Welcome Guest! The IOSH forums are a free resource to both members and non-members. Login or register to use them

Postings made by forum users are personal opinions. IOSH is not responsible for the content or accuracy of any of the information contained in forum postings. Please carefully consider any advice you receive.

Notification

Icon
Error

Options
Go to last post Go to first unread
Righton-Corrick22193  
#1 Posted : 18 June 2019 13:15:39(UTC)
Rank: New forum user
Righton-Corrick22193

Im having a disagreement with one of our first aiders.  My understanding is that first aiders can only recommend to someone who may be having a heart attack to take asprin, that they are not allowed to supply or administer it as part of their first aid duties and that asprin must not be kept in the first aid box.

However, his is adamant that we, the company, must supply it and he has been advised we should keep it in the defib unit box.

Having read the tablets and medication section on the HSE website, asprin is identified as an exception, but does this mean that organisations have to supply it on site and that first aiders are allowed to administer it?

johnwatt  
#2 Posted : 18 June 2019 14:12:35(UTC)
Rank: Forum user
johnwatt

What does your risk assessment of first aid needs state?

The administration of aspirin is recommended in cases of a suspected heart attack and there is no reason why this cannot be given by a first aider or kept within workplace first aid kits etc. Aspirin is NOT a prescription only medicine. 

What is it that you are concerned about? Aspirin costs ~0.60p for 32 tablets OTC.

John

Roundtuit  
#3 Posted : 18 June 2019 14:14:28(UTC)
Rank: Super forum user
Roundtuit

Please provide in black and white the act, statute or regulation where it is stated that "as employer I must..."

The HSE guidance is suitably wooly but pretty clear that tablets should not be available for any one to access via the First Aid Box (or de-fib or chest of drawers)

thanks 4 users thanked Roundtuit for this useful post.
Righton-Corrick22193 on 18/06/2019(UTC), A Kurdziel on 19/06/2019(UTC), Righton-Corrick22193 on 18/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
Roundtuit  
#4 Posted : 18 June 2019 14:14:28(UTC)
Rank: Super forum user
Roundtuit

Please provide in black and white the act, statute or regulation where it is stated that "as employer I must..."

The HSE guidance is suitably wooly but pretty clear that tablets should not be available for any one to access via the First Aid Box (or de-fib or chest of drawers)

thanks 4 users thanked Roundtuit for this useful post.
Righton-Corrick22193 on 18/06/2019(UTC), A Kurdziel on 19/06/2019(UTC), Righton-Corrick22193 on 18/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
Righton-Corrick22193  
#5 Posted : 18 June 2019 14:24:09(UTC)
Rank: New forum user
Righton-Corrick22193

Thanks

but in the HSE guidance is states that they must not be kept in the first aid box.  And other guidance states that first aiders should not administer it but only recommend the use, but its the bit in the HSE guidance that states its and exception, but an exception to what? Its not clear.

Cost is not the issue. 

Originally Posted by: johnwatt Go to Quoted Post

What does your risk assessment of first aid needs state?

The administration of aspirin is recommended in cases of a suspected heart attack and there is no reason why this cannot be given by a first aider or kept within workplace first aid kits etc. Aspirin is NOT a prescription only medicine. 

What is it that you are concerned about? Aspirin costs ~0.60p for 32 tablets OTC.

John

johnwatt  
#6 Posted : 18 June 2019 14:43:22(UTC)
Rank: Forum user
johnwatt

Can you define your understanding of administration? The advice is 300mg Aspirin administered orally not parenterally so the casualty is always going to have to make the decision to swallow this themselves. This whole thing re administration is a bit of a misnomer in first aid and causes much confusion. I've heard so many ridiculous stories in my many years of teaching and practising this. 

Re keeping it in the first aid box, common sense also needs to prevail here. The risk is negligible and if your kit is in a first aid room or other relatively secure area etc, then I see no problem. Perhaps, if your kit was on a wall and accessible to any tom, dick and harry then it might be more of a problem but again what are the risks? The only thing I'd be concerned about personally is ensuring they are not accessible to children and vulnerable adults. 

thanks 1 user thanked johnwatt for this useful post.
jwk on 21/06/2019(UTC)
Roundtuit  
#7 Posted : 18 June 2019 14:54:45(UTC)
Rank: Super forum user
Roundtuit

Aspirin is the one exception to any form of medicine in first aid at work provision

Asthma inhalers, epi-pens, GTN spray should only be in the possession of those prescribed them in the work place. Cold & flu remedies, cough bottles, and other over the counter medicines similarly are for the use of the purchaser not stocking in the works first aid cabinet.

thanks 2 users thanked Roundtuit for this useful post.
A Kurdziel on 19/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
Roundtuit  
#8 Posted : 18 June 2019 14:54:45(UTC)
Rank: Super forum user
Roundtuit

Aspirin is the one exception to any form of medicine in first aid at work provision

Asthma inhalers, epi-pens, GTN spray should only be in the possession of those prescribed them in the work place. Cold & flu remedies, cough bottles, and other over the counter medicines similarly are for the use of the purchaser not stocking in the works first aid cabinet.

thanks 2 users thanked Roundtuit for this useful post.
A Kurdziel on 19/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
johnwatt  
#9 Posted : 18 June 2019 14:59:49(UTC)
Rank: Forum user
johnwatt

Originally Posted by: Roundtuit Go to Quoted Post

Aspirin is the one exception to any form of medicine in first aid at work provision

Asthma inhalers, epi-pens, GTN spray should only be in the possession of those prescribed them in the work place. Cold & flu remedies, cough bottles, and other over the counter medicines similarly are for the use of the purchaser not stocking in the works first aid cabinet.

Kinda, there are exceptions, spare Adrenaline auto-injectors for instance, can be kept by schools. 

Also bear in mind that there are a range of medicines that anybody can legally use in an emergency. Doesn't mean to say they can be kept in first aid kits, but first aiders can and should help the casualty administer where available and trained. Adrenaline auto-injectors, asthma inhalers, etc are all good examples. 

http://www.legislation.gov.uk/uksi/2012/1916/schedule/19/made

Edited by user 18 June 2019 15:04:36(UTC)  | Reason: Not specified

johnwatt  
#10 Posted : 18 June 2019 15:08:20(UTC)
Rank: Forum user
johnwatt

FYI, this is what "currently accepted first aid practice" states:

​​​​​​​https://photos.app.goo.gl/TP97pVwaMQ1UG34t8

jmaclaughlin  
#11 Posted : 18 June 2019 15:53:24(UTC)
Rank: Forum user
jmaclaughlin

While you may not be legally obliged to provide Aspirin, having some at hand might help reduce the impact of a heart attack so is the sensible option, technically it’s just at hand, not being administrated or dispensed.

Also worth considering if somebody had an attack and you didn’t have Aspirin to hand, and in the aftermath somebody asks why didn’t you have such a simple, cheap and effective measure in place,How are you going to respond?.

thanks 1 user thanked jmaclaughlin for this useful post.
johnwatt on 18/06/2019(UTC)
Acorns  
#12 Posted : 18 June 2019 16:42:14(UTC)
Rank: Super forum user
Acorns

Originally Posted by: jmaclaughlin Go to Quoted Post

While you may not be legally obliged to provide Aspirin, having some at hand might help reduce the impact of a heart attack so is the sensible option, technically it’s just at hand, not being administrated or dispensed.

Also worth considering if somebody had an attack and you didn’t have Aspirin to hand, and in the aftermath somebody asks why didn’t you have such a simple, cheap and effective measure in place,How are you going to respond?.

Not sure that question has much value, it could equally apply if we didn't have some sugar or a mars bar (Others are available) in case someone has hyper/hypo diabetes symptoms.  Lots of things can be resolved with simple steps, but we can't be expected to be prepared for them all - or are we?

Roundtuit  
#13 Posted : 18 June 2019 16:58:18(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: jmaclaughlin Go to Quoted Post
somebody asks why didn’t you have such a simple, cheap and effective measure in place

We are talking about the legal duties under First Aid at Work.

To answer your question the coroners court had no interest in whether aspirin was available it was all about why it took over an hour for the paramedics to attend a suspected heart attack despite multiple 999 calls.

NO amount of aspirin availability can balance that situation

thanks 2 users thanked Roundtuit for this useful post.
A Kurdziel on 19/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
Roundtuit  
#14 Posted : 18 June 2019 16:58:18(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: jmaclaughlin Go to Quoted Post
somebody asks why didn’t you have such a simple, cheap and effective measure in place

We are talking about the legal duties under First Aid at Work.

To answer your question the coroners court had no interest in whether aspirin was available it was all about why it took over an hour for the paramedics to attend a suspected heart attack despite multiple 999 calls.

NO amount of aspirin availability can balance that situation

thanks 2 users thanked Roundtuit for this useful post.
A Kurdziel on 19/06/2019(UTC), A Kurdziel on 19/06/2019(UTC)
hilary  
#15 Posted : 19 June 2019 07:37:12(UTC)
Rank: Super forum user
hilary

We're only talking a couple of aspirin here - you don't need a whole box ... how many people are you anticipating will be having heart attacks at the same time?

Just stick a couple in the first aid supplies labelled up "for use in the event of heart attack only" and keep the rest under lock and key elsewhere.

No one is going to be able to kill themselves with two aspirin.

Roundtuit  
#16 Posted : 19 June 2019 07:43:31(UTC)
Rank: Super forum user
Roundtuit

Roundtuit  
#17 Posted : 19 June 2019 07:43:31(UTC)
Rank: Super forum user
Roundtuit

hilary  
#18 Posted : 19 June 2019 07:59:09(UTC)
Rank: Super forum user
hilary

Yeah, and you can drown in a glass of water so let's not do that either.  There are always exceptions but I would expect anyone with an allergy to aspirin not to take this.

Righton-Corrick22193  
#19 Posted : 19 June 2019 08:16:34(UTC)
Rank: New forum user
Righton-Corrick22193

With 100,000 people suffering from heart attacks in the UK you would think it was a no brainer but then when you discover 6 - 20% of the population have Aspirin hypersensitivity (and may not be aware of it) with 20%+ of asthmatics being especially hypersensitive, its a bit of a conundrum.

Really, I want to know what the law says so have contacted the HSE to clarify the point, I dont have a problem having aspirin on site but would rather a rounded level of information to make the right decisions and not put any of our first aiders in a difficult position.

Then what if we ran out of Aspirin on the day someone had a heart attack, would we be chastised for not having it on site? Or it had run out of date?

The guidance also says do not give Aspirin to someone with undiagnosed chest pains - well whats the assumption with chest pains from a first aider point of view?

Originally Posted by: Roundtuit Go to Quoted Post

Edited by user 19 June 2019 08:23:32(UTC)  | Reason: Not specified

Acorns  
#20 Posted : 19 June 2019 09:11:54(UTC)
Rank: Super forum user
Acorns

Originally Posted by: Righton-Corrick22193 Go to Quoted Post

With 100,000 people suffering from heart attacks in the UK you would think it was a no brainer but then when you discover 6 - 20% of the population have Aspirin hypersensitivity (and may not be aware of it) with 20%+ of asthmatics being especially hypersensitive, its a bit of a conundrum.

With over 30million people 'in work', our 100K heart attacks is less than 0.3% compared to the 6-20% were it may cause an issue. ​​​​​​​If you look at your numebrs then there is a persuasion NOT to issue / give / offer aspirin.
thanks 1 user thanked Acorns for this useful post.
Righton-Corrick22193 on 19/06/2019(UTC)
jmaclaughlin  
#21 Posted : 19 June 2019 09:40:55(UTC)
Rank: Forum user
jmaclaughlin

>The guidance also says do not give Aspirin to someone with undiagnosed chest pains - well whats the assumption with chest pains from a first aider point of view?

The point is the AI/Script in the defibulator will probaly instruct you to give the person 300mg of chewable Aspirin in the event of a heart attack as per currrent 1st Aid guidance.

It's not a legal requirement to do so, just very sensible IMO.

thanks 1 user thanked jmaclaughlin for this useful post.
Righton-Corrick22193 on 19/06/2019(UTC)
Roundtuit  
#22 Posted : 19 June 2019 09:48:34(UTC)
Rank: Super forum user
Roundtuit

Only if it is the right type of defibrilator AND there is one present in the workplace - again another useful to have but not a specific legal requirement

thanks 2 users thanked Roundtuit for this useful post.
Righton-Corrick22193 on 19/06/2019(UTC), Righton-Corrick22193 on 19/06/2019(UTC)
Roundtuit  
#23 Posted : 19 June 2019 09:48:34(UTC)
Rank: Super forum user
Roundtuit

Only if it is the right type of defibrilator AND there is one present in the workplace - again another useful to have but not a specific legal requirement

thanks 2 users thanked Roundtuit for this useful post.
Righton-Corrick22193 on 19/06/2019(UTC), Righton-Corrick22193 on 19/06/2019(UTC)
Roundtuit  
#24 Posted : 19 June 2019 20:13:40(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: hilary Go to Quoted Post
Yeah, and you can drown in a glass of water so let's not do that either. There are always exceptions but I would expect anyone with an allergy to aspirin not to take this.
I will agree you can drown in an inch of water - not convinced by a glass The real problem with allergies is we aren't born with a bar code or marker identifying our issues - we only find out after an event what we are allergic to hence my common response to medical practitioners "not that I am aware of" - some food stuffs cause discomfort but given I like the taste I don't want some allergy specialist telling me to avoid them for the rest of my natural "ignorance is often bliss"
Roundtuit  
#25 Posted : 19 June 2019 20:13:40(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: hilary Go to Quoted Post
Yeah, and you can drown in a glass of water so let's not do that either. There are always exceptions but I would expect anyone with an allergy to aspirin not to take this.
I will agree you can drown in an inch of water - not convinced by a glass The real problem with allergies is we aren't born with a bar code or marker identifying our issues - we only find out after an event what we are allergic to hence my common response to medical practitioners "not that I am aware of" - some food stuffs cause discomfort but given I like the taste I don't want some allergy specialist telling me to avoid them for the rest of my natural "ignorance is often bliss"
johnwatt  
#26 Posted : 20 June 2019 07:15:28(UTC)
Rank: Forum user
johnwatt

Originally Posted by: AcornsConsult Go to Quoted Post
Originally Posted by: Righton-Corrick22193 Go to Quoted Post

With 100,000 people suffering from heart attacks in the UK you would think it was a no brainer but then when you discover 6 - 20% of the population have Aspirin hypersensitivity (and may not be aware of it) with 20%+ of asthmatics being especially hypersensitive, its a bit of a conundrum.

<With over 30million people 'in work', our 100K heart attacks is less than 0.3% compared to the 6-20% were it may cause an issue. ​​​​​​​If you look at your numebrs then there is a persuasion NOT to issue / give / offer aspirin.<

So let me get this straight. You think to offer aspirin to a person having a heart attack, an acute/life-threatening illness, is a bad idea, based on the fact that some people are hypersensitive and might come out in a rash?

This is long-standing advice provided by medical experts and peer-reviewed evidence, your Google search doesn't trump this. Aspirin can make a significant difference in the morbidity/mortality of myocardial infarctions.

There are over 100,000 hospital admissions in the UK for a heart attack each year! How many people died of an anaphylactic reaction to aspirin in that same period? Further, as a first aider, you would only be giving a conscious casualty aspirin. They don't lose the ability to tell you they are allergic! The chance of somebody having a life-threatening reaction to aspirin (without knowing they are allergic), and on the back of a heart attack are incredibly small and not worth worrying about. This concept is a basic tenet of risk management.

Sometimes I cannot believe the things I read on here. Google is dangerous. 

Edited by user 20 June 2019 07:17:53(UTC)  | Reason: Quote layout

thanks 2 users thanked johnwatt for this useful post.
webstar on 20/06/2019(UTC), Dave5705 on 21/06/2019(UTC)
stevedm  
#27 Posted : 20 June 2019 07:19:18(UTC)
Rank: Super forum user
stevedm

I do love it when we non-med guys talk about meds :)...adminstration of asprin has pros and cons...not withstanding allergy..

Pro

  • It has an anti-platelet action which reduces clot formation
  • Analgesic, antipyretic and anti-inflammtory

Con

  • Gastric bleeding - how do you know as a first aider?
  • It can cause some asthmatic to wheeze 

Your PT is able to give consent, so good assesment and history is the key...if in doubt don't.

The benefits in general of 300mg asprin will outweigh the risks....that said you first aiders must be aware of the contra-indications...we are really talking about a suspected MI...which you should give asprin in any case...just out of interest...who was the training organisation that said it was a MUST have?

Roundtuit  
#28 Posted : 20 June 2019 07:29:12(UTC)
Rank: Super forum user
Roundtuit

Whilst the comment is likely to have been triggered by a training organisation the OP specifically mentioned the source as one of their first aiders stating it was a MUST

No one in this thread has disagreed aspirin has a beneficial role to play (even with possible allergic side effects).

At the same time no one has identified where it categorically states aspirin MUST (as opposed to nice to) be made available by the employer

Edited by user 20 June 2019 07:47:01(UTC)  | Reason: FFS

Roundtuit  
#29 Posted : 20 June 2019 07:29:12(UTC)
Rank: Super forum user
Roundtuit

Whilst the comment is likely to have been triggered by a training organisation the OP specifically mentioned the source as one of their first aiders stating it was a MUST

No one in this thread has disagreed aspirin has a beneficial role to play (even with possible allergic side effects).

At the same time no one has identified where it categorically states aspirin MUST (as opposed to nice to) be made available by the employer

Edited by user 20 June 2019 07:47:01(UTC)  | Reason: FFS

stevedm  
#30 Posted : 20 June 2019 07:50:35(UTC)
Rank: Super forum user
stevedm

I know...ok for those who need more clarity....'Which training organisation told your first aider that it was a must have?'

CptBeaky  
#31 Posted : 20 June 2019 08:29:39(UTC)
Rank: Super forum user
CptBeaky

During my 1st aid refresher (done 6 months ago) I was told that it was "ok" to keep aspirin in close proximity to the AED (in the box for example). I wasn't told you have to, or you should do. Just it was ok to do this.

This was by St. Johns

stevedm  
#32 Posted : 20 June 2019 10:15:11(UTC)
Rank: Super forum user
stevedm

Thanks...I cannot emphasise enough patient history and assessment in this....this can sometimes sneak up on a person so history is key and initial responses are different - i.e women present more with chest discomfort, whereas men present more with numbness in arms and shortness of breath (there are more this is just to illustrate the point!)...also if training organisations are giving advice on Asprin..that is good, however there are contra-indications and they should know when not to as well as when they should...

first aid is exactly that and no more we talk a lot about competence, knowing what you don't know!? (Scope of clinical practice)...I carry out audits for CS medical response where I have found first aiders with kit that Anesthetists would be jealous of!...(God loves Ebay!)...I only teach enhanced FA now.

We all want to save a life, it is fantastic sense of achievment escpecially to get ROSC (next to delivering a baby that is..!) ...the use of asprin to assist in the early symptoms of an MI are clear...just remember the scope of the First Aiders Practice, Asprin is not a controlled drug under MDA 1971 or MDR 2001...it will come down to your risk assessment again...if your Ambulance Service meets all of its A8 times then great you don't have to think too hard...if not think what you can sensibly do with the skills you have....

Also final thing I will add is practice practice practice - use different scenarios to get your first aiders confident with history taking and handover..if you hesitate I will ignore you and all of that good work will go to waste...PT first.. :)

thanks 2 users thanked stevedm for this useful post.
A Kurdziel on 20/06/2019(UTC), Dave5705 on 21/06/2019(UTC)
Users browsing this topic
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.