First Aid on Site Toolbox Talk
The first aid question is not whether there is a kit. It is how many minutes a hospital is from this gate, because that is what decides whether somebody here has to be trained.
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The talk, read this out
Two questions and I want real answers. Who here holds a current first aid certificate? And what is the address of this site, including the bit an ambulance would need?
The trigger for having a trained first aider is not crew size, which is what everybody assumes. It is distance. In the absence of an infirmary, clinic, hospital or physician that is reasonably accessible in terms of time and distance to the worksite, a person with a valid certificate in first aid training shall be available at the worksite to render first aid.
Reasonably accessible in terms of time and distance. That is a judgment about this gate and this traffic, and it is the employer's judgment to make and defend. A rural job forty minutes from anywhere is a different answer from a job four blocks from an emergency room.
Two things happen before the job even starts. The employer shall ensure the availability of medical personnel for advice and consultation on matters of occupational health, and provisions shall be made prior to commencement of the project for prompt medical attention in case of serious injury. Before. Not worked out on the day.
The kit has rules most people have never read. First aid supplies shall be easily accessible when required, the contents shall be in a weatherproof container with individual sealed packages for each type of item, and the employer shall check it before it goes out on each job and at least weekly on each job, replacing whatever has been used.
Weekly. That is the line that turns a kit from a box with two plasters and a dried out eye wash into something that works. Somebody has to own that check and it should be a name, not a role.
Getting help in is its own requirement. There has to be proper equipment for prompt transport to a physician or hospital, or a communication system for contacting an ambulance. Where 911 is not available, the numbers for physicians, hospitals or ambulances are posted conspicuously.
And where 911 is available, there is a modern rule worth knowing. The employer must ensure the communication system actually works for reaching emergency medical services, and where the system does not automatically give the dispatcher the caller's latitude and longitude, the worksite must post either its latitude and longitude or other location information that tells employees effectively where they are. A mobile call from a half built structure on an unnamed road is exactly the case that rule was written for.
One more thing, because it gets asked every time. The bloodborne pathogens standard, 1910.1030, does not apply to construction work. OSHA said so and has not changed it. What OSHA also said, in the same breath, is that this does not mean construction is free of the hazard: the General Duty Clause still applies, 1926.21(b)(2) requires the employer to train designated first aid providers in the hazards of bloodborne pathogens, and 1926.25 requires containers for the collection and separation of waste, which includes sharps and other hazardous waste from rendering medical assistance.
So whoever on this crew is the one who would go to somebody who is bleeding needs gloves within reach, needs to have been told what the risk is, and needs somewhere to put what comes off afterwards.
Point at these before anybody starts
A talk delivered in a trailer is a meeting. Stand where the work is and put a hand on each of these.
- The first aid kit. Open it now, and look at the dates.
- The last date anybody checked it, and the name of the person who owns that check.
- The site address and, if there is no address, the latitude and longitude posted somewhere visible.
- Whoever holds a current certificate, by name, and whether they are on site today.
- The nearest emergency room, and how long it actually takes at this time of day.
- Gloves, and whether the person most likely to help somebody has a pair on them.
The rules that apply
- The employer shall ensure the availability of medical personnel for advice and consultation on matters of occupational health, and provisions shall be made prior to commencement of the project for prompt medical attention in case of serious injury.
- In the absence of an infirmary, clinic, hospital or physician reasonably accessible in terms of time and distance, a person with a valid first aid certificate shall be available at the worksite to render first aid.
- First aid supplies shall be easily accessible, in a weatherproof container with individual sealed packages for each type of item, checked before being sent out on each job and at least weekly on each job.
- Proper equipment for prompt transportation to a physician or hospital, or a communication system for contacting an ambulance, shall be provided.
- Where 911 is unavailable, the telephone numbers of physicians, hospitals or ambulances shall be conspicuously posted. Where 911 is used and the system does not automatically supply the caller's latitude and longitude, the worksite shall post its latitude and longitude or other effective location information.
- 1910.1030 does not apply to construction work, but 1926.21(b)(2) requires the employer to train designated first aid providers in the hazards of bloodborne pathogens, and 1926.25 requires containers for the collection and separation of waste including sharps.
Ask the crew
Three questions, answered out loud by name. This is the part that tells you whether anybody was listening.
- Who on this site is trained, and are they here today?
- When was the kit last checked, and by whom?
- If you rang 911 from where you are standing, what would you tell them about where you are?
Close with this
Open the kit. Whatever you find in it is what somebody gets on the worst day of their life.
A talk nobody signed for is a talk that, as far as anybody can later prove, never happened. Use the free toolbox meeting sign in sheet in PDF, Word or Excel, or print the PDF above, which already has the signature lines on it.
Questions people ask
How many trained first aiders does a construction site need?
The standard sets no number. It requires a person with a valid certificate to be available at the worksite when no infirmary, clinic, hospital or physician is reasonably accessible in terms of time and distance. In practice sites carry more than one, because availability means available on the shift somebody is actually working.
Does 1926.50 say what goes in the kit?
The current text requires supplies to be easily accessible, weatherproof, individually sealed by item type and checked weekly, and points to consulting a physician on contents. It does not print a shopping list, which is why an ANSI Z308.1 kit is the usual answer: it is a recognized standard somebody can point at.
Does the bloodborne pathogens standard apply to my construction crew?
No. OSHA's letters of interpretation say 1910.1030 does not apply to construction work as defined in 1910.12, because the industry was not given notice in the rulemaking. The duty does not vanish: the General Duty Clause applies to the hazard, and 1926.21(b)(2) requires designated first aid providers to be trained in it.
More toolbox talks
TOOLBOX TALK: FIRST AID ON SITE
Attendance
Everybody who was present signs, including subcontractors and anybody visiting the site.