SECTION 12
ON-SITE MEDICAL AND HEALTH
1. Purpose
To establish guidelines for recording and handling of “first aid cases” and medical treatment.
2. General
Arrangements shall be made prior to start of each project for prompt medical treatment. A copy of the “Authorization For Medical Treatment” form will be provided to the medical facilities along with a list of Standard Maintenance Company, LLC employees on the project who can verbally authorize medical treatment.
The names and telephone numbers of available doctors, hospitals, ambulance, as well as fire and police, will be conspicuously posted at the field office.
Transportation will be available at all times for an injured worker where an ambulance is not needed.
When time allows, the “Authorization For Medical Treatment” form shall be sent to the medical facility with the employee. In cases where the timing of treatment is of the utmost importance, a call to the treating facility will be sufficient with follow up of Authorization for Medical Treatment and any MSDS as required.
3. First Aid
Each project shall have a competent person, who has been trained in Red Cross First Aid and CPR, designated for administering first aid.
First aid supplies shall be maintained on a weekly basis to ensure expended items are replaced. See “First Aid Supplies” at the end of this section for minimum requirements for each twenty-five (25) employees. Additional items may be required based on site requirements.
4. Definition of First Aid Case
First aid cases include one-time treatment and subsequent observation for job related minor scratches, cuts, burns, splinters and so forth which do not ordinarily require medical care even though it may be provided by a physician or registered professional personnel. Administration of a single dose of a prescription medication on the first visit for a minor injury is first aid. Retreatments constitute medical treatment cases. Repeated use of non-prescription medication, other than antiseptic, is a first aid case.
5. On-Site
First Aid Treatments
The administration of first aid at the jobsite shall be limited to the following:
--cleaning or flushing of the surface
--soaking or applying of cold compresses
--application of antiseptic and bandaging
--irrigation for the removal of foreign material not imbedded in eyes
Under no circumstance shall any medications, prescription or non-prescription be administered to any employee to be taken orally. This shall include aspirin, pain aid, etc.
Examples of first aid treatments for certain types of injuries and illnesses:
· Abrasions - Limited to cleaning wound, soaking, applying antiseptic and bandaging on first visit. Follow up visits are restricted to observation and changing bandages.
· Bruises - Limited to a single soaking or applying cold compresses and any follow up visits for observation of the injury.
· Burns, Thermal and Chemical (Resulting in destruction of tissue by direct contact) - Limited to cleaning or flushing the surface, soaking, applying cold compresses, antiseptic and bandaging on first visit. Follow up visits are restricted to observation and changing bandages.
· Cuts and Lacerations - Limited to cleaning wound, soaking, applying antiseptic and bandaging on first visit. Follow up visits are restricted to observation and changing bandages.
· Eye Injuries - Limited to irrigation, removal of foreign material not imbedded in eye. One-time treatment of minor corneal scratches or abrasions and the administration of non-prescription medication and single doses of prescription medications by a licensed physician.
· Inhalation of Toxic or Corrosive Gases - Limited to removing the employee to fresh air or the one-time administration of oxygen for several minutes.
· Splinters and Puncture Wounds - Limited to cleaning wound, removing foreign object(s) by tweezers or other simple technique, applying antiseptic and bandaging on first visit. Follow up visits are restricted to observation and changing bandages.
· Sprains and Strains - Limited to soaking, applying cold compresses or use of elastic bandage on first visit. Follow up visits are restricted to observation and reapplying bandages.
Examples of diagnostic procedures considered first aid:
· Hospitalization for observation where no medical treatment is rendered other than first aid. However, if the employee misses his entire next scheduled shrift, the case becomes a Lost Workday Case.
· Visit to a physician or nurse for observation only is first aid.
· X-ray examination for fractures is diagnostic. Where the x-ray is negative, the case is first aid.
Examples of preventive procedures and treatments considered first aid:
· Tetanus shots are preventative and are first aid cases unless reaction to the shot necessitates treatment.
First Aid Log
In order to effectively control accidents, it is necessary to track minor injuries. The first aid log should be carefully maintained to identify areas that have a potential to cause more severe accidents.
Recording of a First Aid Case
--Record the name of the individual receiving the first aid treatment.
--Date
--Time of the accident.
--What was the employee doing at the time of the accident?
--What cause the injury?
--What treatment was given?
--What was done to prevent this type of accident from recurring?
At the end of each week, the first aid log for that week shall be forwarded to the safety coordinator assigned to that project.
All first aid logs shall be reviewed in the safety department’s weekly meeting.
FIRST AID LOG
Name______________________________________________Date___/___/___Time___:___
What was the
employee doing at the time of the accident
What caused
the injury?
What treatment
was given?
What was done
to prevent this type of accident from recurring
Comments
Name______________________________________________Date___/___/___Time___:___
What was the
employee doing at the time of the accident
What caused
the injury?
What treatment
was given?
What was done
to prevent this type of accident from recurring
Comments
Name______________________________________________Date___/___/___Time___:___
What was the
employee doing at the time of the accident
What caused
the injury?
What treatment
was given?
What was done
to prevent this type of accident from recurring
Comments
Note: Any employee who refuses
medical treatment enter as follows in Comments: “No treatment given” and have the employee sign log.
BLOOD-BORNE PATHOGENS PROCEDURES
1. Purpose
To establish work practices necessary to limit exposure to blood and other bodily fluids that may contain pathogens that an employee may come in contact with while administering first aid.
2. Responsibility
It is the responsibility of all safety department personnel, trained first aid/CPR providers and all superintendents and foremen who are designated first/aid emergency responders to know and understand the safe work practices needed to protect themselves from blood borne, disease causing pathogens. This standard does not include employees who might provide first aid in a “Good Samaritan” situation.
3. Definitions
A. Blood-borne Pathogens
Disease causing microorganisms that are present in blood and can cause disease in humans. These include, but are not limited to, Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).
B. Contaminated
Presence or anticipated presence of blood or other infectious material on any item or surface.
C. Decontamination
The use of physical or chemical means to remove, inactivate or destroy blood borne pathogens on any item to the point where the item is rendered safe for handling, use or disposal.
D. Exposure Incident
Direct contact with the eye, mouth, mucous membrane, blood or other potentially infectious material during the performance of duty without the proper P.P.E.
E. Potentially Infectious Material
The following human body fluids or materials potentially contaminated with the following fluids: blood, semen, vaginal secretions, spinal fluid, amniotic fluid or any other visible body fluid. This does not include nasal secretions, spit, urine, feces, tears, sweat, and saliva or vomit unless they contain visible blood.
F. Universal Precautions
An approach to infection control in which all blood and potentially infectious material is treated as if it was known to contain HIV, HBV or other pathogens.
4. Safe Work Practice
SMC shall provide all necessary P.P.E. including disposable gloves, protective clothing and will assure that such equipment is readily available.
When there is the potential for exposure to blood or other infectious material or fluids, the employee shall use the appropriate P.P.E., which includes, but is not limited to, gloves, gowns, shoe covers and eye and face shields to form a protective barrier.
Eye/Face shields shall be worn whenever splashes, spray, droplets of blood or other fluids may be generated and there is a potential for eye, nose or mouth contamination.
Gloves shall be worn when the potential exists for the employee’s hands to have direct contact with blood, infectious material, and mucous membranes and when handling items or surfaces contaminated with blood or other potentially infectious materials.
Disposable gloves shall be replaced as soon as possible when soiled or punctured. They shall be changed after treatment of each person to avoid the possible contamination of another individual. They shall never be washed or disinfected for reuse.
Protective clothing shall be replaced as needed. All soiled gloves and clothing shall be disposed of using the provided biohazard bag. All contaminated clothing shall be immediately removed from the work area and placed in a designated area for proper disposal. Check with the safety department for disposal methods. Biohazards are not to be disposed of through normal trash/waste removal facilities.
Employees shall wash their hands as soon as possible after the removal of gloves and/or other P.P.E.
Eating, drinking, smoking, cosmetics or handling of contact lenses is prohibited in the work area where there is a potential for exposure to blood or other infectious fluids/materials.
All procedures involving blood shall be conducted in such a manner as to limit the contamination area.
If rescue breathing is required, it should be done using the mouth barrier. These are available through the safety department or by the vendor stocking your first aid supplies.
Mouth suctioning is prohibited.
5. Housekeeping
The medical treatment area shall be periodically cleaned. All persons performing first aid shall clean and dispose of wastes after performance of first aid. Gloves shall be worn when decontaminating the work place.
An acceptable disinfectant along with approximately 10% bleach solution in water shall be used to clean any surface that may be contaminated.
All bins and pails intended for reuse, which has a potential for becoming infectious, materials should be cleaned and disinfected as soon as possible upon visible contamination.
Infectious waste shall be disposed of in properly identified containers. The container shall include the biohazard legend. Check with the safety department for proper disposal of biohazard waste.
6. Exposure Incidents
Exposure incidents must be reported to the safety department immediately. The safety department shall conduct an exposure incident investigation and document the following information:
1. Circumstances surrounding the incident.
2. Likely route of entry.
3. Controls that were in place at time of incident.
4. P.P.E. in use at time of incident.
5. Failures of controls at time of incident.
6. Identification of source individual.
7. Exposed employees training and vaccine records.
7. Post Exposure Evaluation
If an employee has had an exposure incident, the route and circumstances should be identified and the source should be tested for HIV and HBV, after obtaining written consent, using an accredited laboratory. All testing and counseling shall be done confidentially and without cost to the employee(s).
If exposure source is positive for HIV or is unwilling to consent, the employee shall be retested six months and one year after the initial test.
If the exposure and source is negative, the employee may retest three months after the initial test.
If, after an employee has had an exposure incident, a Hepatitis B susceptible employee shall be referred to a health care provider named by SMC. The employee shall be evaluated and counseled by a physician.
If the exposure source is positive or unwilling to consent, the employee shall be given the HVB vaccine.
For each post evaluation, SMC shall obtain and provide a written report with the physician’s recommendations. SMC shall provide this within fifteen days of completion of the physician’s report. All reports shall be confidential.
All reports, evaluations, recommendations and records shall be maintained for 30 years.
8. Training
All employees designated to perform first aid shall attend the American Red Cross Basic First Aid and CPR Course or equal.
All employees shall be given a copy of this procedure the blood borne pathogens OSHA Std. 1910.1030.
This standard, including the OSHA 1910.1030, must be explained to all employees.
Employees considered at risk shall be offered a test for Hepatitis B after the training session and with ten days of assignment. It is offered as part of each employee’s job duties unless that employee has had a previous vaccination or is allergic. If the employee declines the vaccination but later, while still performing these duties, decides to accept, it shall be provided at that time.
Employees not previously vaccinated against HBV or that has no detectable antibody, are considered susceptible to HBV infection. A physician chosen by SMC shall offer susceptible employees HBV immunization at 0, 1 and 6 months.
Employees wishing to be immunized against HBV shall complete the attached consent form.
Employees refusing the immunization shall complete the declination form attached.
HEPATITIS B
CONSENT FORM
The Hepatitis B Vaccine inoculation is recommended for all personnel who are at risk of infection with the Hepatitis B Virus. The inoculation is for immunization against infection caused by Hepatitis B and known subtypes. This vaccine will not prevent hepatitis caused by the Hepatitis A, Non-A, Non-B Hepatitis or other viruses known to infect the liver.
I have been given the opportunity to ask questions about the inoculation and risks that may be involved.
I ________________________________ would like to receive the Hepatitis B inoculation.
Employee Signature________________________________ Date________________________
SSN:________________________________
I have received, read and understand SMC’s blood borne pathogens exposure procedure.
Employee Signature________________________________ Date________________________
Witness__________________________________________ Date________________________
HEPATITIS B
DECLINATION FORM
I understand that due to my occupational exposure to blood and other potentially infectious fluids and materials, I may be at risk of contracting the Hepatitis B Virus. I have been given the opportunity to be vaccinated with the Hepatitis B Vaccine at no charge to myself. However, at this time, I decline the vaccine. I understand that by my declining the vaccine, I continue to be at risk of contracting Hepatitis B. If, in the future, I continue to be exposed to blood and/or other infectious fluids and with to be vaccinated, I can receive the vaccination at no charge to me.
I have received, read and understand SMC’s blood borne pathogens exposure procedure.
Employee Signature________________________________ Date________________________
SSN:________________________________
Witness__________________________________________ Date________________________
UNIVERSAL
PRECAUTIONS FOR ALL PATIENTS
|
Procedure |
Wash Hands |
Gloves |
Protective Clothing |
Face Guard |
Eye Protection |
|
|
|
|
|
|
|
|
Talking |
No |
No |
No |
No |
No |
|
Adjusting Equipment |
No |
No |
No |
No |
No |
|
Examination of employee without touching blood, body fluids, mucous membrane. |
Yes |
Yes |
No |
No |
No |
|
Examination of employee including contact with blood, body fluids, mucous membrane. |
Yes |
Yes |
No |
No |
No |
|
Handling contaminated materials. |
Yes |
Yes |
* Yes |
* Yes |
No |
|
First aid situations with trauma. |
Yes |
Yes |
No |
No |
Yes |
|
Potential of spurting blood. |
Yes |
Yes |
Yes |
Yes |
Yes |
* Use of protective clothing, eye/face wear is required if waste is very contaminated and splattering may occur.
Note: Gloves shall always be available and used when the employee has cuts, abrasions or other wounds and if contamination is likely to occur.
EMERGENCY TELEPHONE NUMBERS
JOB LOCATION:
AMBULANCE:
FIRE DEPARTMENT
POLICE:
SHERIFF:
PLANT SECURITY/EMERGENCY:
OTHER
PROJECT MANAGER:
PROJECT SUPERINTENDENT:
STATE LABOR DEPT/OHSA:
:
:
:
ATTENDING
PHYSICIANS/HOSPITALS
HOSPITAL/CLINIC:
PHYSICIAN:
:
:
:
AUTHORIZATION FOR JOB RELATED MEDICAL TREATMENT
DATE:__________________
JOB NO:________________
Our employee ____________________________________ is authorized to receive medical treatment for:
________________________________________________________________________
________________________________________________________________________
This injury was reported on __________________________________________________ .
Please send invoices and medical information to:
Standard Maintenance Company, LLC
1898 Vanderhorn Dr.
Memphis, Tennessee 38134
_______________________________ __________________________
Job Superintendent Date
FIRST AID SUPPLIES
(Minimum For 25 People)
(50) Adhesive Strips - 3/4" x 3"
(1) Package Sterile Cotton
(2) Rolls of Gauze Bandages 2" x 5 yds.
(1) Large Dressing 5" x 9"
(1) Roll Adhesive Tape 1/2" x 5 yds.
(2) Gauge Pads 4" x 4"
(4) Gauge Pads 3" x 3"
(2) Sterile Eye Pads
(1) 1 oz. Eye Irrigate
(3) Sting Relief Wipes
(1) Triangle Bandage
(1) Tube First Aid Cream
(10) Wound Wipes
(3) Ammonia Inhalants
(1) Pair Scissors
(1) Pair Tweezers
(1) Cold Pack
(1) Instruction Booklet
(1) Mouth Shield
(1) Blood-borne Pathogen Kit Containing:
(1) Pair Vinyl Gloves
(1) Pair Shoe Covers
(1) Barrier Gown
(1) Eye Shield/Face Mask
(1) Container/Scoop
(1) Absorbent Biohazard Blanket
(1) Two (2) fl. oz. Disinfectant
(2) Paper Wipes
(1) .25 oz. Hand Sanitizing Gel
(1) Biohazard Disposal Bag
(1) Instruction Sheet
(1) Exposure Report Form