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First Aid
First Aid

Precis

(Revised 15 December 2017)

Providing immediate and effective first aid to workers or others who have been injured or become ill at the workplace may reduce the severity of the injury or illness and promote recovery. In some cases it could mean the difference between life and death. Providing First Aid and other medical assistance are requirements under the Model WHS Regulation and older OH&S legislation.

In the entertainment industry the requirements and levels of First Aid will be dependent on the phase of the project, bump-in, operational, bump-out and will need to be taking into account the nature of the event, the level of construction and infrastructure and the demographics of the people attending the event.

6.1 Referenced documents:

WHS Regulation 2011

Code of Practice – First Aid in the workplace

Code of Practice – How to manage work health and safety risks

AS 1319 – Safety Signs for the Occupational Environment

AS 1885.1 – Measurement of occupational health and safety performance – Describing and reporting occupational injuries and disease

AS 4031 – Non-reusable containers for the collection of sharp medical items used in health care areas

AS/NZS 4261 – Reusable containers for the collection of sharp items used in human and animal medical applications.

6.2 Definitions

First aid is the immediate treatment or care given to a person suffering from an injury or illness until more advanced care is provided or the person recovers.

First aider is a person who has successfully completed a nationally accredited training course or an equivalent level of training that has given them the competencies required to administer first aid.

First aid equipment includes first aid kits and other equipment used to treat injuries and illnesses.

First aid facilities include first aid rooms, health centres, clean water supplies and other facilities needed for administering first aid.

Victorian OHS Act, 2004, (Section 21[2][d])
‘provide, so far as is reasonably practicable, adequate facilities for the welfare of employees at any workplace under the control and management of the employer’
WA Occupational Safety and Health Regulations 1996 Regulation 3.12 states the responsibilities of employers, main contractors or self-employed persons for providing first aid at a workplace.

6.3 Who has health and safety duties in relation to first aid?

A person conducting a business or undertaking has the primary duty under the WHS Regulation, Clause 42, to ensure, so far as is reasonably practicable, that workers and other persons are not exposed to health and safety risks arising from the business or undertaking. The WHS Regulations place specific obligations on a person conducting a business or undertaking in relation to first aid, including requirements to:

  • provide first aid equipment and ensure each worker at the workplace has access to the equipment
  • ensure access to facilities for the administration of first aid
  • ensure that an adequate number of workers are trained to administer first aid at the workplace or that workers have access to an adequate number of other people who have been trained to administer first aid.

A person conducting a business or undertaking may not need to provide first aid equipment or facilities if these are already provided by another duty holder at the workplace and they are adequate and easily accessible at the times that the workers carry out work.

Officers, such as company directors, have a duty to exercise due diligence to ensure that the business or undertaking complies with the WHS Act and Regulations. This includes taking reasonable steps to ensure that the business or undertaking has and uses appropriate resources and processes to eliminate or minimise risks to health and safety.

Workers have a duty to take reasonable care for their own health and safety and must not adversely affect the health and safety of other persons. Workers must comply with any reasonable instruction and cooperate with any reasonable policy or procedure relating to health and safety at the workplace, such as procedures for first aid and for reporting injuries and illnesses.

6.3.1 What is required in providing first aid?

First aid requirements will vary from one event to the next, depending on the nature of the work, the type of event, the venue size and location, as well as the number of people attending the event. These factors must be taken into account when deciding what first aid arrangements need to be provided and at what time in the project.

The Code of Practice uses a risk management approach to tailor first aid that suits the circumstances of the event, while also providing guidance on the number of first aid kits, their contents and the number of trained first aiders that are appropriate for some types of workplaces.

The risk management approach involves the following four steps:

  • identifying hazards that could result in work-related injury or illness
  • assessing the type, severity and likelihood of injuries and illness
  • providing the appropriate first aid equipment, facilities and training
  • reviewing your first aid requirements on a regular basis or as circumstances change.

6.3.2 First Aid risk assessment

WHS Regulation – Clause 42 (3)
For the purposes of this clause, a person conducting a business or undertaking must have regard to all relevant matters, including the following:
the nature of the work being carried out at the workplace,
the nature of the hazards at the workplace,
the size and location of the workplace,
the number and composition of the workers and other persons at the workplace.

Similar to other aspects of events, First Aid and the response procedures are best prepared with the aid of a risk assessment, see also Chapter 2 ‘Risk Management and Planning’. Every event, even seemingly similar ones, may have vastly different requirements when it comes to First Aid and medical responses. You don’t want to fall short of your duties but nor do you want to waste resources by oversupplying First Aid.

6.3.2.a the nature of the work being carried out at the workplace

The purpose of this part is not to find controls for the hazard but to identify what level of First Aid may be required. Table 1 of the Code of Practice offers some guidance on how to look at the workplace and how work activities are linked to First Aid:

Hazard Potential harm
Manual handling Overexertion can cause muscular strain.
Working at height Slips, trips and falls can cause fractures, bruises, lacerations, dislocations, concussion.
Electricity Potential ignition source could cause injuries from fire. Exposure to live electrical wires can cause shock, burns and cardiac arrest.
Machinery and equipment Being hit by moving vehicles, or being caught by moving parts of machinery can cause fractures, amputation, bruises, lacerations, dislocations.
Extreme temperatures Hot surfaces and materials can cause burns. Exposure to heat can cause heat stress and fatigue. Exposure to extreme cold can cause hypothermia and frost bite.
Radiation Welding arc flashes, ionizing radiation and lasers can cause burns
Violence Behaviours including intimidation and physical assault can cause nausea, shock and physical injuries
Animals / insects Bites, stings, kicks, scratches

 

This would cover much of the bump-in and bump-out parts of the event but will need to reflect all activities on site during that time. Some additions may be:

Hazard Potential harm
Rigging – working overhead Dropped items causing lacerations, bruises, concussion
Noise Exposure to high volume levels can cause temporary or permanent hearing damage
Lasers Potential to damage eye sight

6.3.2.b the nature of the hazards at the workplace

This part of the risk assessment looks at the lay-out of the event workplace and how to ensure response times for emergencies are efficient. Considerations may be:

  • Distance between work areas, certainly for outdoor festivals
  • Hard to reach areas such as roof spaces or follow-spot booths
  • People working alone in a remote area
  • Distance from ambulance and hospital services

The question ask is: If someone needed First Aid here, how do I find out about it and how do we respond.

6.3.2.c the size and location of the workplace

Where there are separate work areas (for example, a number of stages on a festival site or multiple floors in a venue), it may be appropriate to locate first aid facilities centrally and provide first aid kits in each work area. This may include portable first aid kits in motor vehicles and other separate work areas.

The distance of the workplace from ambulance services, hospital and medical centres should be taken into account when determining your first aid requirements. For example, if life-threatening injuries or illnesses could occur and timely access to emergency services cannot be assured, a person trained in more advanced first aid techniques (such as the provision of oxygen) will be needed.

6.3.2.d The number and composition of workers and other people

When considering the size of the First Aid team, you should include any contractors, subcontractors, and volunteers working on site. It is very likely that the size of your workforce will vary over time. For the purposes of deciding who requires access to first aid, you should consider the maximum number of workers that may be on site at any one time. Generally, a larger workforce requires more first aid resources.

6.3.2.e General Public

The information above applies to just the bump-in and bump-out phases of the event. The same has to be done for the operational part of the event in addition to what is already required for the workers on site.

Consideration should be given to the number of people expected, the demographics of the expected crowds and the type of event. For a corporate sporting event the focus should be on dislocated limbs and blisters, for EDM events there must be an understanding of drug use and drug overdose.

Where alcohol is served there is an increased risk of fights, unfortunately, and associated injuries. If the event is outdoors during the day there may be de-hydration and sunburn. All these things need to be considered and included in the First Aid risk assessment to be able to determine the appropriate level of First Aid with the right level of First Aiders.

6.4 First aid kits

All workers must be able to access a first aid kit. This will require at least one first aid kit to be provided at their workplace.

Contents

The first aid kit should provide basic equipment for administering first aid for injuries including:

  • cuts, scratches, punctures, grazes and splinters
  • muscular sprains and strains
  • minor burns
  • amputations and/or major bleeding wounds
  • broken bones
  • eye injuries

The contents of first aid kits should be based on a risk assessment, additional equipment may be needed for specific tasks such as pyro’s, lasers and special effects such as dry-ice..

The recommended content of a typical first aid kit and information on additional equipment is provided in Appendix C of the Code of Practice.

6.4.1 Location

In the event of a serious injury or illness, quick access to the kit is vital. First aid kits should be kept in a prominent, accessible location and able to be retrieved promptly. Access should also be ensured in security-controlled workplaces. First aid kits should be located close to areas where there is a higher risk of injury or illness. For example, an event with a temporary stage should have first aid kits located in these areas. If the event occupies several floors in a multi-storey building, at least one kit should be located on every second floor. Kits should also be available in difficult to reach positions such as control rooms, fly-floors, FOH Towers or follow-spot booths. Emergency floor plans displayed in the site should include the location of first aid kits.

A portable first aid kit should be provided in the vehicles of site crew if that is their workplace. These kits should be safely located so as not to become a projectile in the event of an accident.

6.4.2 Restocking and maintaining kits

A person in the workplace should be nominated to inspect and maintain the first aid kit (usually a first aider) and should:

  • ensure that items are in good working order, have not deteriorated and are within their expiry dates and that sterile products are sealed and have not been tampered with.
  • monitor access to the first aid kit and ensure any items used are replaced as soon as practicable after use

These inspection should be done before the First Aid kits are distributed around the site. Incomplete kits should not be allowed to be send out until properly replenished. Use less critical kits to restock critical kits and then replace the raided kit.

6.4.3 First aid signs

Displaying well-recognised, standardised first aid signs will assist in easily locating first aid equipment and facilities. Further information on the design and use of signs is available in:
AS 1319 – Safety Signs for the Occupational Environment.

6.5 Other first aid equipment

In addition to first aid kits, you should consider whether any other first aid equipment is necessary to treat the injuries or illnesses that could occur as a result of a hazard at your workplace.

6.5.1 Automated external defibrillators

Providing an automated external defibrillator can reduce the risk of fatality from cardiac arrest. It is a useful addition for workplaces where there is a risk of electrocution or where there are large numbers of members of the public.

Automated external defibrillators are designed to be used by trained or untrained persons.
They should be located in an area that is clearly visible, accessible and not exposed to extreme temperatures. They should be clearly signed and maintained according to the manufacturer’s specifications.

6.5.2 First aid rooms

A first aid room should be established at the workplace if a risk assessment indicates that it would be difficult to administer appropriate first aid unless a first aid room is provided. Most entertainment venues will have an area set up as a First Aid room but for greenfield sites or temporary structures it should be considered if only as a more private area to administer First Aid.

The contents of a first aid room should suit the hazards that are specific to the workplace. The location and size of the room should allow easy access and movement of injured people who may need to be supported or moved by stretcher or wheelchair. In an outdoor festival situation consideration must be given to make the First Aid room easily accessible for ambulances.

The following items should be provided in the room:

  • a first aid kit appropriate for the event
  • hygienic hand cleanser and disposable paper towels
  • an examination couch with waterproof surface and disposable sheets
  • an examination lamp with magnifier
  • a cupboard for storage
  • a container with disposable lining for soiled waste
  • a container for the safe disposal of sharps
  • a bowl or bucket (minimum two litres capacity)
  • electric power points
  • a chair and a table or desk
  • details of all nearby hospitals and medical centres[1]
  • a telephone and/or emergency call system
  • the names and contact details of first aiders and emergency organisations.

A first aid room should:

  • be located within easy access to a sink with hot and cold water (where this is not provided
    in the room) and toilet facilities
  • offer privacy via screening or a door
  • be easily accessible to emergency services (minimum door width of 1 metre for stretcher access)
  • be well lit and ventilated
  • have an appropriate floor area (14 square metres as a guide)
  • have an entrance that is clearly marked with first aid signage.

Maintaining a first aid room should be allocated to a trained occupational first aider, except where this room is part of an entertainment venue.

6.6 First aiders

WHS Regulation, Clause 42
(2) A person conducting a business or undertaking at a workplace must ensure that:
a) an adequate number of workers are trained to administer first aid at the workplace, or
b) workers have access to an adequate number of other persons who have been trained to administer first aid.

First aid in the workplace can be provided in a number of ways:

  • training one or more of your own workers to administer first aid
  • arranging for a person who does not work for you to administer first aid to your workers provided they have been trained to do so. These may be first aiders of other businesses who share your workplace or other persons who are qualified to administer first aid. This will involve consulting, co-operating and co-ordinating the access arrangements with the other persons and ensuring that access is available at the times when your workers carry out work.

It is very important to understand that a First Aider does not have to be exclusively dedicated to First Aid and can have other work commitments whilst listed as First Aider. What is important is that First Aiders must be able to instantly respond to an emergency and must be on-site if allocated as a First Aider. It is very common for security staff to be trained First Aiders and they are often a perfect match to double as a First Aider. They would normally carry a two-way radio for communication, they will be familiar with the lay-out of the venue or site, they will most likely have access to all areas within the venue or site.

6.6.1 Number of trained first aiders

The following ratios are recommended:

  • low risk workplaces – one first aider for every 50 workers
  • high risk workplaces – one first aider for every 25 workers.

For the entertainment and event industry, most events would fall in the ‘low risk’ category but if large constructions are required, such as a scaffold stage or similar, it can quickly become a ‘high risk’ workplace.

6.6.2 Event operational

The number of First Aid personnel and posts will vary with the type of event. St John Ambulance Australia have suggested the following formulation.

Patrons First Aid Personnel First Aid Posts
500 2 1
1000 4 1
2000 6 1
5000 8 2
10000 12 2
20000 22+ 4

The number of first aid posts required would depend on what first aid room facilities are available. Every venue should have at least one room where there is power and running water.

The Victorian Code of Practice for ‘Running safer music festivals and events” provides this information:

The appropriate number of qualified on-site first aid and medical personnel can be estimated using the following formula:

  • two level 2 First Aid qualified person for events catering for less than 500 patrons
  • two level 2 First Aid qualified person (or higher) for each additional 1000 patrons up to 5,000.
  • One level 2 First Aid qualified person for each additional 1000 over 5,000.

At large events or events that are conducted over a long period of time, it may be desirable to supplement on-site health services with additional on-site paramedic cover. During the planning stages of the event, organisers should contact the relevant ambulance service for advice on the level of care that should be provided and the risk level of the event.

Part of the pre-production research should be identifying nearby medical centres and hospitals and their contact numbers. There may be moments, such as amputations, where a transport to a nearby facility is more beneficial than waiting for an ambulance. Descriptions and roadmaps should also be prepared to assist workers that may not be familiar with the area.

6.6.3 Record-keeping

To assist in the planning of future events, medical aid personnel should document the number of people they see and the conditions they treat. A record of any first aid treatment given should be kept by the first aider and reported to managers on a regular basis to assist reviewing first aid arrangements. First aid treatment records are subject to requirements under Health Records legislation. Great care must be taken to ensure the privacy of the people treated is protected at all levels.

6.6.4 Procedures and plans for managing an emergency

You should incorporate your first aid procedures into your emergency planning procedures. The WHS Regulation Clause 43 (1)(a)(iv) calls for medical treatment and assistance as part of the overall emergency planning. Emergency procedures should specify the role of first aiders according to their level of qualification and competence. In particular, first aiders should be instructed not to exceed their training and expertise in first aid. Other staff, including supervisors, should be instructed not to direct first aiders to exceed their first aid training and expertise.

Further guidance on emergency plans and preparing emergency procedures is available in Chapter 04 – Emergency Planning.

6.7 Notifiable Incidents

If it is a notifiable incident, secure the site for inspection by a Regulator inspector, if required.

6.7.1 Notification & Assessment

Notify the Regulator if not already done so as a result of the seriousness of the incident.

Analyse the cause of the incident and implement systems that will prevent a re-occurrence.

Whether you are an employer and/or occupier you are required by law to notify incidents to the Regulator and/or your workers’ compensation insurer.

6.7.2 A notifiable incident means:

  • the death of a person, or
  • a serious injury or illness of a person, or
  • a dangerous incident.

6.7.2.a Serious injury or illness

of a person means an injury or illness requiring the person to have:

  • immediate treatment as an in-patient in a hospital, or
  • immediate treatment for:
  • the amputation of any part of his or her body, or
  • a serious head injury, or
  • a serious eye injury, or
  • a serious burn, or
  • the separation of his or her skin from an underlying tissue
  • such as degloving or scalping), or
  • a spinal injury, or
  • the loss of a bodily function, or
  • serious lacerations, or
  • medical treatment within 48 hours of exposure to a substance,

and includes any other injury or illness prescribed by the regulations but does not include an illness or injury of a prescribed kind.

6.7.2.b A dangerous incident

means an incident in relation to a workplace that exposes a worker or any other person to a serious risk to a person’s health or safety emanating from an immediate or imminent exposure to:

  • an uncontrolled escape, spillage or leakage of a substance, or
  • an uncontrolled implosion, explosion or fire, or
  • an uncontrolled escape of gas or steam, or
  • an uncontrolled escape of a pressurised substance, or
  • electric shock, or
  • the fall or release from a height of any plant, substance or thing, or
  • the collapse, overturning, failure or malfunction of, or damage to, any plant that is required to be authorised for use in accordance with the regulations, or
  • the collapse or partial collapse of a structure, or
  • the collapse or failure of an excavation or of any shoring supporting an excavation, or
  • the inrush of water, mud or gas in workings, in an underground excavation or tunnel, or
  • the interruption of the main system of ventilation in an underground excavation or tunnel, or
  • any other event prescribed by the regulations, but does not include an incident of a prescribed kind.

In the event of the above incidents occurring someone who manages or has responsibility for the particular workplace or particular operation at the workplace must notify the Regulator immediately.

6.7.3 A person giving notice by telephone must:

  • give the details of the incident as requested by the regulator, and
  • if required by the regulator, give a written notice of the incident within 48 hours of that requirement being made.

6.7.4 Duty to preserve incident sites

The person with management or control of a workplace at which a notifiable incident has occurred must ensure so far as is reasonably practicable, that the site where the incident occurred is not disturbed until an inspector arrives at the site or any earlier time that an inspector directs

The preservation of an incident site does not prevent any action:

  • to assist an injured person, or
  • to remove a deceased person, or
  • that is essential to make the site safe or to minimise the risk of a further notifiable incident, or
  • that is associated with a police investigation, or
  • for which an inspector or the regulator has given permission

6.8 Other considerations

6.8.1 Providing first aid safely

Before providing first aid to an injured or ill person, first aiders should assume they could be exposed to infection. First aiders should wash their hands with soap and water or apply alcohol-based hand rub before and after administering first aid. First aiders should also wear personal protective equipment to prevent contact with blood and body substances, including disposable gloves. Eye protection, a mask and protective clothing may also be necessary if splashes of blood or body substances are likely to occur.

You should establish procedures to avoid workers becoming ill and exposing others to illness when handling blood or body substances. Procedures could include:

  • proper hand hygiene practices
  • how to handle and dispose of sharps
  • how to clean surfaces and reusable equipment
  • how to manage spills and handle and clean soiled laundry
  • how to handle and dispose of waste
  • when to use personal protective equipment, for example, using resuscitation masks for cardiopulmonary resuscitation.

First aiders should be aware of what to do if they have accidental contact with blood or body substances, a sharps injury or contact with a person known to have a contagious illness. Any part of the body that comes in contact with blood or body substances should be washed with soap and water immediately. Prompt medical advice should be obtained. All first aiders should be offered hepatitis B virus vaccination.

6.8.2 Standard precautions for infection control

First aiders should take standard precautions to avoid becoming ill and exposing others to illness when handling blood or body substances. Standard precautions are work practices that are applied to all patients and their blood and body substances, regardless of their infectious status, to ensure a basic level of infection prevention and control. Standard precautions include hand hygiene, use of personal protective equipment, appropriate handling and disposal of sharps and waste, cleaning techniques and managing spills of blood and body substances.

6.8.3 Contaminated items

All items that are soiled with blood or body substances should be placed in plastic bags and tied securely. Waste disposal should comply with any state or local government requirements.

Sharps, including scissors and tweezers, that have become contaminated with blood or body substances should be disposed of in a rigid-walled, puncture-resistant sharps container by the person that used them. Guidance on the design, construction, colour and markings of sharps containers is provided in:

If a first aider sustains a sharps injury or thinks they are at risk of infection from blood or bodily fluid contamination, they should seek prompt medical advice.

6.8.4 Cleaning spills

Cleaning should commence as soon as possible after an incident involving blood or body substances has occurred. First aiders should wear disposable gloves when cleaning spills and if splashes of blood or body substances may occur, additional protective equipment such as eye protection, plastic aprons and masks should be worn. Surfaces that have been contaminated with blood or body substances should be wiped with paper towelling and cleaned with warm soapy water. It is generally unnecessary to use sodium hypochlorite (chlorine bleach) for managing spills but it may be used in specific circumstances, for example if the surface is hard to clean.

Revision 15/12/2017 – Added link to the First Aid Code of Practice in the First Aid Kit section.