First Aid Skills for Every Jobsite

By Gianni Scarcello, Safety Specialist, The Boldt Company

Knowing and learning first aid is critical for anyone in the construction industry. Construction sites are dynamic environments where accidents can happen unexpectedly. Being prepared to respond effectively in emergencies can make a significant difference in saving lives and preventing further injuries.

Because work in this industry comes with risks, we may find job sites in locations where emergency services response time can be outside the average. It is important to have at least one, if not more, people trained in first aid.

OSHA 1926.50 covers medical services and first aid, while 1926.50 App A covers the contents of a first aid kit. It is important to familiarize yourself with both regulations. Routinely check your first aid kits to ensure items are not expired. It is essential to update all items as they expire, even expired bandages become useless as they lose the ability to adhere to the skin.

Through proper first aid and CPR training, we can have people who can provide important care within a short amount of time following an injury. Before assisting with first aid, always check to ensure the scene is safe for you to be in as well. The last thing you would want to do is burden emergency services by turning a single-victim situation into a multi-victim scenario by injuring yourself too.

Bleeding
Until emergency services arrive, try to control bleeding. If possible, first put on rubber or latex gloves before touching any blood. It is important to avoid coming in contact with blood because of the risk of blood-borne pathogen transmission.
When bleeding is present, your first attempt should be to control it with direct pressure, unless the volume and flow rate seem too great to be able to control with direct pressure alone. Direct pressure on a wound using two hands and body weight is an effective method of slowing bleeding or stopping it altogether. In many cases, it will take 10 or more minutes of continuous pressure to stem the blood flow and form an adequate clot at the bleeding point. Most importantly, there should be no release of the pressure during this time to see whether it is being effective. Letting up on the pressure will allow the bleeding to begin again and undo any benefit obtained up to that point. If the wound can be controlled through pressure, you may also use a wound closure mechanism such as Steri Strips, or microMend.
The warning signs of a life-threatening bleed tend to include the following:

• Pulsatile or steady bleeding that is coming from a wound.
• Blood is pooling on the ground (about half of a soda can’s worth of blood).
• Clothing or bandages are steadily becoming soaked with blood.
• Amputation of an arm or a leg.
• The patient was bleeding and is now unconscious or confused (indicating that the patient is in shock).

If the amount of bleeding cannot be stopped by direct pressure due to any of the above-mentioned signs, a tourniquet can be utilized to halt the bleeding. Tourniquet usage has been a topic of confusion in the past, with a common belief that its application inevitably led to limb loss. However, current knowledge disputes this notion. Data sourced from the U.S. military reveals that individuals suffering from trauma and receiving a tourniquet before entering shock have a survival rate nine times higher compared to those who have a tourniquet placed on them after entering shock. Furthermore, studies prove that tourniquets can be safely used on an extremity for a duration of up to 2 hours without the risk of amputation.

This timeframe aligns well with the usual care duration for construction trauma patients treated in urban and suburban settings in the United States. When applying a tourniquet to control bleeding in an extremity, it is crucial to tighten it adequately to stop the distal pulse completely. This ensures that no blood seeps past the tourniquet and reaches the extremity.

The importance of this tightness lies in two key factors. Firstly, if blood manages to flow past the tourniquet, the patient will continue to bleed, defeating the purpose of its application. Secondly, insufficient tightness of the tourniquet, preventing arterial blood inflow, may obstruct venous outflow instead. This raises the risk of developing compartment syndrome in the extremities, potentially resulting in muscle and nerve damage. Improper usage in this manner could escalate the likelihood of amputation.

Burns and Scalds
Several types of burns can occur, such as thermal, chemical, electrical, or contact burns. Although the causes may vary, the treatment for these burns is quite similar. Start by running cold water over the affected area for at least 30 minutes for thermal, chemical, or contact burns. It’s important to flush the burn before seeking help. If the person’s clothing is stuck to the burn, do not try to remove it. Cut or tear away clothing that is not stuck to the burn. Avoid using ice on the burn, and cover it with clean, cotton material if available. If clean cotton material is not available, leave the burn uncovered. Refrain from scrubbing the burn or applying any soap, ointment, or home remedies. Attempt to keep the victim covered with a blanket. Burn victims may have a decreased ability to keep themselves warm following a burn.

In the case of an electrical burn, do not touch the victim if they are still in contact with the power source, as electricity can travel through the victim’s body and shock you as well. When the victim is clear of the power source, check for airway obstruction, breathing, and circulation. Administer CPR if necessary, and then proceed to run cold water over the burns for a minimum of 30 minutes. Remember to maintain the victim’s body temperature within a normal range.

Unconscious Victims
For unconscious victims, follow the Red Cross “shout-tap-shout” procedure while checking for responsiveness, breathing, and life-threatening conditions. If the person does not respond, is not breathing, is only gasping, or has life-threatening bleeding or another life-threatening condition, immediately call 9-1-1, get equipment, and give care based on your level of training. Start CPR and use an AED if the person is unresponsive and not breathing or only gasping (cardiac arrest).

Choking (adults)
Suppose you suspect a person to be choking on an object such as food. Ask them to try to speak or cough. Generally, if those things can occur, they are getting air. Coughing is a good sign the body is trying to get the object(s) out. When coughing stops and they fall silent, you should be concerned. If this occurs, begin to give the victim 5 back blows in an attempt to dislodge the stuck item. Following the back blows, attempt the Heimlich maneuver. Move your hand across the abdomen to the area above the navel/belly button then make a fist and place your thumb against the stomach. Place your other hand over your fist and press into the victim’s stomach with a quick upward thrust. Continue giving 5 back blows and 5 abdominal thrusts.

• Continue until the person can cough, cry, speak, or become unresponsive.
• If the person becomes unresponsive, lower them to a firm, flat surface and begin CPR (starting with compressions) according to your level of training.
• Trained responders: After each set of compressions and before attempting breaths:
  • Open the person’s mouth.
  • Look for an object.
  • If seen, remove it using your finger. NEVER do a finger sweep unless you can see an object.

For children, you may need to kneel behind them to administer the back blows or stomach thrusts. For pregnant women, do not do stomach thrusts, instead go under their arms (base of the breastbone) and perform chest thrusts.

Debris in eye
The importance of proper eye PPE cannot be understated. We all can likely take our vision for granted, and having that ability to see, or see clearly can change in the blink of an eye. You can attempt to treat it yourself if you are alone or ask another coworker to assist.
First off, do not rub your eye. That may be instinct when something obscures our vision, or we feel something hit us in the eye. However, this could only make matters worse. If you get a chemical in your eye, read, or ask someone to read the label or SDS sheet on what to do. If you get an object in your eye, you can use emergency eye wash from your first aid kit to attempt to wash out the object.

• Make sure you wash your hands with soap and water. You’re already dealing with one foreign substance or object in your eye. Cleaning your hands helps ensure you don’t add to the contamination.
• If you’re wearing contacts, take them out.
• Flush out your eye (or eyes) with warm water. Your goal here is to flush the eye gently with water or a solution to remove whatever object is in it. Keep your eyes open as much as possible during the process.
• Be thorough. Look to spend at least 15 minutes irrigating your eye or eyes if you’re dealing with chemical exposure. If an object gets in your eye, check to see if it has been flushed every few minutes and stop when it’s out.
• When in doubt, seek care from a trained physician.

Get trained in First Aid CPR/AED
All the above scenarios are some of the common first-aid injuries that can occur on the job site. Getting trained in First Aid/CPR/AED is critical in being able to provide potential life-saving measures. Being trained in first aid is important, but continuing to practice it can make the difference in feeling comfortable or second-guessing yourself during a situation. Remember, we don’t rise to the level of our expectations, we fall to the level of our training.

Gianni is a First Aid/CPR/AED instructor, an instructor for LTB (life-threatening bleeding) tourniquet application, FAST (first aid for severe trauma), and Department of Defense: STOP the Bleed.