Roco Rescue was the proud recipient of a support and dedication award from the Baton Rouge Fire Department recently in a ceremony conducted at the Roco Training Center in Baton Rouge. Fire Chief Michael Kimble and Paul Stockstill presented the plaque to Chris Carlsen, Director of Training for Roco Rescue, along with several Roco Instructors.

“We wanted to give Roco something to thank them for all that they have done to help BRFD bring their rescue training to the next level,” Chief Kimble said. He added, “We share a common mission to keep emergency responders trained to respond safer and more effectively.”

Roco will continue its efforts to maximize support for municipal emergency responder wherever we can. Roco has the unique opportunity to influence not only the regulatory frameworks that shape the rescue industry, but also the techniques that are used by emergency responders on a daily basis.

This plaque from the BRFD acknowledges Roco’s on-going efforts to support emergency responders and is therefore very special to us. It is an honor to be recognized.

Your company has a strong safety culture with outstanding employee participation. Everyone is committed to safety and goes out of their way to do things in the safest way possible. As a safety professional, everything is great in your world until suddenly, a “near-miss” report lands on your desk. Supervisors, managers, and company executives are now concerned, worried, or even stressed out about the fact that something unsafe just happened at their company! Many would-be quick to speculate that a near miss is a bad thing; however, as a safety professional, you know that this is not necessarily the case. The reality is, a near-miss or “good catch” report can be one of the most valuable tools for improving your company’s safety program.

What is a Near Miss?

According to OSHA, a Near Miss is an unplanned event that did not result in an injury, illness, or damage – but under different circumstances, could have. Your company may have another term for a near miss such as “close call,” “good catch,” “narrow escape,” “near hit,” “cliffhangers,” or a number of other terms. However, at the end of the day, these are all near misses. Near misses are caused by the same things as accidents: unsafe conditions and/or unsafe behaviors. Near misses are often precursors to accidents and should not be ignored. In fact, according to the National Safety Council (NSC), 75% of all accidents are preceded by one or more near misses.

Heinrich’s Law and Bird’s Safety Triangle

In 1931, Herbert Heinrich published Industrial Accident Prevention: A Scientific Approach where he proposed a concept that would eventually become known as “Heinrich’s Law.” Heinrich’s law states that for every accident that causes a major injury, there are 29 accidents that cause minor injuries and 300 accidents that cause no injury (i.e., near misses).

Years later, Frank Bird analyzed nearly 2 million incident reports from over 300 companies and used his findings to amend and expand upon Heinrich’s theory. Bird developed the “Safety Triangle” (depicted here) which states that for every fatality, there will be 10 serious accidents, 30 minor accidents, 600 near misses, and an unknown, but significant number of unsafe acts. The important thing to take away from this is that near-miss reports should be taken seriously, investigated, and used to prevent future incidents.

Near Miss Reported – Now What?

A Near Miss report is submitted. You’re thankful that it wasn’t an injury report, but you also realize that this could have easily been one under different circumstances. You also realize that this is a potential precursor to something worse, so now what? The answer – Root Cause Analysis. There are many different models to choose from when conducting RCAs. The “5-why” is one of the most popular choices due to its simplicity; it is also recommended in ANSI Z-10 Standard for Occupational Safety and Health Management Systems. There are other formats that are equally effective such as the fishbone diagram, also known as the Ishikawa diagram, Failure Mode and Effects Analysis (FMEA), scatter plots, and many others. What format or method you choose is not as important as actually performing RCAs in the first place. The key takeaway here is, use whatever format you are most comfortable with, as long as you ensure that RCAs are performed when necessary.

There’s almost always a deeper root cause to why a near-miss occurred. While there may be an obvious reason on the surface level, by digging a little deeper into the situation, you may find that there’s more than meets the eye. Correcting the immediate cause may help to resolve the symptom of the problem, but not the problem itself.

For example, a worker at your facility slips in a puddle of water on the floor and falls. The worker is not injured and as a result, a near-miss report was submitted. The investigation should not conclude with “employee slipped in puddle and fell – instructed employee to be more aware of their surroundings.” An effective root cause analysis would instead look for deeper issues, such as:

• Why was the puddle there in the first place?
• Where there changes in the environment, weather, conditions, or a process?
• What was the source of the water?
• What tasks were being performed when the water was spilled?
• Why was the water not cleaned up?
• How long was the water there?
• Was the spill reported?

By performing a root cause analysis, you may learn that it was raining on the day of the near-miss and that the roof in your warehouse has developed a leak, causing a puddle of water to form, creating the unsafe condition that led to the incident. Simply instructing the employee to be more aware of the surroundings may prevent them from slipping again; however, it will not prevent the unsafe condition from reoccurring. The true root cause needs to be addressed; the roof must be repaired.

OSHA provides a great resource for Root Cause Analysis here.

Improving Your Company’s Near Miss Program

You’ve received a near miss, conducted an investigation, identified a true root cause, and took corrective action to eliminate it; now you see the tremendous benefit of near-miss reporting. Then ask what can you do to improve your company’s near-miss program?

1. Keep the reporting process simple.

Consider implementing google forms, phone applications, or even a universal near-miss email address. The key is to make the process to submit a near-miss as easy, quick, and painless as possible. For example, many companies now create QR codes that can be scanned, taking personnel right to the form to complete and submit. This can all be done for free with readily available resources around the internet.

2. Train employees on the importance of near-miss reporting.

If employees don’t recognize the importance of near-miss reporting, they will have no interest in doing so. Ensure that employees know the benefits of near-miss reporting.

3. Keep near-miss reports non-punitive.

No one wants to willingly broadcast their mistakes, especially if they will be punished for doing so. Punishing an employee who submits a near-miss report is a sure-fire way to send a message that safety may not rank as high on the priority list as you claim. This is also a guaranteed way to discourage employees from participating in the program. On the other hand, when near-miss reporting is rewarded, it can change their mindset.

4. Incentivize the program.

Even if employees know the benefits of a near-miss program and know that it will be non-punitive, they may still need a little encouragement to do so. Consider implementing a periodic drawing for all who submit near-miss reports. Alternatively, consider highlighting the best near-miss submitted for the month to promote quality participation.

5. Celebrate and communicate your success.

Perhaps the most important part of a successful near-miss program is communicating your findings and celebrating your success. Communication should be transparent but does not have to be so transparent that it includes every detail of the situation. Include highlights of the near-miss and the corrective actions that will be taken to prevent them in the future. Communicating your findings could help prevent other incidents as well.

Summary

When your employees know they can openly report an incident or mishap without being reprimanded, it can encourage more open communications and improved safety awareness. Most certainly, it gives you the opportunity to take corrective action and prevent a more serious injury, or worse. Actively promoting employee involvement via near-miss reporting will provide a boost to your overall safety program and result in a safer worksite for everyone. A “good catch” is a good catch for all concerned.

Chris McGlynn is a dynamic safety leader who serves as the Director of Safety at Roco Rescue and is dedicated to amplifying the company's safety success. As a Certified Safety Professional, Confined Space and Rope Rescue Technician, and Paramedic, Chris leverages his expertise to provide employees with the necessary tools, training, and support to work safely and efficiently. He also oversees Roco Safety Services, offering high-caliber safety professionals for special projects and turnarounds. As the VPP Coordinator, Chris ensures that Roco maintains its status as an OSHA VPP Star Worksite, continuing the company’s unwavering commitment to excellence in safety and health. Roco has been an OSHA VPP Star Worksite since 2013.

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Additional Resources

• Want a Safer Workplace? Get Employees Involved!

• How to Make an Impact as Safety Professionals

The U.S. Department of Labor issues an OSHA National News Release that announces new enforcement guidelines that could exponentially increase penalties for companies who prioritize profits over safety. Specifically, OSHA addresses the expanded application of instance-by-instance citations and non-grouping of violations in certain cases that will go into effect on March 27th of this year.

Originally published in October 1990, CPL 02-00-080, also known as the “egregious or violation-by-violation penalty procedure,” was intended to “create large aggregate penalties” for willful citations in order to “provide an incentive to employers to prevent safety and health violations in their workplace”. In the first memo, OSHA expands the scenarios that “instance-by-instance” citations may be issued for “high-gravity serious violations of standards specific to falls, trenching, machine guarding, respiratory protection, permit-required confined spaces, lockout tagout, and other-than-serious violations specific to recordkeeping”. If you haven’t noticed, these closely align with OSHA’s “Top 10 Most Frequently Cited Standards”. The scope of this directive applies to general industry, construction, maritime, and agriculture; in other words, this applies to everything under OSHA’s jurisdiction.

So, what does the expanded use for instance-by-instance citations include?

According to OSHA, a decision to use instance-by-instance should be based on the consideration of one or more of the following factors and does not preclude the use of other OSHA initiatives, directives, or emphasis programs.

• The employer has received a willful, repeat, or failure to abate violation within the past five years where that classification is current.
• The employer has failed to report a fatality, inpatient hospitalization, amputation, or loss of an eye pursuant to the requirements of 29 CFR 1904.39.
• The proposed citations are related to a fatality/catastrophe.
• The proposed recordkeeping citations are related to injury or illness(es) that occurred as a result of a serious hazard.
  
  

This is intended to be a targeted strategy for those employers who repeatedly choose to put profits before their employees’ safety, health and well-being.

According to statements released by Doug Parker, Assistant Secretary for OSHA, “Smart, impactful enforcement means using all the tools available to us when an employer ‘doesn’t get it’ and will respond to only additional deterrence in the form of increased citations and penalties.” He goes on further to state that “This is intended to be a targeted strategy for those employers who repeatedly choose to put profits before their employees’ safety, health and well-being. Employers who callously view injured or sickened workers simply as a cost of doing business will face more serious consequences.”

References

https://www.osha.gov/news/newsreleases/national/01262023-0

https://www.osha.gov/enforcement/directives/cpl-02-00-080

https://www.osha.gov/memos/2023-01-26/application-of-instance-by-instance-penalty-adjustments

https://www.osha.gov/top10citedstandards

https://www.osha.gov/memos/2023-01-26/exercising-discretion-when-not-to-group-violations

https://www.osha.gov/enforcement/directives/cpl-02-00-164/chapter-4

Additional Resources

• Want a Safer Workplace? Get Employees Involved!

• How to Make an Impact as Safety Professionals

We are proud to announce that once again Roco has been reapproved as an OSHA VPP Star Worksite organization. VPP Star is the highest level of recognition awarded by OSHA. VPP participants serve as models for other employers, workers, and unions by operating excellent safety and health management programs. Roco has been a VPP Star worksite since 2013 and is excited to continue this tradition of raising the bar on its journey of maintaining an excellent safety and health program.

To earn this distinction, we implemented a comprehensive safety program and underwent a rigorous onsite evaluation by a team of OSHA safety and health experts. The “Star” designation is reserved for companies that “demonstrate exemplary achievement in the prevention and control of occupational safety and health hazards, as well as the development, implementation and continuous improvement of safety and health management systems.”

To our knowledge, we are the only rescue training, services and equipment company to achieve the VPP Star designation. The process of earning and renewing our VPP Star is an important way for us to get external feedback and confirm that we are “walking the walk” as an organization.

Roco’s Total Recordable Incident Rate (TRIR) and Days Away Restricted or Transferred (DART) were 100% below the national average for our industry. Having maintained our status as a VPP Star Worksite for another year has once again validated that we are living up to the highest standards of OSHA’s Voluntary Protection Program. This achievement would not be possible without a dedicated commitment to safety by all Roco employees.

Additional Resources

• Is OSHA VPP a Good Fit for Your Company?
  
  
  
  

So, you’ve got your rescue team up to date on all the nifty tricks in confined space rescue. Litters, knots, anchoring, mechanical advantage systems, the whole kit, and kaboodle. Now, you’ll need some first aid and CPR training to meet OSHA’s standards. Some folks say a simple layperson first aid course will do it. Others argue that teams need a week-long EMS professional course to prepare. Going further, some folks say that investing in drills and skills retention is the most critical issue. To cut through some confusion, let’s look at some of the things employers might factor in when choosing medical training for Emergency Response and Rescue Teams.

What’s the Standard?

OSHA 1910.146(k) requires that employers “Train affected employees in basic first-aid and cardiopulmonary resuscitation (CPR),” and “ensure that at least one member of the rescue team or service holding a current certification in first aid and CPR is available.” That’s a lot, so let’s take a second to dissect this by defining some terms. According to OSHA, “First aid refers to medical attention that is usually administered immediately after the injury occurs and at the location where it occurred. It often consists of a one-time, short-term treatment and requires little technology or training to administer.” Alright, that’s pretty straightforward.

Now, let’s take a look at CPR or Cardiopulmonary Resuscitation. Simply put, rescuers will perform chest compressions to pump blood around the body and typically breathe for the patient. But wait, don’t I need to shock the patient? What about the AED (Automated External Defibrillator)? Am I required to have an AED in my first aid supplies? A 2004 letter of interpretation says no, AEDs are not specifically required in the rescue team first aid kit. However, AED’s are much easier to use today and an abundance of research says you probably should include one in your kit.

Here's why you may want to consider an AED. According to the American Heart Association, every minute after cardiac arrest without defibrillation, the patient’s chances of survival decrease by 7%-10%, and after 12 minutes, survival rates are as low as 2%-5%. In their 2020 guidelines, the AHA adds, “Defibrillation is most successful when administered as soon as possible after onset of VF/VT (lethal cardiac arrhythmias) and a reasonable immediate treatment when the interval from onset to shock is very brief. Conversely, when VF/VT is more protracted, depletion of the heart’s energy reserves can compromise the efficacy of defibrillation unless replenished by a prescribed period of CPR before the rhythm analysis.” If you have an AED handy, the rescue team is more likely to successfully resuscitate the patient rather than waiting for EMS or for someone to retrieve it from across the site.

Now that we’ve translated the standard let’s differentiate two of the most common training course types for rescue teams: Layperson First Aid and EMS/EMR Professional.

Professional Courses vs Layperson Courses

Although the topics and skills taught in basic first aid courses and EMS professional courses are similar, each route has unique advantages and disadvantages. For instance, and obvious to most folks doing the shopping, the price and time commitments vary. Typically, a simple layperson first aid course takes one day with around 4 to 10 hours of total time with the instructor. The American Heart Association, National Safety Council, American Red Cross, and other nationally recognized organizations offer First Aid CPR and AED credentials. So, although you’re only committing a single day you can trust, in most cases, that the information is solid to give your personnel a knowledge of the basics.

However, if you want your emergency response personnel to be able to take greater lifesaving measures, we highly recommend an Emergency Medical Responder (EMR) course. This is especially true if you are located in an industrial site with numerous hazards and possibly isolated from immediate medical care.

In an EMR course students will get around 50 hours of instruction, practice, and evaluation. According to the National Registry, “EMRs have the knowledge and skills necessary to provide immediate lifesaving interventions while awaiting additional EMS resources to arrive. EMRs also provide assistance to higher-level personnel at the scene of emergencies,” EMR is one of the most common medical certifications amongst both volunteer and professional responders. They are typically regulated by a state EMS education agency and taught by private businesses with licensed instructors.

From my personal experience as a Paramedic, I can say that receiving a patient from a layperson with first aid and a trained EMR can make a big difference. Oftentimes, this increases the viability of the patient – especially when access to professional medical care is not immediately available. The assessment taught to Emergency Medical Responders is almost identical to the scene assessment and patient surveys an EMT or Paramedic performs when responding to an emergency. As a component of your emergency response, medical care for the patient must be assessed and considered a vital part of any successful rescue operation.

Drills and Skills Retention

If you don’t use it, you lose it. Regardless of the course, the most critical component of any program is drilling and skills retention. In a 2020 study, a group of medical students went through a 40-hour BLS course. Immediately after training, 78% of the students were evaluated and categorized as “excellent.” However, 6 short months after the training, that number dropped to 40%.

What does this mean for your team? Should they retrain every 6 months? Maybe we could simplify their training to aid in retention.  Research conducted by the European Resuscitation Council (ERC) in 2019 showed an increase in 3-month skill retention after simplifying their guidelines. The simplest answer I can provide is to do what’s best for your unique situation.

Take a look at the hazards on your site, take note of the possible conditions and injuries, and perform a full-speed drill as often as you feel your team needs to stay proficient. If the one-year minimum for your confined space program shows a severe lack in team performance, try 6 months. If twice a year still reveals major gaps, move to 3 or even 4 exercises a year. The fact is, if you find the issues after someone is hurt or killed, the money, time, and resources you save will be nothing compared to the lives that are changed by the tragedy.

The best day to perform a rescue is the day after class. The rust builds up a bit every day that goes by. So, be proactive, aggressively shop the right course for you, and plan on investing heavily in site hazard-specific drills and rescue exercises that involve first aid and CPR. The families that work for you are betting their lives on it.

Conclusion

There are a lot of medical courses out there to choose from. What level of medical care do you want your team to have? One of a layperson to cover the basics or an EMS professional that sees the bigger picture of patient outcome and the continuum of care. Either way, if you don’t take your training seriously and prepare drills for your specific needs, the chances of catastrophe increase by the day. So, invest in your workforce's safety and peace of mind, give them the tools and perspective they need to be successful, and train hard.

References

1.https://www.osha.gov/laws-regs/standardinterpretations/2004-06-17-0

2.https://www.osha.gov/sites/default/files/publications/OSHA3317first-aid.pdf

3.https://www.osha.gov/medical-first-aid/standards

4.https://www.osha.gov/medical-first-aid/recognition

5.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600120/#ref19

6.https://www.ahajournals.org/doi/full/10.1161/circ.102.suppl_1.I-22

7.https://www.ahajournals.org/doi/10.1161/circ.140.suppl_2.139

Additional Resources

• Emergency Medical Responder Course
• First Aid CPR and AED Training Course