437-002-0161 Medical Services and First Aid (1) Definitions. (a) “Emergency medical service” is the provision of care by a medically trained person, whether this service is provided by a hospital, clinic, ambulance, disaster car, or rescue vehicle. (b) “In proximity” is defined as that which is available nearby to ensure prompt treatment in the event of need. (c) “Qualified first aid person” means a person with evidence to show valid (current) first aid training by the American Red Cross or equivalent. (2) First Aid Supplies. (a) The employer shall provide first aid supplies based upon the intended use and types of injuries that could occur at the place of employment. The first aid supplies shall be available in close proximity to all employees. Either bulk pack or unit pack supplies are acceptable. (b) First aid supplies must be stored in containers adequate to protect the contents from damage, deterioration, or contamination. The container shall be clearly marked, available when needed and must not be locked, but may be sealed. (c) The employer shall ensure that the first aid supplies are available for each shift. NOTE:Supplies such as gloves and a mouth barrier device are considered personal protective equipment, and are regulated by OAR 437-002-0134 in Division 2/I, Personal Protective Equipment. NOTE: The Safety Code for Motor Vehicle Transportation of Workers (Rule 735 120 000) adopted by the Motor Vehicles Division of the Department of Transportation contains requirements for the first aid kit which is required when school buses are used to transport workers. In addition, the Public Utilities Commission has adopted Federal Motor Carrier Safety Regulations which apply to for hire buses. (3) Personnel. (a) The employer shall ensure the ready availability of emergency medical services for the treatment of all injured employees. (b) Where emergency medical services are not in proximity to the place of employment, a qualified first aid person shall be available. NOTE: More specific requirements for first aid training are found in: 1910.94, Ventilation, in Division 2/G; OAR 437-002-0118, Reinforced Plastics, in Division 2/H; 1910.120, Hazardous Waste Operations and Emergency Response, in Division 2/H; 1910.252 in Division 2/Q, Welding, Cutting and Brazing; OAR 437-002-0304, Ornamental Tree & Shrub Services, in Division 2/R; 1910.268, Telecommunications, in Division 2/R; Division 2/T, Commercial Diving Operations. (4) Emergency Medical Plan. (a) An emergency medical plan to ensure the rapid provision of medical services to employees with major illnesses and injuries shall be developed. In such cases, the employer shall determine that the service will be available in an emergency. (b) If a physician or an ambulance with Emergency Medical Technicians is readily accessible to the place of employment, then the minimum emergency medical plan must contain the emergency telephone number of the ambulance service. The emergency telephone number shall be posted conspicuously at the place of employment. (c) Employers in areas with a designated 911 telephone number may utilize the 911 service in lieu of posting the specific ambulance telephone number. (d) If the place of employment is not in proximity to emergency medical services, then the employer shall have, in addition to the information required in 437-002-0161(4)(a), a definite plan of action to be followed in the event of serious injury to an employee. The plan of action shall consist of the arrangements for: (A) Communication. Two-way radio, telephone, or provision for emergency communication to contact the emergency medical services. (B) Transportation. Availability of transportation to a point where an ambulance can be met or to the nearest suitable medical facility. Vehicles provided for this purpose shall be available at all times, shall have right of way over all vehicles or equipment under the control of the employer, and shall be equipped so that due consideration can be given to the proper care and comfort of the injured employee. (C) Qualified medical personnel at destination. (D) All employees shall be knowledgeable concerning the qualified first aid person(s), the first aid requirements, and emergency medical plan. (5) Emergency Eyewash and Shower Facilities. (a) Where employees handle substances that could injure them by getting into their eyes or onto their bodies, provide them with an eyewash, or shower, or both based on the hazard. (A) Emergency eyewash and showers must meet the following: (i) Locate it so that 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. (ii) Water must flow for at least 15 minutes. (iii) Install the equipment according to the manufacturer’s instructions. (iv) The eyewash must have valves that stay open without the use of the hands. The shower must not be subject to unauthorized shut-off. (v) Follow the system manufacturer’s criteria for water pressure, flow rate and testing to assure proper operation of the system. (vi) Emergency shower and eyewash facilities must be clean, sanitary and operating correctly. (vii) In self-contained systems, do not use solutions or products past their expiration date. NOTE: If the employer can demonstrate, with the support of a physician board certified in ophthalmology, toxicology or occupational medicine, that an alternative eyewash solution is adequate for their specific hazard, OR-OSHA will accept that solution. An example would be a buffered isotonic solution preserved with a suitable antibacterial agent, that may be less irritating when used in a 15-minute flush. (b) If the product label, MSDS or other information about the expected contaminant gives treatment instructions different from those required in this section, follow the most protective of those instructions. (c) If the contaminant manufacturer requires specific decontaminants or procedures, you must provide them in addition to the eyewash or shower. The employer must assure this treatment is available. (d) If eyewash facilities or showers can freeze, take protective measures to prevent freezing. [ED. NOTE: Appendices referenced are available from the agency.] Statutory/Other Authority: ORS 654.025(2) & 757.726(4) Statutes/Other Implemented: ORS 654.001 - 654.295 History: OSHA 1-2012, f. & cert .ef. 4-10-12 OSHA 1-2005, f. & cert. ef. 4-12-05 OSHA 1-2000, f. & cert. ef. 1-28-00 OSHA 2-1993, f. & cert. ef. 2-3-93 WCB 4-1976, f. 4-5-76, ef. 4-15-76 WCB 4-1975, f. 10-6-75, ef. 11-1-75 WCB 13-1979, f. & ef. 7-7-75