Some random (hopefully relevant) first aid thoughts

It's not fire safety today but first aid (see my profile to tell it's a subject as dear to me as fire!)

Various incidents that happened at a job yesterday made me think of a few key things:

1. A BS 8599-1:2019 Workplace First Aid Kit may cost more than a traditional 'HSE' First Aid Kit - but it's far more use!

Whilst quantities of items have fluctuated the base items in a traditional (& still retailed) 'HSE' first aid kit (the 'HSE' deriving from the kits origins in the suggested contents in the ACOP to the Health & Safety (First Aid) Regulations 1981) are not much different from back in 1981 and assume:

• Hardly any minor injuries (few plasters)
• Lots of major wounds (lots of pad & bandage wound dressings)
• The use of lots of splinting/immobilising of leg & arm fractures with triangular bandages (Which I remember being taught 30 years ago, but fell out of general civilian first aid training a long time ago)

In the case I was at there was nothing of real use, and improvisation was needed because two things that would have been in a BS kit were not there:

• Clothing shears ('Tuf-cuts')
• Adhesive tape

The BS kit contains a wide variety of useful items and quantities reflect actual usage (see here https://www.reliancemedical.co.uk/wp-content/uploads/Flyer_BS8599-1_2019_Guidelines.pdf)

Proper assessments of need for first aid are a rare beast and rarer still by people that understand the range of first aid materials available and their applications - you can (within reason) have anything in your kits 'useful for first aid' that you have trained your first aiders in (no amateur surgeons or pharmacists though!).

The same incident led me onto another fact:

2. First aid dressings are not what they used to be

When I started in first aid at the end of the 1980's wound dressings were substantial heavy duty items, usually a lint pad with a thick cotton wool backing on 'standard' dressings and Gamgee tissue (Google it!) for the 'Ambulance' and 'Mines/Compressed' dressings and could handle even the more serious wounds.

Modern technology has improved them in some ways (easy to apply conforming stretch bandages instead of rigid cotton weave; non woven non stick dressing contact layers to avoid tissue damage and contamination) but they are far less substantial and are not much more than a minor injury non adherent dressing and for the case I was at would have been akin to using tissue paper on a wound -which brings me to my final point:

3. Catastrophic Haemorrhage kits are not just for the battlefield or terrorist incidents

Now formally adopted in BS 8599:2019, kits for Catastrophic Haemorrhage have been in the civilian world for some time, the basic components are usually:

• Trauma dressings: With thick dressing pads akin to the wound dressings of old but with the benefit of modern materials capable of absorbing the flow from life threatening blood loss these have heavy duty bandages that can be used to apply a lot of pressure and can be tied with velcro or a clip depending on make. Some have a pressure bar to apply even more pressure to the wound site, such as the original modern trauma dressing the 'Israeli Dressing'
• Haemostatic gauze or granules: Large wound cavities need packing to control the bleeding and where major vessels are involved even if the wound area is small, control can be difficult by manual pressure and dressings alone. Haemostatic agents encourage natural clotting enhancing the effectiveness of bleeding control techniques
• Tourniquet: Once considered a forbidden word to mention on a first aid course, the correct use of a purpose designed trauma tourniquet is now back in the forefront of first aid - Modern studies show that whilst catastrophic haemorrhage will kill in minutes, tourniquet use takes hours before limb threatening complications can set in - in most civilian settings the casualty would have been transferred to the care of the Ambulance Service and the Emergency Department long before this.

In the case I attended, the normal first aid dressings were not adequate and required the additional materials to provide an adequate pressure dressing.

More in these kits here: https://bhta.com/wp-content/uploads/2019/04/BS8599-2_Advertorial.jpg

Conclusion

It's important to correctly assess the risks in your workplace and ensure that the correct range of materials are provided to cover all likely eventualities. The current regulatory regime is the most flexible ever for the provision of equipment types and additional training, and it's important that a token gesture is not made.

Selecting the right staff and giving them good quality training is also important, good first aiders are a vital tool and personally wish industry pressure hadn't lead to the reduction of First Aid to Work training to three days and introduction of the very minimally trained 1 day Emergency First Aider at Work.

Whilst on the general subject, I'll take the chance to add the importance of quick availability of defibrillators in premises - minutes can save lives and whilst not a legal requirement are probably more of a life saver than the thousands of extinguishers sitting on stands and walls ever will be!

I'm now off to order replacement Trauma Dressings!

Back to fire safety next article....