Designing a First-Aid Program

Every business needs a first-aid program specific to their work settings.

By Alexandra Walsh

It is a requirement of the Occupational Safety and Health Administration that employees be given a safe and healthy workplace reasonably free of occupational hazards.

However, it is unrealistic to expect accidents not to happen. Therefore, employers are required to provide medical and first-aid personnel and supplies relative to the hazards of the workplace. In addition, employers are required by OSHA standard 29 CFR 1910.151 to have a person or persons adequately trained to render first aid for worksites not near an infirmary, clinic, or hospital.

What Is First Aid?

First aid is the medical attention usually administered immediately after an injury occurs and at the location where it occurred. It often consists of a one-time, short-term treatment and requires little technology or training to administer. First aid examples would be cleaning minor cuts, scrapes, or scratches; treating minor burns; applying bandages and dressings; draining blisters; removing debris from the eyes; and providing fluids to relieve heat stress.

Assess the Risks

Obtaining and evaluating information about injuries, illnesses, and fatalities at a worksite are essential first steps in planning a first-aid program. Employers can use the OSHA 300 Log, OSHA 301 forms, their Workers’ Compensation insurance carrier reports, or other records to help identify the first-aid needs for their businesses.

First-Aid Supplies

It is advisable for employers to assign a specific person the responsibility for choosing the types and amounts of first-aid supplies and for maintaining the supplies. The supplies must be adequate, should treat the kinds of injuries that occur, and must be stored in an area readily available for emergency access. An automated external defibrillator (AED) should be considered when selecting first-aid supplies and equipment.

Specific for the Worksite

First-aid courses should be patterned to the needs of the workplace. Some first-aid program elements may be optional for a particular facility. On the other hand, unique conditions at a specific worksite may make it necessary to add customized elements to a first-aid training program.

By assessing the specific needs of their workplaces, employers can be assured adequate first-aid supplies are available. From time to time, employers should reassess the demand for these supplies and adjust their inventories.

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Consulting with local fire and rescue services or emergency medical professionals may be beneficial too. Employers should obtain estimates of EMS response times for all locations for all times of the day and night, and use that information when planning their first-aid program.

It is advisable to put first-aid program policies and procedures in writing. These should be communicated to all employees—and remember to include workers who may not read or speak English. Language barriers should be addressed when instructing employees on first-aid policies and procedures and when designating those individuals who will receive first-aid training and become on-site first-aid providers.

Training for first aid is offered by the American Heart Association, the American Red Cross, the National Safety Council, and other nationally recognized and private educational organizations. OSHA does not teach first-aid courses or certify first-aid training courses for instructors or trainees.

Elements of a First-Aid Training Program

When planning a first-aid training program, consider the following outline and which actions might apply to your workplace.

Teaching methods

  • Base curriculum on consensus of scientific evidence where available.
  • Have trainees develop hands-on skills by using mannequins, practicing with partners.
  • Have appropriate first-aid supplies and equipment available.
  • Expose trainees to acute injuries and illnesses and appropriate response by using visual aids.
  • Include information resources for reference both during and after training.
  • Allow time for emphasis on commonly occurring situations
  • Emphasize skills training and confidence-building over classroom lectures.
  • Emphasize quick response to situations requiring first aid.

Preparing to respond to a health emergency

  • Prevention as a strategy in reducing fatalities, illnesses, injuries
  • Interacting with local EMS system
  • Maintaining current list of emergency phone numbers (police, fire, ambulance, poison control) accessible by all employees
  • Understanding legal aspects of providing first-aid care—Good Samaritan laws, consent, abandonment, negligence, assault and battery, state laws and regulations
  • Understanding effects of stress, fear of infection, panic; how they interfere with performance; what to do to overcome these barriers to action
  • Learning importance of taking precautions and isolating body substances to protect from bloodborne pathogens, other potentially infectious materials
  • Learning about personal protective equipment—gloves, eye protection, masks, respiratory barrier devices; management and disposal of blood-contaminated sharps and surfaces

 Assessing the scene and victims

  • Assess scene for safety, number of injured, nature of the accident.
  • Assess toxic potential of the environment and need for respiratory protection.
  • Establish confined space and need for respiratory protection and specialized training to perform a rescue.
  • Prioritize care when there are several injured.
  • Assess each victim for responsiveness, airway blockage, breathing, circulation, medical alert tags.
  • Take victim’s history at the scene, how the injury happened.
  • Perform head-to-toe check for injuries.
  • Stress need to continuously monitor the victim.
  • Emphasize early activation of EMS.
  • Indicate methods for safely moving and rescuing victims.
  • Reposition injured victims to prevent further injury.

Responding to life-threatening emergencies

  • Establishing responsiveness
  • Establishing and maintaining open and clear airway
  • Performing rescue breathing
  • Treating airway obstruction in conscious victim
  • Performing CPR
  • Using an AED
  • Recognizing signs and symptoms of shock, providing first aid for shock due to illness or injury
  • Assessing and treating a victim who shows unexplained change in consciousness or sudden illness
  • Controlling bleeding with direct pressure
  • Poisoning
  • Ingested poisons: alkali, acid, systemic poisons
  • Inhaled poisons: carbon monoxide; hydrogen sulfide; smoke; chemical fumes, vapors, gases; assessing toxic potential of the environment and need for respirators
  • Knowledge of chemicals at worksite, first aid and treatment for inhaling or ingesting chemicals
  • Effects of alcohol and illicit drugs so first-aid provider can recognize their physiologic and behavioral effects
  • Recognizing asphyxiation and danger of entering confined space without respiratory protection; additional training required if first-aid personnel will assist in rescue from confined space
  • Responding to medical emergencies
  • Chest pain
  • Stroke
  • Breathing problems
  • Anaphylactic reaction
  • Hypoglycemia in diabetics taking insulin
  • Seizures
  • Abdominal injury
  • Reduced level of consciousness
  • Impaled object

Responding to non-life-threatening emergencies

  • Wounds
  • Assessment and first aid for abrasions, cuts, lacerations, punctures, avulsions, amputations, crush injuries
  • Wound care, infection precautions
  • Isolating body substances, precautions, personal protective equipment
  • Burns
  • Assessing severity of burn
  • Recognizing burn is thermal, electrical, chemical and appropriate first aid
  • Reviewing corrosive chemicals at worksite, appropriate first aid
  • Temperature extremes
    • Exposure to cold, frostbite, hypothermia
    • Exposure to heat, heat cramps, heat exhaustion, heat stroke
  • Musculoskeletal injuries
  • Fractures
  • Sprains, strains, contusions, cramps
  • Head, neck, back, spinal injuries
  • Appropriate handling of amputated body parts
  • Eye injuries
  • First aid for eye injuries
  • First aid for chemical burns.
  • Mouth injuries
  • Oral injuries, lip and tongue injuries, broken and missing teeth
  • Preventing aspiration of blood, teeth
  • Bites and stings
  • Human and animal bites
  • Insect bites and stings, treatment of anaphylactic shock


Since accidents are going to happen, it’s critical to have a first-aid program that is detailed and considers all the possibilities that could happen at worksites frequented by employees. Having these elements in your program will help keep workers safe—and working.

Alexandra Walsh is the vice president of Association Vision, a Washington, D.C.–area communications company. She has extensive experience in management positions with a range of organizations.

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