Health and Safety
Executive / Commission
First Aid at work
First aid provision in the workplace regularly features in the list of top ten topics on which HSE receives most requests for information and advice. In 2004, HSE’s Infoline received over 7000 enquiries about first aid. The list below contains responses to some of the more commonly asked questions.
When an employer’s first aid needs assessment identifies that a first aider is not necessary, the minimum requirement is to appoint a person to:
Appointed persons should not attempt to give first aid for which they have not been trained.
There are no legal requirements for appointed persons to have any approved training in order to carry out their responsibilities. However, there are courses available for appointed persons.
See HSE’s free guidance:
As an employer, you will need to carry out an assessment of first aid needs appropriate to the circumstances of the workplace. There is no legal bar to employers making a defibrillator available in the workplace if the assessment of first aid needs indicates such equipment is required.
The Health and Safety (First-Aid) Regulations 1981 do not prevent someone who is specially trained from taking action beyond the initial management of a casualty. It is important that the person who will be required to use a defibrillator, usually a first aider, is appropriately trained. Courses in the use of defibrillators are available. Training providers offering such courses do not need approval from HSE for this purpose.
See HSE’s poster:
There is no mandatory list of contents for first aid boxes. Deciding what to include should be based on the employer’s assessment of first aid needs. A suggested list of contents, where there is no special risk in the workplace, is given in the free leaflet: First aid at work: your questions answered. Equivalent but different items will be considered acceptable. Any items in the first aid box that have passed their expiry date should be disposed of safely.
In general, tablets and medication should not be kept in the first aid box.
A suggested list of contents for travelling first aid kits is included in the Approved Code of Practice and Guidance: First aid at work. The Health and Safety (First-Aid) Regulations 1981 L74.
Although there is no specified review timetable, many items, particularly sterile ones, are marked with ‘best before dates’. Such items should be replaced by the dates given. In cases where sterile items have no dates, it would be advisable to check with the manufacturers to find out how long they can be kept. For non-sterile items without dates, it is a matter of judgement, based on whether they are fit for purpose.
Once an assessment of first aid needs has been carried out, the findings can be used to decide what first aid equipment should be provided in the workplace. The minimum level of first aid equipment is a suitably stocked first aid box. The assessment may indicate that additional materials and equipment are required such as scissors, adhesive tape, disposable aprons and individually wrapped moist wipes. They may be put in the first aid container if there is room or stored separately.
There may be a need for items such as protective equipment where first aiders may have to enter dangerous atmospheres. This should be securely stored near the first aid box, in the first aid room or the hazard area, as appropriate. Access to the equipment should be restricted to those trained in its use.
If mains tap water is not readily available for eye irrigation, at least one litre of sterile water or sterile normal saline (0.9%) in sealed, disposable containers should be provided. When the seal has been broken, the container should not be reused. The container should not be used beyond its expiry date.
The Health and Safety (First-Aid) Regulations 1981 do not oblige employers to provide first aid for members of the public. However, many organisations provide a service for others, for example places of entertainment, fairgrounds and shops, and HSE strongly recommends that employers include the public and others on their premises when making their assessment of first aid needs.
Only in so far as employers are responsible for providing first aid for their employees. At an event, for example a pop concert, it is the organiser’s responsibility to ensure that there is adequate first aid provision. HSE has produced guidance, The event safety guide, which provides further details.
Employers are responsible for meeting the first aid needs of their employees working away from the main site. Employers’ assessment of first aid needs should determine whether:
Employers are responsible for the provision of appropriate first aid equipment and facilities and trained first aiders in respect of their employees – this includes schools, as they are workplaces. However, the Regulations do not oblige employers to provide first aid for anyone else. Nevertheless, HSE strongly encourages employers to consider others when carrying out their assessment of first aid needs and to make provision for them.
The Department for Education and Skills (DfES) has produced a booklet: Guidance on First Aid for Schools. This can be downloaded from the DfES website: www.dfes.gov.uk.
You should provide a suitable first aid room or rooms where your assessment of first aid needs identifies this as necessary.
The room should contain essential first aid facilities and equipment. Typical examples of these are:
If possible, the room should be reserved specifically for providing first aid and your designated person (first aider or appointed person) should be given responsibility for the room. It should be easily accessible to stretchers and be clearly signposted and identified.
All first aid boxes must have a white cross on a green background. Similarly, first aid rooms should be easily identifiable by white lettering or a white cross on a green background.
The signs should be placed where they can be seen (not obstructed from view) and easily identified.
There is no definitive answer. It will largely depend on the outcome of your assessment of first aid needs. The table on pages 6-7 of the leaflet First aid at work: your questions answered, provides some guidance on the number of first aiders, depending on the nature of the work carried out and number of employees.
It is very unlikely that any action would be taken against a first aider who was using the first aid training they have received. HSE cannot give any specific advice on this issue as it has no expertise in this area and it does not fall within HSE’s statutory powers.
It is recommended that you seek legal advice, or advice from your employer’s insurance brokers on whether their policies cover first aiders’ liability.
Yes. If you have identified that your workplace needs first aiders, they must have completed a first aid at work course provided by an HSE approved training organisation.
See HSE’s free leaflet:
First aiders should have a reasonable understanding of the importance of personal hygiene in first aid procedures. This will help to prevent cross infection between the first aider and casualty.
Particular concerns have been raised about the possibility of first aiders becoming infected by a blood-borne virus (including HIV, hepatitis B virus, hepatitis C virus) while performing first aid. HSE’s free leaflet: Blood-borne viruses in the workplace [PDF 92kb], addresses this issue and advises on steps that can be taken to reduce the risk of infection.
Can an individual with a blood-borne virus (HIV, hepatitis B virus, hepatitis C virus) become a first aider in the workplace?
An individual with a blood-borne virus (BBV) can be considered for the role of first aider providing that:
Practising cross infection procedures should include those that can be taken by first aiders to reduce the risk of cross infection when actually administering first aid.
Generally, there is no legal obligation on employees to disclose they have a BBV. If an employee is known to have a BBV, this information is strictly confidential and must not be passed on to anyone else without the employee’s permission. Where an employer is aware that an employee has a BBV, they can take this into account if assessing their suitability as a first aider.
HSE cannot give specific advice on this issue. It is not an area in which HSE has any expertise, nor is it something which falls within HSE’s statutory powers. You could seek legal advice, or advice from your insurance brokers on whether the employer’s liability insurance policy covers first aiders’ liability.
Before 1987, the use of oxygen by first aiders was included under ‘special hazards’ in the Approved Code of Practice on first aid. This was largely intended to cover certain requirements of the Factories Act 1961, concerning the rescue of people from confined spaces. The use of oxygen in this context is now covered by the Confined Spaces Regulations 1997 and if these apply to your premises, you should consult the Approved Code of Practice, Regulations and Guidance: Safe work in confined spaces L101.
Administration of oxygen may also be recommended as part of the first aid treatment of certain chemical incidents, eg cyanide poisoning. Therefore, a requirement for training might emerge from your assessment of first aid needs. This training can be undertaken as an extension to basic first aid training or as a separate course. It does not need approval from HSE.
Oxygen may also be administered as part of cardiopulmonary resuscitation and there are several types of mechanical resuscitation aid which administer oxygen. The use of these is optional, not essential. There are no circumstances in which HSE requires you to provide such equipment but you may do so provided that first aiders are given appropriate training in the use of the equipment. Such training is usually offered by the manufacturers or suppliers and does not need HSE approval.
HSE recommends that it is good practice to provide your first aiders/ appointed persons with a book in which to record incidents that required their attendance. The information kept can help you identify accident trends and possible areas for improvement in the control of health and safety risks. It can also be used for reference in future first aid needs assessments. This record book is not the same as the statutory accident book though the two could be combined.
There is a legal requirement to report accidents and ill health at work. Information on the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 is given in the HSE leaflet RIDDOR Ring and Report (MISC769) [117kb] 
.
Useful information to record might include:
It is usually the first aider or appointed person who looks after the book. However, employers have overall responsibility.
HSE guidance in the Approved Code of Practice and Guidance: First aid at work. The Health and Safety (First-Aid) Regulations 1981 L74, states that first aid at work does not include giving tablets or medication to treat illness and such items should not be kept in the first aid box. However, strictly speaking, there is no legal bar to employers making such items available to employees, if the assessment of first aid needs indicates they should be provided. HSE has no objection to paracetamol or aspirin being made available in the workplace. First aiders administering these tablets should have a reasonable understanding of what is involved.
HSE has no objection to employers providing vending machines for dispensing paracetamol. It is preferable that these machines are not located in areas where the public will have access to them.
Some workers carry their own medication such as inhalers for asthma or ‘Epipens’ which contain injectable adrenaline for the treatment of severe allergic (anaphylactic) reactions, for example to peanuts. These medications are prescribed by a doctor. If an individual needs to take their own prescribed medication, the first aider’s role is limited to helping them do so and contacting the emergency services as appropriate.
Medicines legislation restricts the administration of injectable medicines. Unless self administered, they may only be administered by or in accordance with the instructions of a doctor (eg by a nurse). However, in the case of adrenaline there is an exemption to this restriction which means in an emergency, a suitably trained lay person is permitted to administer it by injection for the purpose of saving life. The use of an Epipen to treat anaphylactic shock falls into this category. Therefore, first aiders may administer an Epipen if they are dealing with a life threatening emergency in a casualty who has been prescribed and is in possession of an Epipen and where the first aider is trained to use it.
The use of tablets and medication in the context of first aid provision in the offshore industry is dealt with separately (see sections on offshore work under ‘The law’ and ‘Training’).