First Aid: Don't Worry About Using the Tourniquet
(Article #23)

MAKING MEDICAL ROUNDS!

Think about it! If there were an accident in your school’s science laboratory requiring application of first-aid procedures on an employee or student, would you know what to do? Is there someone with medical expertise that you could call? Do you have the means (telephone, intercom) to contact the individual from the laboratory? Can you legally without threat of lawsuit, provide first-aid to the injured? Are first-aid supplies available? Do you really need a first-aid kit in the laboratory? Can you just wait until the school nurse arrives? These are all very valid and real questions which many science teachers and supervisors need to address.

To provide some answers and direction on the topic of first-aid, we need to first refer to the Occupational Safety and Health Administration (OSHA) and American National Standards Institute (ANSI) regulations and standards.

IS THERE A DOCTOR IN THE HOUSE?

OSHA 29 CFR 1910.151 Subpart K Medical and First Aid standard requires the employer to ensure the ready availability of medical personnel for advice and consultation. If a clinic, hospital or infirmary are not in proximity to the workplace for treatment of all injured employees, OSHA requires that someone on the job site must be adequately trained to render first-aid. In addition, first-aid supplies must be made available. Furthermore, OSHA specifically notes that for situations where a person’s eyes or body may be exposed to injurious corrosive materials, facilities for quick drenching or flushing of eyes and body must be available for immediate emergency use.

Subpart K gives some direction for school science teachers and supervisors. Namely, if you have an EMT, nurse, physician or first-aid certified individual on site or in close proximity, training of employees in first-aid is not required.

However, the last part of the standard makes the science teacher the exception to the previous statement. Science laboratories generally make use of injurious corrosive materials. Science teachers and supervisors must therefore have some first-aid training relative to the use of drenching or flushing equipment. Eyewash and acid shower use should be annually reviewed as part of the first-aid training of all science teachers and supervisors.

Given that the first few minutes following a laboratory safety incident are absolutely critical, there are some additional items for which science teachers and supervisors need first-aid training. By the time medical responders get to the laboratory site, it may be too late.

From a legal perspective, if an employee provides first-aid without training or in some instances provides no first-aid, there is potential for legal action from the victim, should things go bad! Be certain to request formal first-aid training as appropriate for science laboratories from your employer.

MEDICINE 101!

Safety incidents requiring first-aid training for science teachers working in school laboratories should include:

Burns: Chances are good that someone will get burned in the laboratory from Bunsen burners, matches, hotplates, etc. Should that happen, immediately soak the burned area in cold water. Request immediate assistance from the school’s health care provider.

Chemical Exposure: With an increased emphasis on hands-on, process and inquiry-based science, chemical exposure has a heightened probability of happening. Be certain to have the MSDS available for each hazardous chemical used and review it prior to any laboratory work being done. Should there be an exposure, have the injured person immediately (within 10 seconds) use the eyewash or acid shower, as appropriate. Flush with copious amounts of tepid water for a minimum of 15 minutes. Request immediate assistance from the school’s health care provider. Note that an eyewash and acid shower are required safety engineering equipment for science laboratories!

Swallowed Poisons: Accidental swallowing of poisonous chemicals in the laboratory can happen. It is critical to review MSDS with students prior to use of these chemicals so all are familiar with their potential harm to the body. If the person becomes unconscious or is convulsing, do not induce vomiting. The same is true should the person complain of a “burning feeling” in their throat. Provide plenty of water or milk if available. Request immediate assistance from the school’s health care provider. It is also wise to contact the Poison Control Center if you know what poison has been accidentally taken.

Penetrating Objects: Use of projectiles, walking in a laboratory with sharp hazards, etc., can be hazardous and cause body penetration. Do not remove the object. Try to keep the individual calm and still. Request immediate assistance from the school’s health care provider.

Lacerations: Broken glassware or other sharp objects can cause cuts in the skin. If bleeding occurs, try to have the injured person put on latex or NIOSH approved plastic gloves and apply direct pressure to control bleeding. It that is not possible, use caution to keep a barrier (glove) between you and the injured person while trying to apply direct pressure. Request immediate assistance from the school’s health care provider.

FIRST-AID KITS: NON-MANDATORY OR ARE THEY?

The OSHA 29 CFR 1910.151 Appendix A First Aid Kits section is listed as “non-mandatory.” In other words, although first-aid supplies are required to be readily available, OSHA does not provide a mandatory list of contents. The good news is, OSHA notes employers who follow the basic list of first-aid kit contents available from the American National Standards Institute (ANSI Z 308.1-1978), will have the necessary first-aid supplies to handle most workplace emergencies. Included in the ANSI list are large and small sterile bandages, adhesive tape, antibiotic cream, antiseptic solution, scissors, eyewash, cotton balls and swabs.

Additional items for consideration in workplace environments with unique needs can be considered by reviewing the OSHA 300 log. For example, if the log lists injuries with cuts and/or other sources of blood, your first-aid kit should provide personal protective equipment to be available; e.g. latex or other suitable gloves and eye protection (Bloodborne Pathogen standard – 29 CFR 1910.1030).

THAT’S A WRAP!

Bottomline is as in other cases with safety standards, science teachers are special! Safety first-aid training for hazardous chemicals and bloodborne pathogens is required. Additional first-aid with training is also needed for other types of incidents in the laboratory such as chemical exposure, burns, swallowed poisons, penetrating objects and lacerations.

Additional Resources:

Occupational Safety and Health Administration: http://www.osha.gov

American National Standards Institute: http://www.ansi.org

American Red Cross: http://www.redcross.org

Author’s Note: Special thanks goes to Jan Williams, BSN, Head Nurse, Glastonbury Public Schools (CT) and John Able, Occupational Safety Training Specialist, State of Connecticut, Department of Labor, Division of Occupational Safety and Health, Wethersfield (CT), for their technical assistance in writing this article

LIVE LONG AND PROSPER WITH SAFETY!

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Dr. Ken Roy
K-12 Director of Science & Safety & authorized OSHA instructor
c/o Glastonbury Public Schools
Glastonbury, CT 06033-3099
Fax 860-652-7275
E-Mail: royk@glastonburyus.org