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chris42  
#1 Posted : 22 June 2016 10:45:13(UTC)
Rank: Super forum user
chris42

I know this is like the question how long is a piece of string and do an assessment, however I am doing an assessment. I’m looking for any guidance on what is an appropriate time for how long and or distance it should take as a maximum to get to an injured person. I know it will depend on the type of injury and the Guidance (L74) uses the word quickly, and immediately, but it is not realistic to have a first aider every 2 meters. You may have large sites, or short distances but with natural obstructions or even man made obstructions ie busy road between buildings. Has anyone come across any guidance that gives any indication of max treatment times for given potential injury types. I’m not so interested in biological or chemical issues more physical injury. Obviously safe working procedure to prevent, but if things go horribly wrong you need to have a backup, in terms of first aid provision. The types of injury that have a potential may be; crush injury from vehicle, significant cuts, possibly even amputation of finger or even hand, loss of consciousness from fall, type things I was considering. Given the above has anyone seen any other guidance other than L74, or a view from experience on when something is too far. Possibly just info on treatment times for above injuries, in terms of effectiveness on preserving life etc. For example 1) if you had a large site with the possible injuries noted above or 2) if you had two buildings with a busy road between and the injuries noted above possible in both buildings. I appreciate at the end of the day it will be down to both experience of the assessor and their opinion, but formal guidance and even others opinions can be helpful especially in convincing others. As always any help appreciated Chris
David Bannister  
#2 Posted : 22 June 2016 11:04:49(UTC)
Rank: Super forum user
David Bannister

A severed major artery can bleed out in 1 minute. Choking without air allows max 3 minutes. If I was in a working environment where I was exposed to a major amputation I would hope that a competent first aider could be with me before I died. Similarly with heart failure/major trauma/lack of breathing.
Kate  
#3 Posted : 22 June 2016 11:08:25(UTC)
Rank: Super forum user
Kate

The Resuscitation Council has figures for the impact of waiting for CPR, defib, paramedics on survival rates following cardiac arrest.
Graham Bullough  
#4 Posted : 22 June 2016 11:43:20(UTC)
Rank: Super forum user
Graham Bullough

Chris The following comments don't answer your question but might still be worth considering in relation to the main theme of your thread. Because of the various factors which can affect the capacity of first aiders to get to casualties as quickly as possible (and also affect how quickly they are told about casualties needing attention), I think there's a good case, wherever feasible, for employees to receive and understand emergency first aid training. Thus, if someone suffers a laceration resulting in serious bleeding, any other employee in the vicinity might have more confidence and initiative to try and staunch the bleeding as a holding action until a fully trained first aider can arrive. I've known of a number of organisations, including schools, which had a policy of training all employees in emergency first aid so that they could take appropriate urgent action if necessary until designated first aiders could take over. Also, some of the schools, notably primary schools, gave first aid training to their older pupils. Though such training is not on national curriculums, I think it's highly commendable and gives the pupils involved invaluable knowledge and ability for dealing with first aid scenarios which can occur anywhere, whether at home, school or during leisure activities, etc. (I know I've written about this aspect before and make no apology for grabbing an opportunity to do so again!) Graham B
RayRapp  
#5 Posted : 22 June 2016 12:00:23(UTC)
Rank: Super forum user
RayRapp

Chris I don't think there is a ready answer for this question as there are so many variables. The response times for emergency services also varies greatly but they do their best to attend...quickly.
chris42  
#6 Posted : 22 June 2016 12:27:12(UTC)
Rank: Super forum user
chris42

Thank you all for the replies so far. The reason I'm asking as I have a difference of opinion with another manager who is not willing to accept my "recommendation" which is purely based on my view. I was therefore hoping to put together a logical argument, backed by any guidance I can (or even others opinions) why a particular area should have their own First aider. We all have this type of conversation from time to time where you have to "prove" your advice "opinion". The problem with the HSE guidance is asks you to consider, which I did, but he has a different conclusion when he considered. Of course there is a financial consideration, but I think mostly no one in the area wants to be a first aider. I think it fair we should get challenged on our advice from time to time, but we all know that some of what we advise is based on experiences and many things reads and discussed over many years and not something written in nice black and white. In fact most risk assessment will have a lot of opinion in them. Anyway this diverges from the original question, So any other useful guidance ( I will look into Kate's comments) and opinions on the scenarios given. Chris
Invictus  
#7 Posted : 22 June 2016 12:53:10(UTC)
Rank: Super forum user
Invictus

If no-one in the area wants to be a first aider then it is them you need to convince with facts about how long it will take for someone to get to them in an emergency from another part of the site. You cannot force someone to do it, so there is no argument really.
chris42  
#8 Posted : 23 June 2016 09:35:16(UTC)
Rank: Super forum user
chris42

quote=Invictus]If no-one in the area wants to be a first aider then it is them you need to convince with facts about how long it will take for someone to get to them in an emergency from another part of the site. You cannot force someone to do it, so there is no argument really.
You are correct you cannot force them to do it, but it is not down to them to decide if it is needed. It is down to myself and the manager of that area. If we decide it is required then we have to move people about or get fresh blood in (so to speak). My question was mainly about information to help me decide and more so convince the manager. It seems obvious to me the situation we have a first aid person in this area is required. But he, faced with the same information came to a different conclusion. As noted above lots of factors, but the main one I see is the nature of the potential injuries and what would be appropriate treatment times to prevent death / permanent injury / disablement etc. Phrases like quickly or ASAP, are subjective, even "immediately" has to be taken with a pinch of salt. HSE guidance asking you to consider this and that is all well and good, but you need more information to make an informed decision. Would you want someone to say take 5 minutes to get to the IP given the previously noted injury types. Then again is it realistic for it to be 30 seconds (nice, but not realistic - is it). I keep hearing with regard to first aid and TV adverts for strokes etc that every second counts, but what is a practical aim for the above types of injury. Others must have similar injury types as a possibility, what rule of thumb (guidance) do they use. Not a first aider myself, not keen on blood, especially if it is coming out of someone Chris
neil88  
#9 Posted : 23 June 2016 11:30:48(UTC)
Rank: Forum user
neil88

chris42 wrote:
I know this is like the question how long is a piece of string and do an assessment, however I am doing an assessment. I’m looking for any guidance on what is an appropriate time for how long and or distance it should take as a maximum to get to an injured person. I know it will depend on the type of injury and the Guidance (L74) uses the word quickly, and immediately, but it is not realistic to have a first aider every 2 meters. You may have large sites, or short distances but with natural obstructions or even man made obstructions ie busy road between buildings. Has anyone come across any guidance that gives any indication of max treatment times for given potential injury types. I’m not so interested in biological or chemical issues more physical injury. Obviously safe working procedure to prevent, but if things go horribly wrong you need to have a backup, in terms of first aid provision. The types of injury that have a potential may be; crush injury from vehicle, significant cuts, possibly even amputation of finger or even hand, loss of consciousness from fall, type things I was considering. Given the above has anyone seen any other guidance other than L74, or a view from experience on when something is too far. Possibly just info on treatment times for above injuries, in terms of effectiveness on preserving life etc. For example 1) if you had a large site with the possible injuries noted above or 2) if you had two buildings with a busy road between and the injuries noted above possible in both buildings. I appreciate at the end of the day it will be down to both experience of the assessor and their opinion, but formal guidance and even others opinions can be helpful especially in convincing others. As always any help appreciated Chris
In my previous companies we had the following KPI's for Medical Emergency Response First Aid - 4 minutes to arrive on scene Medic - 20 mins (1 hour for certain remote locations) Medevac (transfer to hospital) - within 4 hours Transfer to specialist hospital - casualty dependent. This was for oil & gas companies where people may be remote or offshore.
stevedm  
#10 Posted : 27 June 2016 07:57:41(UTC)
Rank: Super forum user
stevedm

I do the Health Risk Assessment including emergency response for on and off shore ..which is the bit before Neil's KPis.. :) Your assessment should also consider the local emergency response times... I did a recent assessment in Wales where the local response times are pretty poor which justified further training and support to deal with things (similar to remote setting) and another near Stafford which didn't so in answer to your question. This is a quantitative way of calculating the response times on site...just bear in mind that a lot of what you are talking about here is outside your control. In the end if you don't comply with the Regs then you need to do something about that...despite your mangers opinion :)
chris42  
#11 Posted : 27 June 2016 09:59:23(UTC)
Rank: Super forum user
chris42

Thanks for the further replies. interesting numbers neil88, I have worked out that the response time is likely to be 5 minutes or more, it is unlikely to be less. I think this is too much, but take note of your 4 minute first aid time. Steve, this is not in Wales, but is an interesting thought about emergency service times. My original thought were on initial response, but if the first aider is longer getting to the IP then the potential worse condition the IP may be in. This means the longer they have to preserve life for the now more serious condition,before the emergency services get there. If I can't convince the Manager, plan B is I escalate it up. I just wanted to be sure, before doing so and wondered if there was any guidance on how to work it out. Odd though isn't it, people must be "working" these distances / times out all the time. But little formal guidance on how to do that. Plan C is to do a test, and prove the response time. Plan B and C may be the other way around. Plan D - not sure
MadiB  
#12 Posted : 29 June 2016 15:32:39(UTC)
Rank: Forum user
MadiB

I have had the same conversation many times over the last few years. At one point our FD suggested that we didn't need anyone on our saturday team in the office & warehouse trained as the shop could cover it. The shop is 1 1/2 miles across town with busy roads! I did get my point over on that one. We offer our first aiders a bonus for being qualified, £100 pa for emergency first aiders and £300 ps for full FAW (equivalent now). That helps persuade people. We have more than most "calculators" suggest we need due to a complex and spread out site but we interpose full and emergency rather than have all full. Once I had the initial "conversation" about numbers we no just replace any that leave. As an aside we issue them with an additional job description which includes making them responsible for one first aid kit. In previous years I have to check 10!
Reed21854  
#13 Posted : 29 June 2016 15:45:07(UTC)
Rank: Forum user
Reed21854

Hi there What type of work environment is this in? That has to be taken into account in terms of first aid risk assessment and the likelihood of a serious injury. I work in civil engineering and often we are working on different carriageways of a motorway project and / or on long linear sites. In terms of first aid we make sure all Supervisors are trained first aiders as part of their job role, we don't have any of the "I don't want to do that" scenario. We do also have take a pragmatic approach to supervision and will sometimes have one supervisors covering 2 or 3 discreet work areas, but they need to be close together and easy to get to ... I'm not sure this helps your debate.
kmason83  
#14 Posted : 29 June 2016 15:51:29(UTC)
Rank: Forum user
kmason83

Just a note that the ambulance 7 minute response time (or whatever it is now if it has changed although I don't think it has) is not based on a medical facts at all, so even the professionals have made a judgement call. From an FE/HE perspective assessing the level of cover required is based on the level of risk if you deem the risk level high enough that the area needs local cover then what more is there to say. It's great if you have financial incentive (but not all work places do) a further argument I have come across is that of full days lost in staff time owing to the same person taking all of the calls. You can spend hours thrashing out these issues at a senior team meeting, pushing the legislation along with associated cost and publicity implications should the proverbial hit the fan. Or what I find more effective is to to try and demonstrate your perspective as a practitioner and find out where the compromise is ensuring you still get the level of cover as per your risk assessment.
chris42  
#15 Posted : 30 June 2016 09:34:13(UTC)
Rank: Super forum user
chris42

Thanks all for the responses. I was hoping there was some official / tangible guidance out there I could point to. However as there is not, I will take the lead discussed in earlier posts. I want to get the manager on side, so he thinks the same as me about the need. If what he states is true about volunteers, I suspect it may be the way they were approached and not sold to them as a good idea both in work and their activities out of work. We cannot and will not try and force someone, but if needs must we can move people about or bring it up as a requirement for any new positions. I have so far looked into those injury types I noted earlier, which if things went horribly wrong with any of our controls, we could get. I have then listed the issues with delayed first aid provision and times, showing a five-minute response time (at best) is in appropriate. I’m hoping this is enough to convince him, but at the moment he is thinking about it. If still no from him, I have the option of persuading the directors to tell him, but that will not help future working relationships, so is last resort. The response time for an ambulance is interesting, but they effectively get there when they get there. My concern is about the preservation of life and general significant conditions until they arrive (sufficient first aiders and other provisions to allow this). Once I have the Manager on side, I hope I can persuade someone to volunteer. Point out that it could be useful in any external clubs they are in or for their family or themselves in a pinch. I suspect at best they were asked “anyone want to be a first aider?” – “No, ok then”. I think I can do better. It’s never come up as an issue before and most people can’t see why he thinks it would not be a reasonable requirement. But for me, first time in actually having to justify this sort of issue. I even asked a first aider what they were told. They said it was not covered, just “as soon as possible” or “quickly”. However, as I noted earlier not very helpful phrases, not precise or really meaningful. But we like things to not be prescriptive or limits set. Again thanks for all your input. Chris
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