Our GM has asked me to come up with some guidelines to follow when employees are injured to to help us decide if in-house first aid is ok, or if we should send the employee for outside treatment. Does anybody have anything like this in place already that you wouldn't mind sharing. Or maybe you can point me in the right direction.

Thanks,
Bob

Bob,

I think your guidelines are going to have to be a function of what skills your first aid responders have and the hazards in your facility. Being trained in first aid implies that you can respond to cuts, strains, sprains, breaks, burns, allergic reactions, and diabetic events (I probably missed a few). If you're trained in CPR/AED it is assumed you know how to respond to sudden cardiac arrest and fibrillation events. At some point in time, the responder is going to have to decide whether or not the injury/illness requires more attention than he can provide. Part of the problem is that can vary widely from responder to responder.(e.g. a 100 pound woman responding to a 250 pound man in cardiac arrest). I tell my people if in doubt call 911.

With respect to sending people for offsite treatment, as a rule of thumb, if the victim cannot self administer the first aid they probably need to go to the clinic. There's a lot caveats with that rule but it generally works.

MikeCJ

Hi Mike, thanks. I agree with everything you said, but what I'm really looking for is written guidelines that our first aid reaponders and supervisors can use to help them determine at the time of injury (or during any follow-up) if our in-house first aid was enough, or if the injured employee should be sent to a doctor for additional treatment. Here's the case that prompted this.

 An employee was struck in the thumb. There was some bleeding around the thumb nail and some pain. First aid was administered on sight. The employee said she felt OK to continue working and didn't feel she needed to see a doctor. I followed up with her occasionally over the next few weeks. Each time she said she was fine, but did still have some pain, as it was still healing. Now, after a few months. the employee said the thumb is still bothering her from time to time. We discussed it and both agreed she should have it checked out, and have done so.

So now, in hindsight, we feel we could have done better a better job at handling this injury. We should have had her thumb looked at by a doctor sooner. I'm thinking if we had a checklist or guidelines to refer to, we might have a better chance at making the right decision much sooner. Maybe just more thorough follow-up would have helped us. Any other advise is welcome.

Thanks again.

The incident you describe would have probably been a tough call under any circumstances.

Basic first aid training should provide the guidelines you are looking for. There are always some things that you call an ambulance for--unconsciousness, profuse bleeding, serious fractures etc. Then there are the things you transport to the ER--anything needing stitched up, minor fractures, minor eye injuries, etc.

Some things can almost always wait to go to a clinic later--strains, sprains, back injuries, etc. In a lot of these cases a little rest and sincere expressed concern can go a long way toward avoiding that trip to the ER or clinic.

You want to avoid the ER unless it is needed. Once the employee goes there, your control of the outcome is diminished significantly.

Many of my peers are much more conservative about this. And I agree that you need to ensure proper care. But my experience with ERs is that once they go there, it will be recordable regardless of what it is.

Hey 6376584,

Thanks for the input. Those are some good suggestions. I'll definitely include them in my written guidelines. I also agree with you whole-heartedly in avoiding the ER unless absolutely warrented. It seems like if we send someone to the ER, even for a minor injury, it always turns into recordabale, even Lost Time, very easily. Our first choice for outside medical care has been a local occupational health clinic. Even though they're part of our local hospital system, they've always seemed to understand that, while the injured employee's care is #1, we also need to consider our OSHA record. Recently there has been a change in doctors at the occupational health clinic, and In the case I described above, I really think that change in doctors is the reason this injury turned in to a recordable one, The doctor prescribed some medication that the injured employee isn't even taking, although, as I'm sure you know, just the fact that the prescription was written makes this recordable.