider revolves around concerns with becoming legally liable. However, if the first aider performs their duties according to their training, they are unlikely to face legal action.
But first aiders are always urged to ensure that they understand the policies that their employer implements to cover the liability of first aiders.
First Aid Products required to provide First Aid
The employer must ensure that a regular review of their first aid arrangements is carried out. This must be done with workers in the different work areas to ensure that these measures are current and applicable. Employers can ensure that they comply by doing the following:
- They can hold a meeting with employees who have responsibilities under first aid procedures, ensuring that these individuals are familiar with first aid
- If work procedures or activities are changed or new procedures are introduced, the employer must review these activities against a predetermined risk assessment to ensure that arrangements are still enough.
- Carry out routine emergency drills to test the emergency procedures and first aid
- Maintain first aid kits, equipment, and rooms to ensure that they are accessible and that they can cater for any incidents, emergencies, or accidents unique to the workplace.
- If an incident occurs and first aid is needed, the employer must evaluate the overall effectiveness of first aid This allows the employer to refine their first aid procedures to ensure that it is comprehensive and effective.
- If new information is gathered about a hazard that was previously unidentified, the first aid measures that are currently in place must be reviewed to ensure their effectiveness.
First aid kits in the workplace are not something that can be neglected regardless of the working area, industry or the company’s nature of business. Even though there are emergency procedures in place along with the use of Personal Protective Equipment (PPE), accidents and incidents can occur, and they can lead to injuries and/or illness.
There is no holy grail of standards that dictates the exact components for a first aid kit, how many employees must be trained, or whether all employees must have it. There are some minimum requirements that employers can follow, and the rest is site-specific according to the organisation’s unique work environment, workforce, and activities.
While there is no set list of the components of a first aid kit, OHSA provides the following recommendations regarding the contents of a first aid kit:
- Adhesive bandages
- Adhesive tape
- Antibiotics and antiseptics
- Breathing barriers
- Gel-soaked burn dressings and treatments
- Cold packs
- Eye coverings
- Eye and skin wash
- Hand sanitiser and/or skin wash
- Exam gloves
- Roller bandages in two and four-inch sizes
- Sterile pads
- Trauma pads
- Triangular bandages
Additional items that employers can incorporate into their unique first aid equipment and provisions can also include eyewash stations, showers, insect repellent, sunscreen, or any other items.
First Aid Kit Inspections
First aid kits must be inspected to ensure that all the minimum requirements are met and that the necessary, basic items are in the kit. First aiders must have access to first aid kits in their working area and they must be familiar with the contents of their first aid kit.
First aid kit inspections must focus on checking the following:
- Go through all the products to ensure that nothing is unsafe, damaged, or contaminated.
- Review and observe the inventory list to ensure that necessary components are in the kit and that anything that has been used can be accounted for with an incident report.
- The first aid kit must be organised, and each component must be packed away neatly.
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