CBL First Aid Plan

FIRST AID PROCEDURES & PERSONNEL

In the event of an accident with severe personal injuries immediately contact the Emergency Medical System (EMS) by dialing 9 then 911.

FIRST AID FOR CHEMICAL EYE INJURIES

Strong acids and alkalis are used in the manufacture of chemicals and in the production of automotive, electrical and even some plastic products. In large companies, the use of potent chemicals at high temperatures, under pressure, frequently exposes workers to injury.

The single most important treatment in the management of the chemically-burned eye is copious irrigation within seconds of injury. This procedure probably has more of an influence on the outcome of an injury than any other therapeutic approach. It is important not only to flush away the caustic substance, but to remove any particulate matter which may have lodged on or under the eyelids. Often, these particles are dislodged with copious irrigation alone. Any non-toxic liquid can be used to initiate irrigation prior to arrival at a health-care facility, but it is preferable to use a preserved, physiologically correct solution.

The availability of eye wash fountains in well marked locations is a critical step in the first aid treatment of a chemical injury to the eye, and the eye wash solution made available to the victim should cause as little additional damage to the eye as possible. Although cold tap water is often the only liquid available, it can be extremely discomforting to the victim. A preferred alternative to water is a commercially available, preserved pH-balanced physiologic solution that has been tested by the manufacturer.

Immediately after the accident, flood the eye(s) with the liquid, using fingers to keep the eye(s) open as wide as possible. Instruct the victim to roll the eyeball as much as possible in order to remove any particles retained under the eyelids. While the patient is being transported to a professional eyecare provider, continue to irrigate the eye(s), since strong acids/alkalis can penetrate within seconds/minutes. A corrosive chemical in a viscous liquid form, or a corrosive substance in a powdered or particulate form, can easily become trapped inside the eyelid(s). These substances can be absorbed by the ocular tissues and as a result are not easily flushed from the eye. The only way to deal with this problem is continuous irrigation.

If irrigation was begun promptly, many times the eye(s) will heal without permanent damage. Such patients will do well with eye patches, analgesics and follow-up by an Ophthalmologist within 24 hours. Severe burns can result in many problems, including variations in pressure, eyelid deformity and dysfunction, tear abnormalities and corneal ulceration.

CONTACT LENSES

The following quotation is from the National Society to Prevent Blindness " Guide to Controlling Eye Injuries in Industry" dated 10/91:

Contact lenses, of themselves, do not provide protection in the industrial environment. However, fears that contact lenses would increase the likelihood and/or severity of injury in the workplace are not founded.

In general, contact lenses can be worn in most workplace environments when used with appropriate protective eyewear devices that conform to the Z87.1 standard. However, if the work environment entails regular exposures to chemicals, vapors, splash, radiant or intense heat, molten metals, or highly particulate atmospheres, contact lens use should be restricted accordingly. Decisions about contact lens use should be made on a case-by-case basis in conjunction with the guidelines of the Occupational Safety and Health Administration. Other federal or state regulations may also limit their use.

If wearing contact lenses is allowed, a specific written management policy on contact lens use should be developed with employee consultation and involvement. The policy should include the following:

• Protective eyewear meeting or exceeding ANSI Z87.1 must be worn at all times by individuals in designated areas.
• Employees and visitors should be advised of defined areas where contacts are not allowed.
• At work stations where contacts are allowed, the type of eye protection required should be specified.
• Restrictions on contact lens wear do not apply to usual office or secretarial employees.
• Advise medical and first-aid personnel to follow normal eye injury first-aid procedures. Attempts to remove contact lenses can delay proper treatment (e.g., chemical splash requires *immediate* flushing of the eyes) or may result in further injury.
• Employees should be required to keep a spare pair of contact lenses and a pair of up-to-date prescription safety glasses (meeting Z87.1 standard) in their possession. This will allow employees to perform their job functions, should they desire wearing contact lenses.

FIRST AID TRAINING

The CBL campus has several employees trained in basic first-aid / CPR / and AD use and work in various building throughout the campus. After calling 911, contact the Directors Office to have a trained First-Aid employee provide assistance.

TICKS

For those of you exposed to ticks, a simple, but effective, way to avoid Lyme disease and Rocky Mountain Spotted Fever is to remove any ticks before they have been imbedded for more than 6 hours. Ticks require about six hours to feed, after which they regurgitate a small amount of blood before leaving your body; thus if you inspect your body or your children at lunch, dinner and before retiring you may avoid possible contamination by ticks.

EPINEPHRINE ANAPHYLACTIC REQUIREMENT

Anyone with an epinephrine anaphylactic requirement for bee stings, shellfish, or other reactions please notify your Supervisor so that we may be able to assist you in such an emergency.

TOOTH INJURIES

Should you have a tooth knocked out; place it in a glass of milk and take it to your dentist. They may be able to reinsert it.

FIRST AID FOR BURNS

Basic first aid for non-chemical burns is to apply cool running water or some kind of ice pack for a minimum of 5 minutes. The time will vary, due to exposure time and location of the burns, etc. Below is some information you may find helpful.

The time needed for a full thickness burn from hot water:

Adult Child

5 minutes @ 122F 1 minute @ 127F

30 seconds @ 13OF 10 seconds @ 130F

5 seconds @ 14OF 1 second @ 140F

2 seconds @ 150F 0.5 seconds @ 149F

TREATING ACID BURNS

Concentrated acid, such as sulfuric, hydrochloric, etc., doesn't burn your skin immediately; it needs to be diluted. Therefore, when washing concentrated acid off the skin do it rapidly and with COPIOUS amounts of water or you can get a thermal burn from the heat generated when the acid is diluted.

Concentrated acids can start pulling water from the skin and then start to burn. This is the reason that burns under jewelry usually are more severe. Armpits, feet and genital areas are also more moist and have thinner skins; this is the reason we recommend removing clothing while under an emergency showers when an acid splash accident occurs.

For strong caustics the recommended time for washing requires at least thirty to sixty minutes for complete washing. With safety showers in general once shivering has occurred hypothermia should become a concern and the patient should be removed from the shower, given a blanket, you may use our emergency fire blankets, and continue localized washing of the affected area for the time necessary. Or maybe you can provide a tepid shower. Hot showers are generally not condoned as an initial first aid measure.

If eye contact with strong caustic has occurred initial forced delivery eyewash is paramount - 15 minutes is good but most people complain of sore eyes and stop. Washing MUST be continued. ALL CAUSTIC INJURIES TO THE EYES ARE SERIOUS UNTIL PROVED OTHERWISE. The patient should be taken to a medical facility capable of ophthalmic examination and treatment. Washing should still be continued en route. CAUSTICS HAVE A DESENSITIZING EFFECT and quite often a person may not be aware of the damage a caustic is causing.