Pegasus Health & Safety Training

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Update - October 2015

AED's (Defibrillators) as you should be aware there are not enough of these about in communities. If you buy an AED the guidance is to register with the Ambulance Service and also with the websites/Apps below:


GoodSAM (Good Smartphone Activated Medics). Their app has the 'Defibrillocator' integrated AED locator, which has the UK's (and the World's) largest defibrillator / AED register.

I am currently one of many Individuals/Groups/Charities who are trying to get more AED's out in the community and train as many people in basic life support/CPR

Safe Guarding

Children and social work Act 2017: As well as the new updated guidelines for working together to safeguard children - currently under consultation. 

 Some info on the Act  

http://llrscb.proceduresonline.com/pdfs/policy_briefing.pdf 

Proposed changes to working together .  

https://www.nspcc.org.uk/what-we-do/news-opinion/government-consultation-working-together-guidance/

 

Anaphylaxis

The latest Guidance is related to Anaphylaxis and the Medicines Act, see the report and the new guidance

The Report  

http://www.reactfirst.co.uk/live/tips36.asp

The Act itself.  214 

Exception Chapter 3.  

 http://www.legislation.gov.uk/uksi/2012/1916/made




The latest guidelines are out from the Resuscitation Council from October 15th 2015. Not many changes but they are encouraging the use of Defibrillators (AED's) including teaching Children how to use them

 The Resuscitation Council (UK) recommends that to improve survival from cardiac arrest: 

 

  1. All school children are taught CPR and how to use an AED.
  2. Everyone who is able to should learn CPR.
  3. Defibrillators are available in places where there are large numbers of people (e.g. airports, railway stations, shopping centres, sports stadiums), increased risk of cardiac arrest (e.g. gyms, sports facilities) or where access to emergency services can be delayed (e.g. aircraft and other remote locations).
  4. Owners of defibrillators should register the location and availability of devices with their local ambulance services.
  5. Systems are implemented to enable ambulance services to identify and deploy the nearest available defibrillator to the scene of a suspected cardiac arrest.
  6. All out-of-hospital cardiac arrest resuscitation attempts are reported to the National Out-of-Hospital Cardiac Arrest Audit. www.warwick.ac.uk/ohcao.
 
The other changes put forward by RCUK and ERC are:-
  •  Resuscitation Council (UK) Guidelines


    Whilst the updates to resuscitation were minimal, there are three subtle changes that will impact on how first aid is taught in the future:

    1.    ‘Shouting for help’ is no longer a step to be taught on its own. The guidelines now state that the first aider should ‘ask someone to call 999’ after checking for normal breathing.

    The guidelines now only instruct the first aider to ‘ask someone to call 999’ after checking for normal breathing. This further simplifies the guidelines, making accurate recollection of the sequence even easier. It also acknowledges the frequent availability of mobile phones as the new guidance also says to use the speaker function on mobile phones for ease of communication.  


    2.    Increased emphasis on seizure as a possible presentation of cardiac arrest

    Immediately following cardiac arrest, blood flow to the brain is reduced to virtually zero. This may cause a seizure-like episode that can be confused with epilepsy. Bystanders should be suspicious of cardiac arrest in any patient presenting with seizures. It is also extremely important to teach first aiders how to recognise agonal gasps.


    3.    Teach first aiders to activate the speaker function on their phone when calling 999 to help communication.

    A common feature on modern mobile phones, this addition helps the first aider to communicate with the Emergency Medical Despatcher at the same time as assisting the casualty. Guidance says that it is reasonable to show the first aider how this can be done on their own mobile phone.

  • European Resuscitation Council (ERC) First Aid Guidelines

    For the first time in history, the ERC have published guidelines on first aid. This follows an ILCOR led review of evidence in specific first aid topics. The ERC first aid guidelines are based on a worldwide expert consensus of best practice following an international evidence-based review, making them an extremely important addition to first aid practice in Europe.

    Below are the key changes that will affect how first aid is taught:


     4.    Elevation and Indirect pressure points are no longer recommended for the treatment of bleeding.

    Elevation and indirect pressure have been removed due to a lack of evidence that either is effective in stopping bleeding, particularly life-threatening bleeding.


    5.    Haemostatic dressings and tourniquets are to be used when direct pressure cannot control severe bleeding.

    Following extensive use and research in combat, there is a wealth of evidence that tourniquets are effective, save lives and have a relatively low rate of complications following application. Similarly, haemostatic dressings have also undergone significant improvements in recent years, have low complication rates and have saved many lives.

    The balance of complications versus possible outcomes if not used have led to both tourniquets and haemostatic dressings being introduced into main-stream first aid.  Of course, a small office workplace is unlikely to find that catastrophic bleeding is a significant risk to their employees, so they wouldn’t necessarily have to rush out and buy this new equipment. A waste recycling plant or tree surgeon on the other hand may wish to consider having these available. 

    The good news is that the guidelines are very clear that “training is required to ensure application is safe and effective”.


    6.    Sucking chest wounds should be left open to the environment – Three sided dressings are no longer recommended.

    Due to clinical experience of both improvised and purpose made dressings inadvertently becoming occlusive, the ERC guidelines recommend to ‘leave the wound in open communication with the environment’. This means that there is no longer a requirement to cover it with a dressing. The main emphasis on providing care should be to ‘do no harm’, and the risk of dressings becoming occlusive is significant.


    7.    For the treatment of Asthma, first aiders should be taught how to administer an inhaler and how to use a spacer device.

    The exact wording is “First aiders must be trained in the various methods of administering a bronchodilator”. In the UK, that includes assisting a casualty to take their own prescribed inhaler and how to take it using a spacer device.  


    8.    Hypoglycaemia – first aiders should aim to give 15-20g of glucose.

    This has been in diabetes hospital management guidance for a while so it’s good to see more clarification on quantities in first aid guidance. The updated Paediatric First Aid Made Easy book will also include some further guidance for children, as this is the adult requirement.


    9.    Oral Carbohydrate-electrolyte beverages (sports energy-rehydration drinks) now recommended for exertion related dehydration.

     

    Specific sports energy-rehydration drinks have proven to be more effective than water as they also replace lost body salts. Evidence also suggests that semi-skimmed milk and tea can also be as effective as water.  


    10.    Burns should be cooled with water for a minimum of 10 minutes, as soon as possible.

Changes made on October 2014:-

From 1st October 2014 the Human Medicines (Amendment) (No. 2) Regulations 2014 will allow schools to buy salbutamol inhalers, without a prescription, for use in emergencies

The emergency salbutamol inhaler should only be used by children, for whom written parental consent for use of the emergency inhaler has been given, who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication.

The inhaler can be used if the pupil’s prescribed inhaler is not available (for example, because it is broken, or empty). This change applies to all primary and secondary schools in the UK. Schools are not required to hold an inhaler – this is a discretionary power enabling schools to do this if they wish.

Schools which choose to keep an emergency inhaler should establish a policy or protocol for the use of the emergency inhaler based on this guidance. Keeping an inhaler for emergency use will have many benefits. It could prevent an unnecessary and traumatic trip to hospital for a child, and potentially save their life.

Parents are likely to have greater peace of mind about sending their child to school. Having a protocol that sets out how and when the inhaler should be used will also protect staff by ensuring they know what to do in the event of a child having an asthma attack 

Changes made in 2010 were:- 

Workplace Health & Safety Guidance

Health & Safety Executive (HSE)

The information below is intended for general guidance. You may contact the H.S.E directly at: Health & Safety Executive, Health Policy Division, Magdalen House, Stanley Precinct, Bootle L20 3QZ.

Employers’ legal duties

The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel to ensure their employees receive immediate attention if they are injured or taken ill at work. These Regulations apply to all workplaces including those with less than five employees and to the self-employed. Detailed information can be found in First aid at work. The Health and Safety (First Aid) Regulations 1981. Approved Code of Practice and guidance[2].

Training courses

If you have identified that first-aiders are needed in your workplace, they must have a valid certificate of competence in FAW or emergency first aid at work (EFAW). EFAW training enables a first-aider to give emergency first aid to someone who is injured or becomes ill while at work. FAW training includes EFAW and also equips the first-aider to apply first aid to a range of specific injuries and illnesses. The findings of the first-aid needs assessment can help you decide whether your first-aiders should be trained in FAW or EFAW.

HSE strongly recommends that first-aiders undertake annual refresher training, over half a day, during any three-year FAW/EFAW certification period. This will help qualified first-aiders maintain their basic skills and keep up to date with any changes to first-aid procedures.

In the event of injury or sudden illness, failure to provide first aid could result in a casualty’s death. The employer should ensure that an employee who is injured or taken ill at work receives immediate attention.

HSE will prosecute in cases where there is a significant risk, a disregard for established standards or persistent poor compliance with the law. More information can be found in 'HSE's Enforcement Policy Statement' [134KB] [1].

www.hse.gov.uk

RIDDOR


The legal responsibilities for “Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995

Employers, the self-employed and those in control of premises must report specified workplace incidents.

Areas covered by the ICC: England, Scotland & Wales


www.riddor.gov.uk

www.hse.gov.uk

www.communities.gov.uk/fire/firesafety



The Regulatory Reform (Fire Safety) Order 2005


Fire safety law and guidance documents for business

The Regulatory Reform (Fire Safety) Order 2005 (FSO) came into effect in October 2006 and replaced over 70 pieces of fire safety law.

The FSO applies to all non-domestic premises in England and Wales, including the common parts of blocks of flats and houses in multiple occupation (HMOs). The law applies to you if you are:

  • responsible for business premises

  • an employer or self-employed with business premises

  • responsible for a part of a dwelling where that part is solely used for business purposes

  • a charity or voluntary organisation

  • a contractor with a degree of control over any premises

  • providing accommodation for paying guests

Under the FSO, the responsible person must carry out a fire safety risk assessment and implement and maintain a fire management plan. Further information on what you need to do when carrying out a risk assessment is available in the 5-step fire risk assessment checklist below.

In addition, more detailed advice and guidance on the implementation of a fire risk management plan can be found in the series of guidance documents available below or on the Fire Gateway website (see link on right). The more technical guidance documents have been produced with specific types of business premises in mind.

If, having completed a fire risk assessment, you need more practical advice or information, you local Fire and Rescue Authority may be able to help. You may feel more comfortable employing a fire safety specialist to help you. Companies providing fire safety services are listed in local directories. Alternatively you may be able to ask your insurer for a recommendation.

http://www.communities.gov.uk/fire/firesafety/

 

 

A.2 Example form for recording significant findings

Risk Assessment – Record of significant findings

Risk assessment for

Building:


Location:

Assessment undertaken by

Date:

Completed by:

Signature:

Sheet number Floor/area:

Use:

Step 1 – Identify fire hazards

Sources of ignition

 

Sources of fuel


Sources of oxygen


Step 2 – People at risk



Step 3 – Evaluate, remove, reduce and protect from risk

(3.1) Evaluate the risk of the fire occurring


(3.2) Evaluate the risk to people from a fire starting in the premises


(3.3) Remove and reduce the hazards that may cause a fire


(3.4) Remove and reduce the risks to people from a fire




 

Assessment review

Assessment/review date

 

Completed by

 

Signature

 

Review outcome (where substantial changes have occurred a new record sheet should be used)

Notes:

(1) The risk assessment record of significant findings should refer to other plans, records or other documents as necessary.

(2) The information in this record should assist you to develop an emergency plan; co-ordinate measures with other ‘responsible persons’ in the building; and to inform and train staff and inform other relevant persons.

 

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