The facility First Aid box is in place with the hope that it will never be used. If staff are properly trained and use all required Personal Protective Equipment (PPE) then the seal on this box should never need to be broken. If you have not reviewed the ORFA First Aid Misconceptions Guideline, you may want to start here before reading on.
First Aid kits all started with an accidental conversation that inspired the first Johnson & Johnson’s First Aid Kit in 1888. Aboard a train, company founder Robert Wood Johnson struck up a conversation with the Denver & Rio Grande Railway’s chief surgeon. The doctor explained to Johnson the dangers of railroad construction and the lack of medical supplies to treat the unique industrial injuries that were often incurred great distances from hospitals. From this exchange, Johnson saw an opportunity to both advance the field of healthcare and build his business.
In 1960, a disastrous accident that caused the deaths of five workers changed the face of safety regulations forever in Ontario. A new definition – "SAFETY" was introduced to the Factory Act of 1884 and the name changed to the Industrial Safety Act of 1964. Regulation 1101 was added to the Act as it continued to expand and focus on various workplace health and safety pressure points. At this time, the Ministry of Labour, Training and Skills Development (MLTSD) is proposing to transfer the responsibility of workplace first aid from the Workplace Safety and Insurance Board (WSIB) to MLTSD. The first Canada 911 service was adopted in 1972, and the first 911 call in Ontario occurred in 1974 in London.
First Aid kits and worker training remains a workplace staple. The reality is with improved worker training, risk and hazard awareness and proper use of PPE, the need for First Aid supplies has been reduced but other responsibilities have been added. The installation of automated external defibrillator (AED) in public areas began when the Chase McEachern Act came to be by the Ontario government in 2006. More recently, the installation of Naloxone kits in public areas has become common and is also moving towards being mandatory.
Under Regulation 1101, there is an applied expectation that workers will assist workers when they require First Aid. When it comes to responding to facility user First Aid response there is no legal obligation but rather a good Samaritan or moral obligation to assist. Then why have this conversation? Well, times have changed a lot since the concept of providing First Aid in the workplace became law. When First Aid was added to a workers training responsibility, it was to ensure that if a person was “injured at work” that their co-workers would have a basic understanding on how to control bleeding, comfort and obtain assistance. It is the job of the trained first aider to provide initial treatment to injured or ill employees consistent with a first-aider’s level of training and competence. If an individual requires treatment beyond a first-aider’s level of competence, the first aider would then recommend that the injured or ill person seek medical assistance.
It is one level of expectation to have staff care for co-workers, it is another level of responsibility to expect staff to be public first response for every health crisis. Consider that in Canada, more than 40,000 people per year die of sudden cardiac arrest. This is one person every 12 minutes, and over 100 people per day. While statistics show that there were 1,720 apparent opioid toxicity deaths between April and June 2021 (approximately 19 deaths per day). In addition, recreation workers will often encounter individuals with mental health or other social issues who are using public facilities for personal care or living in community greenspaces.
The line of worker responsibility and public accessibility to health tools such as an AED and naloxone kits has become blurred as many workplaces rely on the moral responsibility of their staff to determine the level of first response engagement. This becomes more complicated as elected officials make public announcements, often without consultation, as to how they are preparing their staff to be able to effectively respond to a variety of health issues when in a public facility. Legislation such as the Good Samaritan Act and the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 limit personal response liability but what is often lost is that not all persons (workers) are capable of acting in these capacities without suffering some personal mental impact themselves. A worker can now evaluate the potential of the odds of a co-worker becoming injured based on the number of staff on shift, the type of work being performed, and the health and safety culture of the workplace. There is limited ability to calculate what will happen once they open the doors to the public.
The question becomes, how are first aid and first response responsibilities described in a worker’s job description. As some members have stated, “I didn’t sign on to be EMS, but it’s become part of my expected duties”. Given the different media reporting the pressures that EMS services are encountering during the pandemic, facility staff should not expect immediate outside support once they activate 911 making their first response even more important. Facility managers must define both legal and moral responsibilities for first response by their staff while ensuring they are providing both adequate, ongoing training as well as support post medical response to any staff member who responded. Today’s facility manager has much more responsibility then hanging a First Aid box somewhere in the building. First Aid has become much more complicated requiring detailed management of all aspects of facility first response.
Comments and/or Questions may be directed to Terry Piche, CRFP, CIT and Technical Director, Ontario Recreation Facilities Association
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