6.3 First Aid Response After an Accident on Site
Key Takeaways
In almost every site injury scenario, the first action is to send for or contact a first aider, because competent treatment must be summoned immediately.
If a casualty has stopped breathing, send for help first and then start CPR at 30 compressions to 2 breaths.
Burns need immediate cooling under cool or cold running water for at least 20 minutes; never apply creams or ointments.
First aiders must not give medicines without authorisation, and First Aid at Work and Emergency First Aid at Work certificates must be renewed every three years.
With an electric shock, cut off the power and call for help before touching the casualty, and have a first aider check them even if they say they feel fine.
6.3 First Aid Response After an Accident on Site
The Fire and Emergency topic of the ECS assessment includes "the importance of first aid following an accident", and the question bank contains more first-aid scenarios than fire-extinguisher questions. Section 3.2 explains how employers provide first aid: needs assessments, first aiders, kits and records. This section covers what you should do in the minutes after someone is hurt or taken ill. The most important rule is simple: competent first-aid treatment is essential, so summon a first aider immediately.
Why First Aid Matters
First aid has three aims, often remembered as the three Ps:
- Preserve life: keep the casualty breathing and their heart working.
- Prevent the condition worsening: stop bleeding, keep them still, protect them from further danger.
- Promote recovery: reassure them, keep them warm and hand over to trained help.
First aiders are trained to do these things; they are not trained to diagnose illness or dispense medicines. A first aider must never give tablets or other medicines without authorisation, which is also why first-aid boxes contain no medication.
The Primary Survey: DR ABC
Trained first aiders follow a sequence such as DR ABC. Knowing it helps you assist and give accurate information:
| Step | Check | What it means for you |
|---|---|---|
| D: Danger | Is the area safe? | Do not become a second casualty. Isolate electricity, stop machinery, keep clear of falling objects. |
| R: Response | Does the casualty respond to your voice or a gentle shake? | An unresponsive casualty needs urgent help. |
| A: Airway | Open the airway with head tilt and chin lift. | Only if you have been trained. |
| B: Breathing | Look, listen and feel for normal breathing for no more than 10 seconds. | If they are not breathing normally, call 999 (or 112) and start CPR. |
| C: CPR | 30 chest compressions to 2 rescue breaths, at 100 to 120 compressions a minute. | Send someone to fetch the defibrillator (AED). |
If someone has fallen and stopped breathing, send for help first and then try to get them breathing with CPR. An unconscious casualty who is breathing normally may be placed in the recovery position by a trained person, unless a spinal injury is suspected; then keep them still and wait for the first aider.
Common Site Scenarios
| Situation | First action | Avoid |
|---|---|---|
| Workmate falls and is unconscious | Send someone for the first aider, and call 999 if they are not breathing | Moving them unnecessarily or leaving them alone |
| Fall from a ladder; casualty says their leg is broken | Send for the first aider and keep them still | Helping them walk to the cabin or bandaging their legs together yourself |
| Burn from hot metal | Cool the burn under cool or cold running water for at least 20 minutes while help is called | Creams, butter or Vaseline; bursting blisters; pulling off stuck clothing |
| Electric shock; casualty looks pale but says they are fine | Make sure the supply is off, then send for the first aider | Assuming they are fine, because heart rhythm problems can develop later |
| Foreign body in the eye | Send for the first aider and stop them rubbing the eye | Trying to remove it with a handkerchief or tool |
| Sudden back pain while lifting | Stop the lift and send for the first aider | Letting them carry on lifting |
| Severe stomach pains or near-collapse | Send for the first aider | Giving food, drink or painkillers |
| Small cut on a finger | Get first aid to clean and cover it, and record it in the accident book | Carrying on with an open wound, which risks infection |
Notice the pattern: in almost every ECS scenario the correct answer is to send for, or contact, the first aider, not to find out what happened, give them a drink, or tell them to visit their doctor. Investigating and reporting come afterwards.
Electric Shock: the Special Case
Never touch someone who may still be in contact with a live conductor. First cut off the power at the isolator, switch or emergency stop and call for help. If you cannot switch off quickly, separate them with a dry non-conductive object while standing on dry insulating material. Every electric-shock casualty should be checked by a first aider and is usually advised to seek medical assessment, even if they feel well, because burns can be deeper than they look and heart rhythm problems can develop later. The full rescue sequence is in section 11.2.
Supporting the First Aider
- Tell them exactly what happened, when, and whether the casualty was unconscious at any point.
- Keep onlookers back and the route clear for an ambulance; send someone to meet it at the site gate.
- Fetch the AED and first-aid kit if asked.
- Afterwards, make sure the accident is entered in the accident book (BI 510) and reported to your supervisor (section 3.2).
First-Aid Training Facts
First Aid at Work (FAW) and Emergency First Aid at Work (EFAW) certificates are valid for three years, so first aiders must retrain at the end of that period, and HSE strongly recommends an annual refresher in between. When planning first-aid provision, employers must consider the likely types of injury from their work, the number of people on site and how far away emergency services are.
ECS Exam Focus
- If you come across an injury on site, the first thing to do is contact a first aider.
- If someone has fallen over and stopped breathing, send for help first, then try to start them breathing.
- For a burn, put it in cold water if available.
- A first aider must not give medicines without authorisation.
- FAW and EFAW first aiders retrain every three years.
A workmate burns their hand on a piece of very hot metal. What should you do first?
Cover the burn tightly with something dry
Rub cream or Vaseline into the burn
Cool the burn under cold running water
Warn others about the hot metal first
A labourer gets an electric shock, looks pale, but says they are all right. What should you do?
Go and check the wiring so it cannot happen again
Send someone for the first aider
Tell them to report it at the end of the shift
Offer them a hot drink and a sit-down
In an on-site emergency, which action must a first aider not take?
Treat a casualty who is unconscious
Control serious bleeding with direct pressure
Give the casualty medicines without authorisation
Give resuscitation to a casualty who is not breathing
Sections you finish are checked off in the contents.