First aid management
First aid must take into account:
- For the workplace: workplace policies and procedures; safe work practices; industry/site specific regulations, codes of practice; WHS requirements; State and territory legislative requirements;
- The setting in which first aid is provided, including: location and nature of the incident; associated situational risks e.g. electrical and biological hazards, weather, motor vehicle accidents; location of emergency services personnel.
- Australian Resuscitation Council (ARC) guidelines.
- Guidelines from Australian national peak clinical bodies.
- First aid requirements for services under the Education and Care Services National Law as required.
- The age, culture, ability or disability, health and mental status of the casualty.
- Legal, social and community responsibilities of the first aider including: stress management techniques and available support; duty of care; respectful behaviour towards a casualty; consent; privacy and confidentiality; debriefing; currency of skill and knowledge.
- Considerations when providing first aid including: safety; the use and availability of first aid equipment and resources; airway obstruction due to body position; appropriate duration and cessation of CPR; appropriate use of a defibrillator; standard precautions and infection control; the differences between adults and children.
Workplace practices, policies and procedures
State and territory legislation relevant to your workplace, and industry or site specific regulations must be taken into consideration when developing policies and procedures for first aid. Included in any document for the provision of first aid must also be emergency plans, safe work practices for risks and hazards and infection control, and how to provide first aid in accordance with guidelines from ARC and clinical peak bodies. A workplace first aider must be able to locate, and have an understanding of, the organisations policies and procedures for safety requirements and for the provision of first aid. First aid requirements will vary from one workplace to the next, depending on the nature of the work, the type of hazards, the workplace size and location, as well as the number of people at the workplace. These factors are taken into account when deciding what first aid arrangements need to be provided. The ‘First Aid Code of Practice’ provides information on using a risk management approach to tailor first aid that suits the circumstances of your workplace.
First aid Code of Practice
Codes of Practice are practical guides to achieving the standards of health, safety and welfare required under the Work Health and Safety (WHS) Act
and the relevant WHS Regulations in a jurisdiction. An approved Code of Practice applies to anyone who has a duty of care in the circumstances described in the code. Note
- A Code of Practice deals with particular issues and does not cover all hazards or risks that may arise. Therefore, health and safety duties also require duty holders to consider all risks associated with work, not only those for which Codes of Practice cover. The ‘FIRST AID IN THE WORKPLACE’ Code of Practice has been developed by Safe Work Australia and approved under the WHS ACT as a model Code of Practice for providing first aid safely in the workplace. For further information go to: safeworkaustralia.gov.au
The First Aid Code of Practice provides guidance for:
- using risk management to tailor first aid to suit the circumstances e.g.: identifying hazards that could result in work-related injury or illness; assessing the type, severity and likelihood of injuries and illness; providing the appropriate first aid equipment, facilities and training; reviewing first aid requirements on a regular basis or as circumstances change.
- the number of first aiders required in the workplace;
- the training that first aiders must receive and who provides it;
- the contents of first aid kits and its location;
- other first aid equipment such as automatic defibrillators (AED), eye wash and shower equipment, first aid facilities and rooms;
- procedures including: record keeping for first aid; first aid requirements when managing an emergency.
Duty of care
If a first aider decides to provide assistance to a person in need, they must provide a standard of care appropriate to their training (or lack of training) and never go beyond their own skills and limitations. Act in ‘good faith’ and without recklessness and with reasonable care and skill. First aid must be provided in accordance with established first aid principles. The casualty must be made as comfortable as possible using available resources and equipment. First aid equipment must be operated according to manufacturer’s instructions. The first aider should stay with the casualty unless it is necessary to call for medical assistance, a rescuer of equal or higher ability takes over, or continuing to give aid becomes unsafe. If you are trained in first aid, it is imperative that you maintain currency of skills and knowledge. Routinely attend refresher courses and be aware of changes to legislation, policy and procedures and ARC guidelines in relation to first aid. First aid in the workplace - In a workplace emergency, all workplace first aiders and staff have a duty of care. One must use common sense which dictates that, while they should not act beyond their capabilities, they are expected to do as much as they can to take appropriate action.
- Provide treatment - recognise symptoms; administer first aid in accordance with procedures and protocols;
- Report - complete a report as soon as possible after the incident according to relevant procedures and legislation;
- Self-evaluate and debrief - to address individual needs and improve response to future incidents.
Privacy and confidentiality
Personal information about the health of a casualty must be kept confidential and should only be accessed by authorised people. Information includes details of medical conditions, treatment provided and the results of tests. Disclosure of personal information, without that person's written consent, is unethical and in some cases may be illegal.
The consent of an injured or ill person must be obtained before any assistance is rendered, regardless of age, ability, health or mental status. If the casualty is a minor, consent must come from a parent or guardian. Legal action and damages may be taken against you if you act without obtaining consent. The requirement for consent may be waived in certain circumstances, or implied, for example, if a casualty is unconscious. Competent adults are legally entitled to refuse any treatment, even if it is life-sustaining. Substitute decision-makers, such as parents or guardians of minors or legal guardians can likewise refuse treatment but only if in the ‘best interests’ of their charge.
Ethical issues are dependent on law, cultural beliefs and principles and on moral grounds. Simple ethics include always displaying respectful behaviour towards the casualty, maintaining respect for their beliefs, privacy and dignity and paying careful attention to consent and confidentiality.
The role of the first aider depends on gaining the trust of casualties. Maintaining trust requires attentiveness and finding culturally appropriate ways of communicating that are courteous and clear. A strong sense of cultural awareness is required for all first aiders. Cultural awareness is required for treating casualties from diverse backgrounds. You need to be able to respect the values of different cultural groups and treat them with sensitivity. It may sometimes be necessary to communicate through verbal and non-verbal communication and you need to have the ability to identify issues that may cause conflict or misunderstanding.
Evaluation of own performance
Whilst providing the initial care for a casualty, you must be aware of your own skills and limitations. Your basic treatment can save lives, however, evaluating your own performance can provide you with an opportunity for self-improvement. It may be beneficial to speak with the paramedics who attended the incident. It is extremely important to recognise the possible psychological impacts on yourself, other rescuers, and children (if you work with children), especially when involved in critical incidents.
Each person reacts differently to traumatic events and in some instances, a situation may evoke strong emotions, which may affect the health, well-being and work performance of some individuals. What might be minor to one person may be quite significant and traumatic to another. In short, there is no right or wrong way to feel. What a person experiences is valid for that person. In some cases symptoms can develop into a chronic illness, requiring extensive and long term treatment. ANY traumatic event can leave devastating emotional residue. Symptoms can appear immediately or later, days, months or even years after the original event. In a workplace, debriefing should be done with a supervisor so that the incident can be discussed, evaluated and recorded for future improvement and referral. Also to ensure the first aider is not suffering emotionally after attending the incident. Where multiple people are involved, a group discussion, meeting or debriefing will be required.
Signs and symptoms of stress
Feeling stressed following a first aid response is a perfectly normal occurrence. You must understand the need for stress management techniques and find out what support is available following attendance at an emergency situation. Some of the signs and symptoms of stress include:
- Physical- fatigue, headache, insomnia, muscle aches, stiff neck, heart palpitations, chest pains, abdominal cramps, cold extremities flushing/sweating, frequent colds;
- Mental- decreased concentration/memory, indecisiveness, mind racing/going blank, loss of sense of humour;
- Emotional- anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper;
- Behavioural - pacing, fidgeting, nervous habits, crying, yelling, swearing, blaming, throwing things, eating, smoking, drinking. Feeling anti-social towards others.