What does an employer need to do to provide First Aid and O2 to employees

[MRE]

I have a friend who works for a fairly small subsidiary of a very large company. He says that his employer has one person working for them that used to be an EMT who has a jump kit and maybe O2 in his desk, and now the employer wants my friend to also be prepared with a jump kit and O2 for other employees if a medical emergency arises. My friend is a lifeguard and certified in Pro Rescuer CPR and First Aid, so he is by no means an EMT. The employer wants to go through Administering O2 and Bloodborne Pathogens material with him, but not give him a cert card in them.

It definitely sounds like there is something fishy going on here, and I would like to advise him as to what the employer would need in order to legally provide first aid care and medical oxygen to their employees. I don't know what is in the jump kits, but can probably find out. The O2 is what concerns me though.

I figure that they need a standing order from a physician for the O2, certain training for the employees who will be administering aid (First Responder maybe) and possibly some kind of medical control?

The business is in Connecticut.

Does anyone know for sure?

Thanks

 

[JSL22]

I of course do not know for sure what statues and laws exist in Conn. but I can tell you that in NJ, most businesses will not allow you to administer any sort of first aid to other employees or customers, EMT or not. Before I began my job with a hospital, I worked for a supermarket and a video game retail store, and in both cases, I was instructed not to do anything but call 911 in an emergency as it is a liability to the company. This of course conflicts with our "Duty to Act" but in that situation, I guess it is up to you what is more important, your job or your certs. In a truly life threatening situation, you would of course take action but with other issues, you're better off letting a squad or someone outside the company handle it.

As far as O2 goes, without standing orders or protocols, that person has no right to be administering it to anyone. In NJ, O2 is considered one of the 3 "medications" we are allowed to carry and administer as EMTs (glucose and epi-pens being the other two.) There is nothing wrong with the basic first aid aspects of what he is doing but as his friend I would advise him against even having O2 in the work place as it could be a liability to the company if administered by an untrained/unlicensed individual.

 

[VentMedic]

A place of business can apply for O2 on site such as in Health Clubs along with the AED. There are also non-professional O2 certificates of training as well as Bloodborne pathogens classes available. The ARC and DAN will sometimes offer these. The cert will be required of at least the primary employees if the permit is obtained. The O2 permit is also necessary to have the tanks refilled or kept in compliance with local, state and Federal laws.

HOWEVER, the legislation on non-perscription Emergency O2 administration is NOT meant for every yahoo to carry their own tank just like you wouldn't keep an AED in your duffel bag "just in case".

 

[MRE]

Ok, that sounds reasonable.

I teach all those classes for the ARC, but never knew the regulations for having the equipment. Thats really the reason I heard about this, the employer is doing the training but not certifying people. My guess is that the "medical person" at the company is that past EMT who isn't a current instructor for anything as far as I know. My friend asked if I would certify him.

I'll have him ask to see the paperwork for the O2 and I'll do his training so he has his bases covered.

Thanks

A place of business can apply for O2 on site such as in Health Clubs along with the AED. There are also non-professional O2 certificates of training as well as Bloodborne pathogens classes available. The ARC and DAN will sometimes offer these. The cert will be required of at least the primary employees if the permit is obtained. The O2 permit is also necessary to have the tanks refilled or kept in compliance with local, state and Federal laws.

HOWEVER, the legislation on non-perscription Emergency O2 administration is NOT meant for every yahoo to carry their own tank just like you wouldn't keep an AED in your duffel bag "just in case".

 

[BossyCow]

Very often the criteria is being set by the liability insurance carrier of the business, not a government agency. In our state, an employer can sometimes lower their L&I rates by having a certain ratio of employees certified in FA/CPR but it's a financial thing, not a legal obligation.

 

[LifeLine]

Connecticut Good Samaritan Act



C.G.S.A. §52-557b.

"Good samaritan law". Immunity from liability for emergency medical assistance, first aid or medication by injection. School personnel not required to administer or render

A person licensed to practice medicine and surgery under the provisions of chapter 370 or dentistry under the provisions of section 20-106 or members of the same professions licensed to practice in any other state of the United States, a person licensed as a registered nurse under section 20-93 or 20-94 or certified as a licensed practical nurse under section 20-96 or 20-97, a medical technician or any person operating a cardiopulmonary resuscitator or a person trained in cardiopulmonary resuscitation in accordance with the standards set forth by the American Red Cross or American Heart Association, who, voluntarily and gratuitously and other than in the ordinary course of his employment or practice, renders emergency medical or professional assistance to a person in need thereof, shall not be liable to such person assisted for civil damages for any personal injuries which result from acts or omissions by such person in rendering the emergency care, which may constitute ordinary negligence. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.

A paid or volunteer fireman or policeman, a teacher or other school personnel on the school grounds or in the school building or at a school function, a member of a ski patrol, a lifeguard, a conservation officer, patrolman or special policeman of the Department of Environmental Protection, or ambulance personnel, who has completed a course in first aid offered by the American Red Cross, the American Heart Association, the National Ski Patrol, the Department of Public Health or any director of health, as certified by the agency or director of health offering the course, and who renders emergency first aid to a person in need thereof, shall not be liable to such person assisted for civil damages for any personal injuries which result from acts or omissions by such person in rendering the emergency first aid, which may constitute ordinary negligence. No paid or volunteer fireman, policeman or ambulance personnel who forcibly enters the residence of any person in order to render emergency first aid to a person whom he reasonably believes to be in need thereof shall be liable to such person for civil damages incurred as a result of such entry. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.
An employee of a railroad company, including any company operating a commuter rail line, who has completed a course in first aid offered by the American Red Cross, who is trained in cardiopulmonary resuscitation in accordance with standards set forth by the American Red Cross and who renders emergency first aid or cardiopulmonary resuscitation to a person in need thereof, shall not be liable to such person assisted for civil damages for any personal injury or death which results from acts or omissions by such employee in rendering the emergency first aid or cardiopulmonary resuscitation, which may constitute ordinary negligence. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.
A railroad company, including any commuter rail line, which provides emergency medical training or equipment to any employee granted immunity pursuant to subsection (c) of this section shall not be liable for civil damages for any injury sustained by a person or for the death of a person which results from the company's acts or omissions in providing such training or equipment or which results from acts or omissions by such employee in rendering emergency first aid or cardiopulmonary resuscitation, which may constitute ordinary negligence. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.
A teacher or other school personnel, on the school grounds or in the school building or at a school function, who has completed both a course in first aid in accordance with subsection (b) of this section and a course given by the medical adviser of the school or by a licensed physician in the administration of medication by injection, who renders emergency care by administration of medication by injection to a person in need thereof, shall not be liable to the person assisted for civil damages for any injuries which result from acts or omissions by the person in rendering the emergency care of administration of medication by injection, which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross, wilful or wanton negligence.
The provisions of this section shall not be construed to require any teacher or other school personnel to render emergency first aid or administer medication by injection.

(1991; 1963, P.A. 205; 1967, P.A. 282; 1967, P.A. 878; 1969, P.A. 785; 1971, P.A. 729; 1975, P.A. 75-132; 1975, P.A. 75-456, §1, eff. June 26, 1975; 1977, P.A. 77-225; 1977, P.A. 77-349, §3; 1977, P.A. 77-614, §323, eff. Jan. 1, 1979; 1978, P.A. 78-122, §1; 1982, P.A. 82-160, §224; 1982, P.A. 82-286; 1983, P.A. 83-375, §2; 1984, P.A. 84-546, §119, eff. June 14, 1984; 1986, P.A. 86-237, §1, eff. May 30, 1986; 1987, P.A. 87-589, §34, eff. July 9, 1987; 1989, P.A. 89-149.)

 

[LifeLine]

Every state is different. With regards to an AED the user must be trained in Conneticut. My guess is that would be the same for O2. The place of business should have a medical oversight program.

http://www.cprinstructor.com/CT-AED.htm

 

[VentMedic]

Every state is different. With regards to an AED the user must be trained in Conneticut. My guess is that would be the same for O2. The place of business should have a medical oversight program.

The laws governing Oxygen use are Federal. Then, it is up to each state and local governing agency for specific regulations on O2 and/or AEDs. No, the business does not necessarily need medical oversight unless they are hiring medical personnel such as EMTs or Paramedics to practice under their scope and their duty will be medical in nature. Many industrial companies, dive boats and health clubs have emergency O2 with people certified in its use that are not EMTs. But, first-aid and basic emergency O2 administration is the extent of their medical practice and they do not hold themselves out to be medical personnel. If the place is into practicing medicine or charging for the medical services rendered, they must have the facility licensed as such with medical oversight.

If you have an EMT license you may still only be practicing to the extent of the job you are hired for. There may be EMTs working at Burger King but can only do the first aid with only the equipment available to them at the restaurant. The only advantage will be the knowledge to recognize an emergency which is what most are hired for at some businesses and not their actual medical skills or the practice of medicine. Another example would be security guards.


http://www.lifecorporation.com/cder.html

[SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]Fresh Air "2000" provides FDA's interpretation of how the minimum current good manufacturing practice (CGMPs) regulations apply to the manufacturing, filling, transfilling cascading, etc. of medical gases compressed and cryogenic. Please note this presentation is not all-inclusive.[/SIZE][/FONT][/FONT][/SIZE]
[SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1](Edit. Note The following paragraph on page 13 provides the exemption for emergency oxygen from prescription RX requirements . Please read the "--- or for emergency use,..." phrase. It is not easy to interpret but the FDA does confirm therein that Emergency Oxygen remains Non-Prescription.[/SIZE][/FONT][/FONT][/SIZE]
[SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif]However, if a firm sells Oxygen U.S.P. to emergency medical services, i.e.' fire departments, rescue squads, ambulance companies, etc. or for emergency use, then the label is required to contain the statement: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only."[/FONT][/SIZE][/FONT][/SIZE][SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif]​

[/FONT][/SIZE]

[SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]FDA - FOOD AND DRUG ADMINISTRATION [/SIZE][/FONT][/FONT][/SIZE][SIZE=-1][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif]
[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-2]COMPLIANCE POLICY GUIDES GUIDE 7124.10[/SIZE][/FONT]

[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]CHAPTER 24 - Devices[/SIZE][/FONT]
[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]SUBJECT: Oxygen Equipment Emergency and [/SIZE][/FONT][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]OTC Use[/SIZE][/FONT]​

[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]POLICY:[/SIZE][/FONT]​

[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]Oxygen equipment intended for emergency use can be marketed for OTC distribution. Such equipment must deliver a minimum flow rate of 6 liters of oxygen per minute for a minimum of 15 minutes.[/SIZE][/FONT][FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]Labeling for emergency oxygen for OTC use may not contain references to heart attacks, strokes, shock or any other medical condition amenable to diagnosis or treatment only by a licensed practitioner .[/SIZE][/FONT]​

[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]Oxygen units delivering a minimum flow rate of less than 6 liters of oxygen per minute for a period less than 15 minutes and labeled for emergency use are considered adulterated and misbranded.[/SIZE][/FONT]​

[FONT=Arial,Helvetica,Univers,Zurich BT,sans-serif][SIZE=-1]If the units are not intended for emergency use and provide less than 6 liters/minute or are labeled for human use for other than emergency use, such units are regarded as prescript ion devices and must bear the prescription legend.[/SIZE][/FONT]​

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[LifeLine]

We are probably talking about the same thing, but here is my take.

State law in Connecticut as well as many other states requires that a "Licensed Physician" must oversee an AED if placed at a place of business. Some AEDs require the sale be by or on the order of a physician. I see that as medical oversight. Medical oversight for an AED is inexpensive and will help any business provide due diligence and abide by state laws with their AED which will help that they do not leave themselves open for a lawsuit. The American Heart Association recommends medical oversight for an AED.

Why should a licensed physician or medical authority be involved with purchasers of AEDs?
This is a quality control mechanism. The licensed physician or medical authority will ensure that all designated responders are properly trained and that the AED is properly maintained. He or she also can help establishments develop an emergency response plan for the AED program.

If oxygen can also be used than, medical oversight is probably a good idea.

Sec. 2. (NEW) (Effective October 1, 2008) Any person or entity that maintains upon public or private property one or more automatic external defibrillators, as defined in section 19a-175 of the general statutes, that are available for public use by such person or entity, shall (1) maintain such automatic external defibrillators in a publicly accessible location on the property and shall have conspicuous signage on the property that indicates the location of such defibrillators; (2) routinely inspect such defibrillators to ensure that they are in proper working order; (3) maintain and test such defibrillators in accordance with the manufacturer's guidelines; and (4) promptly notify a local emergency medical services organization after each application or use of such defibrillators.

As far as the original post. At a minimum your friend must be certified to use the O2.

 

[VentMedic]

Why should a licensed physician or medical authority be involved with purchasers of AEDs?
This is a quality control mechanism. The licensed physician or medical authority will ensure that all designated responders are properly trained and that the AED is properly maintained. He or she also can help establishments develop an emergency response plan for the AED program.

Have you seen the hundreds of ads for "medical oversight"? They will probably discourage any small or even large business from acquiring an AED. How many small companies can afford $50K to $100K for a "rent a medical director" program and all the accessories that must be purchased with the M.D.?

 

[LifeLine]

Have you seen the hundreds of ads for "medical oversight"? They will probably discourage any small or even large business from acquiring an AED. How many small companies can afford $50K to $100K for a "rent a medical director" program and all the accessories that must be purchased with the M.D.?

Medical oversight is NOT that expensive, not even close. Medical oversight is only a few hundred dollars for an AED program and is readily available and quite affordable for small organizations, churches, schools, small business and even large corporate businesses with multiple locations in multiple states. The problem is there is only a few companies that do this and most importantly, do it right.

Another problem is, no one knows about them and people and businesses find themselves in the exact same situation and the original posters friend. His friend works for a small subsidiary of a large company. If they allow this problem with oxygen, think about what else is going on that will open the door to lawsuits.

Tell your friend to talk to his employer about medical oversight and he will be fine.

 

[VentMedic]

Medical oversight is NOT that expensive, not even close. Medical oversight is only a few hundred dollars for an AED program and is readily available and quite affordable for small organizations, churches, schools, small business and even large corporate businesses with multiple locations in multiple states. The problem is there is only a few companies that do this and most importantly, do it right.

The problem is, no one knows about them and people and businesses find themselves in the exact same situation and the original posters friend. His friend works for a small subsidiary of a large company. If they allow this problem with oxygen, think about what else is going on that will open the door to lawsuits.

Tell your friend to talk to his employer about medical oversight and he will be fine.

Clarification: The OP is NOT my friend. I am NOT arguing for him to run around with an O2 tank or advocating he gets an AED!

I posted the regulations for O2 at the Federal level as mandated by the FDA.

As far as medical oversight, not all areas are the same and I would suggest you call up a couple of firms and see what a couple hundred dollars will get you. Yes, you can get a consultant for that if you do not understand how to fill out the application or where to go for training. However, there are many, many "consultants or medical oversight specialists" who are taking advantage of firms who you may advise them to go to for "medical oversight" that will screw them out of thousands of dollars unnecessarily. Be careful what you advise or where you refer. Don't make blanket statements for states and areas you know little or nothing about.

There are good employers out there who want to provide a better environment for their employees in case of an emergency. Just because the person described in the OP was clueless does not mean the rest of the world should be deprived of access to O2 and AEDs if their personnel have met the requirements. Most states also recognize, that as the AHA explained, the recommendations from the AHA are just that "recommendations" and guidelines. Some areas make enforce them as "law" and some may just keep them as guidelines.

 

[VentMedic]

LOL! I just viewed your online profile.

You occupation explains it all.

Consultant for Public Access Defibrillators

Drumming up a little business for yourself?

Yes, there are organizations and people who will assist getting AEDs and O2 into public areas that will do so for free or a small amount of money. But, there are many more that are going to make every dollar they can off of unsuspecting clients through the fear of legal action even when some states have specific statutes for the lay person using the AED.

 

[LifeLine]

Clarification: The OP is NOT my friend. I am NOT arguing for him to run around with an O2 tank or advocating he gets an AED!

No, I was referring to the OP's friend.

LOL! I just viewed your online profile.

You occupation explains it all.

Consultant for Public Access Defibrillators

Drumming up a little business for yourself?

Yes, there are organizations and people who will assist getting AEDs and O2 into public areas that will do so for free or a small amount of money. But, there are many more that are going to make every dollar they can off of unsuspecting clients through the fear of legal action even when some states have specific statutes for the lay person using the AED.

I think you are reading into this a little too much. I see all the time where businesses and organizations are not providing due diligence when it comes to a AED/CPR first aid program, as in the OP. I have also seen where AED/first aid companies sell, sell, sell and then turn their back and leave the business or organization hanging in thin air on training and medical oversight. I was only trying to help the OP and anyone else interested in this sort of thing make sure they do the right thing.

 

[VentMedic]

I think you are reading into this a little too much. I see all the time where businesses and organizations are not providing due diligence when it comes to a AED/CPR first aid program, as in the OP. I have also seen where AED/first aid companies sell, sell, sell and then turn their back and leave the business or organization hanging in thin air on training and medical oversight. I was only trying to help the OP and anyone else interested in this sort of thing make sure they do the right thing.

The money that is spent on a "professional consultant" might be put to better use on an attorney that specializes in medical-legal applications to review one's insurances and licenses according to the statutes as well as seeing the necessary forms are in order. A consultant probably won't be representing them if a legal condition does arise. They may also be able to inform the agency of the legal liability of holding out to provide a MEDICAL service beyond that of community access what is allowed for lay person's AED/O2 usage.

Since many states now mandate AEDs for certain building or facilities, the information is readily available.

A list of the current legislation:
http://www.ncsl.org/programs/health/aed.htm

The agencies that teach the AED and emergency O2 should also have the area's regulatory information on this equipment. There should be a defining point as to what constitutes a "first-aid" kit and medical devices that may require additional training and/or a medical license with the proper MEDICAL oversight. There is also a fine line that can be crossed for misrepresentation or giving the impression of having a title or training that one does not have.

I do appreciate your advocacy for the AED and there probably are some businesses that welcome someone to do the paperwork or check the batteries.

I am trying to be polite but I have also seen many companies like yours also muscle in on patients that have PRESCRIBED AEDS from their physicians with training from their physician's office or hospital and are provided all the services you mentioned by the hospital or doctor. I have also heard of some very hard sell representatives from these companies that do try scare tactics, especially concerning liability, with businesses that are compliant with all regulations.

Your company may be very different and I really hope it is. That would be refreshing.

 

[LifeLine]

I am trying to be polite but I have also seen many companies like yours also muscle in on patients that have PRESCRIBED AEDS from their physicians with training from their physician's office or hospital and are provided all the services you mentioned by the hospital or doctor. I have also heard of some very hard sell representatives from these companies that do try scare tactics, especially concerning liability, with businesses that are compliant with all regulations.

Your company may be very different and I really hope it is. That would be refreshing.

I agree with you 100%. There are many companies that prey on business and organizations with scare tactics concerning liability. The Good Samaritan laws in place provide protection from the majority of lawsuits as long as one provides a high standard of due diligence. With regards to the OP, having a employee not properly trained/certified in the use of oxygen is asking for trouble and not living up to that due diligence.

Just so we don't get off topic. We can discuss what I do as a PAD/AED Consultant through PM's. I think you will be pleasantly surprised.

 

[VentMedic]

The company should also check with their state EMS office to see if they are crossing the line where the services they are providing require at least a First Responder cert if it is perceived to be more than just a "community access" or layman's first-aid issue. The required medical oversight can then be determined.

 

[MedicMeJJB]

I AM an EMT at a warehouse

Hi, I am currently the EMT-Supervisor of onsite medical for a warehouse. I am in Indiana and laws will surely be different..
I am contracted to work for this company through a hospital owned occupational health center - this is why I can perform the tasks that I can while working here in the warehouse. I am able to give O2, make treatment decisions, and I carry an AED, O2 tank, and a jump bag. I do all of this with no online medical direction, I am allowed to do this as standing order since I am an employee of a hospital. Now, from what I can understand the employee is not a trained O2 provider, such as an EMT-B or higher.. nor does he have standing order from an advanced care provider.. and O2 is considered a treatment. The NRB mask I have in my hand says that "Federal Law restricts this device to sale by or on the order of a physician" - and I believe that most O2 delivery devices all say that it must be prescribed. If I were your friend I wouldn't do anything without proper state certification, CPR only. Also, if your friend's employer wants this type of service on-site I believe he should look into a proper contractor who provides this care. This could all get very hairy considering laws, and however OSHA regulates their business.
Hope this was helpful.

 

[LifeLine]

The NRB mask I have in my hand says that "Federal Law restricts this device to sale by or on the order of a physician" - and I believe that most O2 delivery devices all say that it must be prescribed.

You also see this on the bottom of some AEDs.

Sorry, bad picture.

 

[LifeLine]

After doing a little more research, any oxygen treatment over 6 liters would need special medical oversight. Not many physicians touch because it opens up a whole new set of circumstances. Unlike an AED, oxygen use would require the company to carry special insurance or at a minimum it would affect their liability insurance. AED's do not affect insurance.


I would suspect that if the company knew what was going on they would not condone it. Especially the parent company.