437-004-1305 Medical Services and First Aid (1) Definitions. Emergency medical service is care by a medically trained person such as in a hospital, clinic, ambulance or rescue vehicle. Qualified first aid person has evidence to show valid first-aid and CPR training within the last two years. (2) First aid supplies. (a) Provide first-aid supplies based on the types of injuries that could occur at the place of employment. The first-aid supplies must be immediately available to all workers on all shifts when needed. Do not lock up or otherwise restrict access to first-aid supplies. (b) Protect first-aid supplies from damage, deterioration, or contamination. Clearly mark containers. First-aid containers may be sealed to protect the contents from contamination. NOTE: Supplies such as nitrile gloves and a mouth barrier device are personal protective equipment covered by Division 4/I, Personal Protective Equipment. (3) Medical treatment and services. Emergency medical services for injured or sick employees must be available and summoned in time to give appropriate treatment for the circumstances. NOTE: These services can be by outside sources such as the local 911 response system or by employees who are qualified first-aid persons. (4) Emergency medical plan. (a) Determine the appropriate type of medical service for each place of employment. You must do a survey and develop an emergency medical plan. You must evaluate these areas: (A) Determine the types of injuries and illnesses that are likely to occur at the worksite. (B) Contact the local emergency response system and get information about their ability to handle these types of emergencies and their response time. Consider things such as nearness of the responding teams, traffic, equipment, average response times, and whether the system is staffed by volunteers or full-time people. (C) Based on this information, decide whether the local response system can handle your situation or whether you need your own qualified first-aid persons. (D) Train all employees about the medical plan and their responsibilities during an emergency. (b) If the local response system is adequate, then the minimum emergency medical plan must contain the emergency phone number and emergency action instructions for employees in case of an injury or illness. Post this emergency medical plan where employees gather or are most likely to read it. (c) If the response system is not adequate to handle your potential injuries or illnesses, then your plan must also contain clear and specific emergency action instructions for employees in case of injury or illness. The plan of action must have: (A) The names, locations, and phone numbers of people trained and authorized to give first aid and other treatment. (B) Any special instructions about communications like two-way radios, telephones or other provisions for emergency communication to contact the emergency medical services. (C) A plan for transportation to the ambulance or nearest suitable medical facility. (5) Emergency eyewash, shower equipment, or both. (a) Based on the hazard, provide employees with an emergency eyewash, shower, or both to decontaminate themselves when one of the following applies: (A) Employees use a chemical substance that can cause corrosion or permanent tissue damage to the eyes or when areas of the body may be exposed to quantities of materials that are either corrosive or toxic by skin absorption. (B) Employees handle pesticide products labeled Danger or Danger/Poison, and with a first-aid section on the label that requires rinsing for 15-20 minutes for eye or skin exposure. NOTE: OAR 437-004-1305(5) does not apply to eye flushing supplies required for early entry workers covered under 170.112(c)(8) or agriculture field workers covered under 170.150 of the pesticide Worker Protection Standard in Division 4, Subdivision W. (b) Emergency eyewashes or showers, whether plumbed potable water systems or self-contained units, must meet the following requirements: (A) Locate it so exposed employees can reach it and begin treatment in 10 seconds or less. The path must be unobstructed and cannot require the opening of doors or passage through obstacles unless other employees are always present to help the exposed employee. (B) Install the equipment according to the manufacturer’s instructions. (C) Valves must stay open once activated, without the use of hands. (D) Follow manufacturer’s instructions for use and inspection. (E) Fluid quality and temperature must be appropriate for the anticipated types of decontamination treatment. (F) Flow and pressure must provide the needed treatment without risking injury to the employee. (G) If the eyewash or shower could freeze, take protective measures to prevent this from occurring. (c) If the product label or material safety data sheet requires specific decontaminaants or procedures, you must provide them in addition to the eyewash or shower. Certain substances like acids, chlorine and anhydrous ammonia require special treatment. NOTE: ANSI Z358 has information about the performance requirements for eyewashes and showers. Statutory/Other Authority: ORS 654.025(2) & 656.726(4) Statutes/Other Implemented: ORS 654.001 - 654.295 History: OSHA 4-2010, f. 7-8-10, cert. ef. 1-1-11 OSHA 9-2006, f. & cert. ef. 9-22-06 OSHA 4-1998, f. 8-28-98, cert. ef. 10-1-98