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Safety and Health Topics:
November 25, 2002

Medical and First Aid Compliance

It is a requirement of OSHA that employees be given a safe and healthy workplace that is reasonably free of occupational hazards. However, it is unrealistic to expect accidents not to happen. Therefore, employers are required to provide medical and first aid personnel and supplies commensurate with the hazards of the workplace.

The details of a workplace medical and first aid program are dependent on the circumstances of each workplace and employer. The intent of this page is to provide general information that may be of assistance. If additional information is required, an Occupational Health Professional should be contacted. The key elements of a compliance program are delineated below:

  1. Recognition
  2. Evaluation
  3. Control
  4. Compliance
  5. Training


Recognition

  • It is the responsibility of each employer to determine their requirements for medical and first aid services. OSHA does not recommend nor approve programs. However, during an inspection the employer's plan will be evaluated for adequacy.
  • If there is any chance for contact with a corrosive material, eyewash and body flush facilities must be provided.
  • No Longer Valid Link Medical Services and First Aid: OSHA Standard 1910.151. The National Ag Safety Database (1993, August), 1 page. This Fact Sheet, AE-192, by Florida Coop. Ext. Service, presents highlights of the OSHA Standard with an emphasis on agricultural operations.


Evaluation

  • All employers must evaluate their workplace for medical and first aid requirements. Among the factors that should be considered are:
    • Location and availability of medical facilities and emergency services
    • Availability of medical personnel to consult on occupational health issues
    • Types of accidents that could reasonably occur at the workplace
    • Response time for external emergency services
    • Number of employees at the plant and the locations of employees within the plant
    • If corrosive materials are in use at any place in the workplace
    • If there are any industry specific requirements
    • What first aid supplies should be available. This is determined in consultation with a physician.
    • What level(s) of training should employees receive, and which employees should be trained
  • No Longer Valid Link OSHA Guidelines on First Aid Training. The National Ag Safety Database (1993, August), 3 pages. Fact Sheet, AE-213, Florida Coop. Ext. Service. Provides a summary of information OSHA compliance officers look for in a first aid program.
  • Guidelines for First Aid Programs, OSHA Directive CPL 2-2.53 (1991, January 7), 9 pages.


Control

  • The design and implementation of a medical and first aid program is dependent on the specific workplace. It is advisable that a plan be devised for each workplace, and that the plan be written. Elements of the plan should include:
    • The availability of medical personnel for consultation regarding occupational health issues. Provide the names and telephone numbers for professionals with whom the employer has agreements.
    • At least one person, and preferably two or more, trained in first aid must be available at the worksite if either of these conditions exist:
      • If life threatening injuries can reasonably be expected, trained personnel must be available within 4 minutes. This generally means that community emergency medical services cannot be relied on since their response time is usually greater than 4 minutes.
      • If serious injuries other than life threatening injuries can be expected, the response time for trained personnel is extended to 15 minutes.
      • Multiple individuals should be trained in order to provide coverage when the primary responder is unavailable.
    • The trained first aid responder(s) should be designated and the other workers should know who they are and how to contact them so they can respond within the required time.
      • The trained responder must have a current first aid certificate.
      • Designated responders are covered by the requirements of the Bloodborne Pathogen Standard. See the Technical Links Bloodborne Pathogens page.
    • A first aid kit must be available at the worksite. The contents of the first aid kit must be determined in consultation with a physician. Note that some industries have specific requirements for first aid kit locations and contents.
    • Emergency telephone numbers should be conspicuously located by each telephone.
    • Sufficient ambulance service should be available to handle any emergency. This requires advance contact with ambulance services to ensure they become familiar with plant location, access routes, and hospital locations.
    • If corrosive materials are used, eyewash and body flush facilities must be provided.
      • Where possible, these should provide large quantities of clean water. The water source must be pressure controlled and clearly identified.
      • Portable eyewash stations must contain a minimum of 1 gallon of potable water.
      • Emergency Eyewash and Shower Equipment, ANSI Standard Z358.1-1990, provides standards for eyewash facilities.
      • No Longer Valid Link Eye Safety, Manitoba Department of Labour, Worksafe, Bulletin NO.104a, 3 pages. A fact sheet on eye safety and eye wash facilities that includes a summary of the ANSI requirements.
  • Records of first aid and medical treatments should be maintained in accordance with OSHA's recordkeeping standards. See the Technical Links page for Recordkeeping.


Compliance

  • OSHA Standards
    • 1910.151, Medical services and first aid
    • 1915.98, First aid (Ship Repairing, Shipbuilding and Shipbreaking)
    • 1917.26, First aid and lifesaving facilities (Marine Terminal Operations)
    • 1918.97, First aid and lifesaving facilities (See Appendix V of this part) (Longshoring)
    • 1926.23, First aid and medical attention
    • 1926.50, Medical services and first aid

      There are several standards that address first aid and medical services for specific industries or operations.

    • 1910.269(b), Electric Power Generation, Transmission, and Distribution
    • 1910.266(d)(2), Logging operations
      • App A, First-aid Kits (Mandatory)
      • App B, First-aid and CPR Training (Mandatory)
    • 1910.421, Pre-dive procedures
  • OSHA Directives
    • CPL 2-1.19, Logging Operations, Inspection Procedures and Interpretive Guidance (1995, March 17), 14 pages.
    • CPL 2-1.22, Logging Operations, Inspection Procedures and Interpretive Guidance Including Twelve Previously Stayed Provisions (1996, September 27), 20 pages.
    • CPL 2-2.53, Guidelines for First Aid Programs (1991, January 7), 9 pages.
    • CPL 2-2.60, Exposure Control Plan for OSHA Personnel with Occupational Exposure to Bloodborne Pathogens (1994, March 7), 16 pages.
    • STD 1-8.2: 29 CFR 1910.151(c), Medical Services and First Aid; 29 CFR 1926.50 and .51, Medical Services and First Aid, and Sanitation, Respectively; Applicable to Electric Storage Battery Charging and Maintenance Areas (1982, March 8), 4 pages.
    • CPL 2.2, American Red Cross Agreement. Information regarding first-aid training requirements and courses (1978, October 30), 2 pages.
    • CPL 2-2.59A, Inspection Procedures for the Hazardous Waste Operations and Emergency Response Standard, 29 CFR 1910.120 and 1926.65, Paragraph (q): Emergency Response to Hazardous Substance Releases (1998, April 24).
    • STD 1-23.2, 29 CFR 1910.401-1910.441, Subpart T–Commercial Diving Operations (1978, October 30), 20 pages.
    • No Longer Valid Link STD .2, Identification of General Industry Safety and Health Standards (29 CFR 1910) Applicable to Shipyard Work (1985, November 4), 9 pages.
  • Review Commission and Administrative Law Judge Decisions
    The Occupational Safety and Health Review Commission (OSHRC) is an independant Federal agency created to decide contests of citations or penalties resulting from OSHA inspections of American work places. To locate decisions related to this topic, search for keywords at the OSHRC site.


Training

  • As part of initial and ongoing training, all employees should receive training in the employer's medical and first aid program.
  • The American Red Cross offers first aid and CPR courses. Two groupings of available courses are:
  • The National Safety Council, First Aid Institute provides training courses throughout the country, course providers, and training schedules are available.
  • The Mayo Clinic provides a Web page that addresses a number of first aid and CPR topics. Some of these include short movies.
  • Active First Aid Online. PARASOL, Australia (1999, November 1). The cyber-text of their official EMT First Aid book. It provides first aid information on a large number of topics.

    Revised: 07 March 2001
 
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