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Posted By Kate Graham
First aid question:
Some safety data sheets state "induce vomiting" after ingestion.
On first aid at work courses, I've been told "never induce vomiting".
Any ideas on which is right, in particular to include in a COSHH assessment of such chemicals?
Kate
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Posted By Linda Crossland-Clarke
Hi
Some first aid trainers don't have the H&S background and don't understand COSHH, MSDS etc. The theory is, if you drink something, it burns you on the way down and on the way back up again. However, depending on the substance, there will be things that cause more harm if you didn't bring them back up. Maybe someone else can give an example? Poisons and target organs could be a thought in the right direction....
So I would always go by the MSDS.
Linda
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Posted By Gavin
Depending on the product, I would contact the Guys Hospital poisons unit, or similar and get their advice. Also check when the MSDS was last updatted - guidance on tis changes. Document any advice you get and store it with the master COSHH assessment. Train your first aiders appropriately and inform your first aid trainer of the products and guidance - they will also advise
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Posted By Jimmy
What is the real likelihood of this type of occurance at the (controlled)workplace?
Could anyone account for a deliberate act of ingestion.
First aid at work is now "emergency first aid", and, I suppose, being able to react responsibly, quickly and positively to a situation to save a life, whislt also assessing how long it would take for proffessional help to arrive. Theres alot to do!!
Many MSDS that I see are based on an LD50 oral rat, but then professionals in an analytical, chemical or microbiological background would have their own views on firt aid after "accidental" ingestion.
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Posted By Jim Walker
I'm "on the fence" regarding do you or don't you.
However, be aware that if First Aiders vear away from standard practices (don't induce is one) then they are making themselves vunerable to subsequent litigation.
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Posted By Ron Hunter
Induce vomitting? He/she's potentially damaged their stomach and gullet, so let's give the product a second chance to come up again and enter the lungs? I think not!
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Posted By Jim Walker
Nice point Ron.
I knew you should not induce vomiting, but was hazy as to why.
I'm off the fence and on your side now.
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Posted By Jimmy
So, in the meantime you'll poison them any way while waiting for professional help and when they arrive you'll blame them for the slow response when the person deteriorates. Seen it before
what is worse---
Person received injuries in spite of rapid firt aid
or person received injuries whislt first aider waited for someone to take over.
Like the flock of sheep waiting for the collie to arrive!!!!!!!!
Hmmmm
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Posted By Hilary Charlton
We have some of these products which require you to induce vomiting as well. I guess it depends on the harm to the organs of the product staying in or the harm to the throat and lungs of the product coming out - one has to assume a risk assessment has taken place and on these particular products it is felt less harmful or less of a risk to induce vomiting. I should always go with what the MSDS says.
Hilary
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Posted By Ron Hunter
Jimmy might be missing the point of my last entry, at least in part.
The stomach is a fairly robust organ and can take a fair bit of abuse,and would most likely survive until help is at hand - could your lungs?
In a work environment, hard to think of a product which is both likely to be ingested and would give rise to such rapid poisoning that you either can't wait for or wouldn't do better to actually take the person to the professionals!
Why the 'knee jerk' wait on an ambulance? Get them to the nearest A & E yourself if its a viable option.
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Posted By Ron Hunter
Oh and by the way folks, if that MSDS happens to be a load of cobblers, it won't get you of the hook when the Sh*t hits.
Maybe the supplier did have duties under CHIP, but you had duties under HASAWA and COSHH!!!
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Posted By Jane Blunt
It looks as though you are using substances that require special first aid techniques - a direction on the MSDS which is clearly contrary to normal first aid protocol puts them in that category.
Before you ever have to make this decision in a real emergency situation, could I suggest that the management, first aid representatives, Occupational Health personnel and safety personnel get together to define which substances this applies to, and how they are going to implement it.
It may sound daft, but because inducing vomiting is not a recognised first aid technique your first aiders might not be able to do it. Some techniques for inducing vomiting are potentially dangerous (drinking salty water, for instance is likely to be fatal if tried too often without success. This method was abandoned in hospitals some years ago because it was said that more people were dying from the salt water than the potential poisons).
There is a precedent for having first aiders adopt a special protocol for special, named substances (e.g. cyanide, hydrofluoric acid), but please don't wait until the first aider who has drawn the short straw has to make the big decision.
Jane
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Posted By Kate Graham
I do seem to remember on a very long-ago first aid course that the recommended way to induce vomiting if you ever did have to do it was to tell the casualty to put their own fingers down their throat (and on no account to put your own fingers in their mouth).
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Posted By Jimmy
Like a conciousness reduction kit
BANG HEAD HERE
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Posted By Karen Todd
I think it most unlikely in practice that someone would ingest these substances by accident (people should not be siphoning or pipetting by mouth).
The natural reaction would be to spit it out or gag, so very little would enter/remain the stomach.
If someone has decided to drink the stuff to cause themselves harm, that is another matter.
Karen
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Posted By Jimmy
Thanks Karen I share that with you.
That was the opening of my initial posting.
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Posted By Kate Graham
I agree it is unlikely, but not impossible if the bucket fell down, its lid flew off and someone who wasn't wearing their respirator got splashed in the face.
The point that the first aiders haven't been trained in how to induce vomiting is very relevant I think.
Oddly enough I have an msds for a substance that is *not* toxic and *is* irritant yet says "induce vomiting". I think I'll check out the msds for similar substances as possibly in this case the advice may be poor (the msds is up to date but it could be based by the supplier on out of date practice).
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Posted By John Murgatroyd
The general rule is NOT to induce vomiting.
In the case of cyanide, it is a waste of time. The treatment recommended is oxygen. But more than 50mg of cyanide and you're looking at a corpse, no mouth-to-mouth. Hydrofluoric acid: No. water or milk to wash the mouth. We use it at work, believe me, you're better-off replacing it with something less dangerous. Get it on your skin and you'd better wash it off quick, and then apply calcium gluconate gel and THEN get to hosital fast.
Get the container the ingested material came in, then get the casualty to hospital.
The St John ambulance recommended action is not to induce vomiting.
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