The first few minutes can be critical in cases of serious injuries involving stopped breathing, cardiac arrest, or uncontrolled bleeding. While large-scale, well-planned construction projects will have made provisions to comply with OSHA standards that require that prompt first aid be available, if (for example) yours is a follow-on trade, and you work on a lot of smaller, non-union projects, it would be easy to overlook that, quite possibly, one or more of your current jobsites is not in compliance with this potentially life-or-death requirement.
While of course the lives and the safety of your employees ought to be your paramount concern, yes, even if you’re a follow-on trade, and the general contractor has primary responsibility to ensure compliance with the first aid requirements, if your workers happen to be onsite when the OSHA inspector happens by, you will probably be cited based on OSHA’s multi-employer policy, and be liable for violations and penalties as an "exposing employer."
The basic first aid requirements can be found in 29 C.F.R. Sec. 1926.50. The employer is required to "insure the availability of medical personnel for advice and consultation on matters of occupational health," and to make provisions, "prior to commencement of the project, for prompt medical attention in case of serious injury."Sub-paragraph (c) of the standard provides:
In the absence of an infirmary, clinic, hospital, or physician, that is reasonably accessible in terms of time and distance to the worksite, which is available for the treatment of injured employees, a person who has a valid certificate in first-aid training from the U.S. Bureau of Mines, the American Red Cross, or equivalent training that can be verified by documentary evidence, shall be available at the worksite to render first aid.
While the standard does not define the key term, "reasonably accessible in terms of time and distance to the worksite," OSHA interprets that as requiring that emergency medical care be available no more than 3-4 minutes’ travel time distant from the workplace, at least in workplaces where falls, suffocation, electrocution, or amputation are possible. (Longer response times are permissible in less hazardous workplaces, such as offices).
The better practice is, if you are a subcontractor sending employees to work on a site in an urban area, have your office make its own inquiry as to whether there is a proper facility (such as an emergency room or infirmary) within 3-4 minutes’ driving time from the job site. While, obviously, every GC running a job should have the location and directions to the nearest emergency care at its fingertips, even if you’re not the GC, make sure your foreman has that information.
The standard requires that a communication system for contacting an ambulance service be provided, and (in areas not served by "911") that the telephone numbers for the ambulance service, hospitals, or physicians be conspicuously posted.
The more rural or remote the job site is, unless (obviously) the site happens to be near to a known emergency care facility, the more critical it will be that someone with the proper credentials, and truly competent to render first aid, be on the site.
The surest way to guarantee that on-site first aid will be available, should your employee be injured, is to hire employees who can document American Red Cross or equivalent first-aid training, or to make an investment in providing such training to some of your more trusted employees.
As for the first aid kit, while there is no one-size-fits-all prescription for what must be included, an appendix to the standard references ANSI Standard Z308.1-1978, "Minimum Requirements for Industrial Unit-Type First Aid Kits." OSHA recommends, also, that your local Fire/Rescue Department, medical professional or emergency room be consulted, concerning additional items to include, and that employers periodically assess the specific needs of their worksite.
Also, if it’s anticipated that employees using first-aid supplies will be exposed to blood or other potentially infectious materials, suitable PPE (gloves, gowns, face shields, masks and eye protection) should be provided, and kept together with the first aid kit.
Note also that the first aid kit must be in a weatherproof container, with individual sealed packages for each type of item, and must be checked by the employer before being sent out on each job, and at least weekly during each job, to ensure that items expended are replaced. A form enclosed in a plastic sheet should be kept in the kit, for the recording of each date and the signature of the person performing each check of the kit as required.
Also included in the first aid standard is the requirement for facilities for quick drenching or flushing of the eyes and body, where these may be exposed to corrosive materials.
If you’re a general contractor, since, under the standard, provisions for prompt medical attention are to be made "prior to commencement of the project," clearly you have the responsibility to take on a leading role.Among other things, if you will not have employees of your own with first-aid training and certificates on the job, that needs to be a consideration in choosing and engaging subcontractors.
As GC, you certainly ought to identify the nearest emergency room or similar facility, ensure that the phone numbers are posted, and provide and check regularly the required first-aid kit (and, if applicable, the eye/body washing facility).
At the outset of the job, and again on the arrival of each new subcontractor, efforts as necessary should be made to ensure that every trade knows where the emergency room (infirmary, clinic, or physician) is located, and how to make contact; who the qualified first-aid providers on-site are, and where the first aid kit is maintained. As always, it’s not only good to do these things, but you are wise to document having done them as well. Your safety director or other senior employee should prepare a memo including such information, have each subcontractor countersign the memo to acknowledge its receipt, and retain in a safety/OSHA file for the project the countersigned copy.
These particular OSHA standards arguably should not be necessary. A basic understanding of construction hazards, minimal concern for the lives and the safety of the men and women who work at construction sites, and a modest dose of common sense should suffice to make the required practices a matter of course.
It is not unheard of, unfortunately, that serious accidents occur, followed by the discovery that there is no trained first aid giver at hand, or that no one knows where the first aid kit is stored. Precious time is sometimes lost, because no one had the forethought to identify in advance the nearest hospital or other suitable facility.
It’s counter-productive, obviously, to observe the most highly technical construction safety standards, while neglecting the basics. OSHA’s first aid standards are among the easiest to comply with, as well as the most important. It’s well worth double-checking, to ensure that your company is in compliance.