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

Safety professionals want to make sure all workers get home safely, but what are the best ways to do that?

Ask any safety professional what drives or motivates them to get out of bed in the morning and you’ll probably get 1,000 different answers. Some people may be motivated by their experience working in the industry, some may be motivated by combat experience, some may be motivated by their desire to help people and some may be motivated by money; the point is, we’re all motivated by something. While it’s great to know what motivates you, it’s even more important to ask yourself, “what impact do I want to make today?” 

Click here to read the full article by our own Chris McGlynn that was originally posted on OH&S’s website recently: https://ohsonline.com/articles/2022/12/05/how-to-make-an-impact.aspx?admgarea=news

Chris McGlynn is the Director of Safety/VPP Coordinator for Roco Rescue. He is a Certified Safety Professional (CSP) through the Board of Certified Safety Professionals as well as a Certified Confined Space and Rope Rescue Technician, and a Nationally Registered Paramedic. As Director of Safety, Chris oversees all corporate safety initiatives, ensuring that employees at Roco have the tools and training that they need to do their work safely and effectively. He is also responsible for managing Roco's Safety Services Division, which provides trained safety professionals for turnarounds and other special projects. Finally, Chris serves as the VPP Coordinator for Roco, continuing Roco’s long-standing commitment to excellence in safety and health. Roco has been an OSHA VPP Star Worksite since 2013.

Follow Chris 

Additional Resources

• Roco’s Professional Safety Services
• Want a Safer Workplace? Get Employees Involved!
  
  
  

Inspect all CMC ProSwivel or Rock Exotica Omni-Block swivel pulleys immediately.

CMC and Rock Exotica, who makes CMC's ProSwivel pulleys, have both issued recall notices on their 1.1" swivel pulleys and SwivaBiner pulleys. The concern is surrounding the set screws that hold the button in. The button secures the side plate, so if the button comes out, the side plate could open and let the rope fall out - which could mean severe injury or death.

The recall only applies to the 1.1" versions manufactured from February 2020 through October 2022, however both manufacturers are recommending that all of these swivel pulleys be inspected.

If you have a pulley subject to the recall, return it to the manufacturer at no charge for inspection/repair. If you purchased your pulleys from Roco, we will be happy to assist you with the recall and inspection.

If you have 1.1" pulleys made outside of the recall window, or have other sizes of any date, you may inspect them yourself or return them for professional inspection.

1. 2018 to present
   1. There should be a dab of epoxy sealant that fills the set screw hole. It may be brownish/yellowish or a white/grey color.
   2. If the epoxy is missing, return the pulley for repair.
   3. If the sealant is protruding above the surface, determine the color. If it is white/grey, that's okay. If it is brownish/yellowish, return the pulley for repair.
2. 2016 and 2017
   1. There should be a dab of epoxy sealant like the current models have, but it will only be white/grey. It's okay if it is above the surface of the hole, but if it's missing, return the pulley for repair.
3. Prior to 2016
   1. No visible sealant was used on these models, so don't worry when you see the bare set screw. Just make sure the set screw is even with or below the surface.
   2. If you are not comfortable doing this inspection yourself, you can send your pulleys to the manufacturer or to Roco for inspection.
   3. You may want to add your own epoxy to these models to make your daily gear inspections easier. (see details in the inspection notices linked below)

Instructions for identifying your pulleys and locating the serial numbers are included in the manufacturer recall and safety notices. Be sure that you are using the proper notice for your pulley, as the CMC and Rock Exotica serial number locations are slightly different.

Manufacturers' Detailed Information

Note that CMC's and Roco's offices will be closed 12/23/22 through 1/2/23 and reopen Tuesday, January 3rd. However, if you have an urgent need during the holidays, you may reach CMC at info@cmcpro.com and Roco at 800-647-7626 (follow the prompts for emergency after-hours service).

Always remember to inspect your gear before each use. Stay safe, and Merry Christmas!

Companies with active safety and health programs that train workers to identify hazardous conditions and use required protective measures can prevent serious and fatal injuries.

In Centre County, PA, three family members died in a grain silo incident. A father, age 47, and his sons ages 14 and 19 all died after becoming trapped inside a silo. The family members reportedly died from asphyxiation due to gasses in the silo. Neighbors said it was a ripple effect with one going in to help the next when they all eventually succumbed to the hazardous atmosphere inside the space.

Tankers Can Be Death Traps

A 48-year-old worker entered a tanker-tailer in Lemont, IL, to inspect it as part of an annual U.S. Department of Transportation requirement and was overcome by exposure to bleach and chlorine gas. The worker was found unconscious in the tanker-trailer; however, he later died of his injuries.

An OSHA investigation determined that the worker’s employer had failed to:

1. identify and evaluate atmospheric hazards in the confined space,
2. train workers on the confined space program, and
3. ensure employees filled out a confined space permit before entry into a confined space.

OSHA also found that the employer failed to equip the worker rescuing the unconscious employee with a retrieval system, implement its own procedures for summoning rescue and emergency services and numerous other violations of its permit-required confined space regulations.

The company was also cited for failing to provide fall protection to an employee working on top of tanker trailers and providing training on fall hazards, respirators, and hazard communication.

The Chicago regional office established a Regional Emphasis Program in 2021 due to the dangers involved in inspecting tanker-trailers. The program is designed to reduce the risks tank cleaning workers face.

“In recent years, OSHA has investigated instances in which workers suffered tragic injuries because employers failed to follow appropriate procedures for ensuring healthy atmospheric conditions inside a confined space and use of adequate respiratory protection before allowing workers to enter tanks,” explained the OSHA Area Director.

Additional Resources

• Attendant Safety Requirements Poster (pictured here)
• Confined Space Entry Checklist
• Common Causes of Confined Space Fatalities

Safe + Sound Week is a nationwide event held each year in August that aims to recognize the successes of workplace health and safety programs and offers information and ideas on how to keep America’s workers safe. Last year, more than 5,300 businesses helped to raise awareness about workers’ health and safety!

As an OSHA VPP Star Worksite, Roco prides itself on our continual quest to achieve excellence in safety. VPP worksites must operate a comprehensive safety and health management system that includes four key elements: worksite analysis, hazard prevention and control, safety and health training, and our focus for this week, management leadership and employee involvement. To be effective, a safety and health program needs meaningful participation from employees in the workplace.

Here are five examples of a way to generate meaningful employee involvement in your organization.

1. Ask workers for their ideas for improvement.

Who knows the job better than those performing the work? Give employees an opportunity and encourage them to suggest improvements to their work practices. In our experience, many of the most innovative ideas come from employees who are actively involved in the workplace. When employees have the ability to create meaningful change in their work environment, they will be more likely to participate in safe work practices. Additionally, workers will enjoy a morale booster when these innovative ideas are implemented in the workplace. This is also an excellent way for an employer to demonstrate that they care about their employees and are committed to providing a safe and healthy workplace. Consider creating a centrally located drop box to deposit safety suggestion cards; alternatively, create a digital means of submissions or email such as safetysuggestions@company.com to allow for ease of submitting ideas. You might be surprised what your employees come up with!

2. Involve employees in workplace inspections.

No matter your industry, a safe workplace will always incorporate frequent workplace inspections into its planning and maintenance schedules. Typically, someone from the safety department or the maintenance department will conduct workplace inspections; however, having the same person perform these inspections each month can create a situation where this individual becomes “blind” to obvious hazards. Involving employees in workplace inspections allows for a “fresh” set of eyes and a new perspective as each individual will notice hazards in a different light.  Consider rotating different employees into workplace inspections whenever possible. You can also make this a positive experience for the employee selected by treating them to lunch afterward.

3. Train workers on hazard identification and reporting.

If you are waiting on “the safety guy” to identify the hazards and correct them, then it could be a while. While safety professionals are a great resource to have on staff, they can’t be everywhere at once! The truth is the safest companies train and involve all employees in hazard identification and reporting. When everyone in the company knows how to identify hazards and take steps to mitigate them, you now have an army of safety professionals! One VPP worksite implemented “hazard hunts” into their monthly plan for the facility. This was similar to an easter egg hunt, but for an industrial worksite. Employees spread out throughout the facility to identify hazards in the workplace. At the end of the hunt, the employee with the most legitimate hazards identified as well as the employee with the most serious hazard identified was rewarded with a gift. This is an outstanding idea for bringing fun to the workplace while also taking steps to involve employees and make a safer working environment!

4. Allow workers to lead trainings.

Most companies have periodic safety meetings implemented into their routine. These are typically led by someone from the safety department and can be a great way to highlight and emphasize current safety concerns or best practices in the workplace.  As a way to get employees involved, consider selecting someone different in the workplace to develop and lead a safety training. This doesn’t have to be an hour-long production! Something as simple as a 5-minute talk about heat illness prevention can work. Each person will have their own unique style which will help to keep these safety meetings “fresh”. Be sure to have fun with this one; these presentations don’t have to be intense or serious. The key here is to get employees involved in creating and delivering safety presentations. 

5. Reward workers who take the extra effort for safety.

There is a lot of debate and controversy over incentives for safety; in recent years, there have been several flip-flops on the support for these types of programs.  It really comes down to what you are promoting and how you are doing it when you incentive safety. Creating an environment that discourages reporting of accidents in exchange for a company-wide steak dinner is probably not the most ideal way to go about it. Instead, find ways to praise employees who go above and beyond in safety. When an employee submits a great safety suggestion for improvement and it gets implemented, reward the individual who submitted the idea! Perhaps an employee volunteered to perform the monthly facility inspection and take them out to lunch! If an employee identifies a serious hazard and takes action to mitigate it on the spot, reward them with something nice. Another great idea is having a near miss reporting process; consider doing a quarterly drawing for a gift for everyone who submitted a near miss for that quarter. The big takeaway from rewarding workers is to praise them heavily when they take the initiative to work safely, and coach and support them when they fail to meet those expectations.

Chris McGlynn is the Director of Safety/VPP Coordinator for Roco Rescue. He is a Certified Safety Professional (CSP) through the Board of Certified Safety Professionals as well as a Certified Confined Space and Rope Rescue Technician, and a Nationally Registered Paramedic. As Director of Safety, Chris oversees all corporate safety initiatives, ensuring that employees at Roco have the tools and training that they need to do their work safely and effectively. He is also responsible for managing Roco's Safety Services Division, which provides trained safety professionals for turnarounds and other special projects. Finally, Chris serves as the VPP Coordinator for Roco, continuing Roco’s long-standing commitment to excellence in safety and health. Roco has been an OSHA VPP Star Worksite since 2013.

Follow Chris 

Additional Resources

• Is OSHA VPP a Good Fit for Your Company?
• Roco Safety Services