Ready to save a worker's life in all of these situations?
Consider every possible hazard
Amputation, anaphylactic shock, asthmatic reaction, cardiac arrest, convulsion, seizure, diabetic emergency, head injury, heat stroke, and pneumothorax.
These are just some of the emergencies that can occur in your workplace at any given moment. "The occupational health nurse needs to be aware of the conditions that can occur as a result of an individual's health status and also work-related issues," says Bonnie Rogers, DrPH, COHN-S, LNCC, director of the North Carolina Occupational Safety and Health Education and Research Center, and the Occupational Health Nursing program at the University of North Carolina, both in Chapel Hill.
Every day, you may potentially save an employee's life by encouraging healthy lifestyle changes and safe work practices, and never know it. However, there are occasionally dramatic "saves" made by OHMs that literally save an employee's life or limb.
"You must be familiar with all the jobs that are done at the worksite, in order to put prevention strategies in place," says Rogers. For example, an employee using potentially dangerous equipment could suffer an amputation. In this case, "you will need to provide immediate emergency care to make sure the worker is breathing, stop any bleeding, and arrange for immediate transport of the employee to the hospital, while taking care of the affected part that was amputated," says Rogers.
If an employee has an anaphylactic reaction from an allergy to food or latex, it can trigger respiratory distress, bronchospasm, wheezing, and cardiovascular collapse. "Here, you will need to be sure the airway is open, administer oxygen and epinepherine per written medical standing order, monitor vital signs, and immediately provide for transport to the hospital," says Rogers.
Be ready for cardiac arrest
According to Bruce Sherman, MD, medical director of global services at Akron, OH-based Goodyear Tire and Rubber Company, "the most likely setting for an occupational health professional to provide a critical emergency response is a cardiac arrest." Consider these items:
Ensure timely access to an automated external defibrillator (AED).
"This is essential for improving the likelihood of resuscitation from cardiac arrest," says Sherman. "My recommendations are to have AEDs available in the workplace so that the device can be transported and used within five minutes of recognition of cardiac arrest."
To be of any value, AEDs must be readily accessible to trained personnel, says Patrick Stover, MD, senior medical director at General Motors Corporation in Detroit. "We have established a guideline that includes a 'drop to shock' time of three to four minutes," says Stover. To meet this goal, he says that AEDs are required to be:
- Highly visible, such as in wall mount units.
- Near expected responders, such as in security vehicles or first aid stations.
- Close to where the largest numbers of people spend their time.
- Near hazards or where high-risk activities take place.
- Tied into the communications system.
- Accessible during all shifts or hours of operation.
- Protected from tampering.
Site assessments were done by occupational health staff, with special attention paid to difficult-to-reach areas, such as upper floors in a high-rise building and secured locations. "Each site is required to have a written emergency response plan. The AED protocol must be incorporated into this plan," says Stover.
Develop an emergency response team.
"This is ideal for most workplace settings, where team members have received training and certification regarding cardiopulmonary resuscitation and AED use," says Sherman.
Consider the need for additional resources.
For geographically remote areas with significant delays in the arrival of emergency medical services, additional advanced cardiac life support medications, and individuals certified to use them, may be warranted, says Sherman.
"Equipment, including supplemental oxygen and a means for passive and active administration, should also be available," says Sherman.
SOURCES
For more information on the occupational health response to workplace emergencies, contact:
Joel R. Bender, MD, PhD, MSPH, FACOEM, Corporate Medical Director, General Motors Corporation, Detroit, MI. Phone: (313) 665-1642. Fax: (313) 665-1652. E-mail: [email protected]
Jonathan Dawe, Director, Safety, Health and Workers' Compensation, Simmons Bedding Company, Atlanta, GA. E-mail: [email protected]
Bonnie Rogers, DrPH, COHN-S, LNCC, Director, North Carolina Occupational Safety and Health and Education and Research Center, Chapel Hill. Phone: (919) 966-1765. Fax: (919) 966-8999. E-mail: [email protected]
Bruce Sherman, MD, Medical Director, Global Services, Goodyear Tire and Rubber Company, Akron, OH. Phone: (330) 796-9295. Fax: (330) 796-1362. E-mail: [email protected]
Patrick Stover, MD, Senior Medical Director, General Motors Corporation, Detroit, MI. E-mail: [email protected].
Amputation, anaphylactic shock, asthmatic reaction, cardiac arrest, convulsion, seizure, diabetic emergency, head injury, heat stroke, and pneumothorax.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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