My HSE booklet

MY HSE BOOKLET A guide to an ever better working day

sitert.no

Our goal: 0 accidents and injuries 100% safety and wellbeing This booklet belongs to: Name: Phone no.: e-mail:

Other important numbers: FIRE BRIGADE

NORWAY SWEDEN UK CANADA

110

POLICE

112 112 112 911

MEDICAL EMERGENCIES

113

Contents: Introduction

4

Definitions

6

Different roles within HSE

7

Distribution of responsibility

9

New workplace?

11

HWES inspections

12

Undesirable incidents

14

OI-Report

16

Emergency preparedness

17

Notification

18

The media

19

Preventive work

20

Personal protective equipment

21

Some good advice

22

Exercises

23

Special work situations

30

Hazardous substances

36

Risk of burns/fire

38

Power tools

40

Drugs and alcohol

41

Protection of the external environment

42

Stop and think

45

Check-list

46

Thank you!

48

First aid i a hurry

49

We want to be among the best!

Malthus is an ambitious employer. We want to inspire each other and work together as a team each and every day. We want strong focus on health, safety, the environment and quality to ensure a good working environment, with healthy and safe workplaces.

We will improve, always You will find detailed information in the form of reports and documents in Antenor, but it is important that our established regulations and routines do not become laurels to rest on. In proper Malthus spirit and in line with our values, applicable laws and regulations, we all represent Malthus, and we will seek to achieve continuous improvement in our handling of the following issues: • • • • • • • •

Work routines.

Strain injuries.

Absence due to illness.

Accidents at work.

Choice of materials and products.

Waste management and recycling.

Reducing wasteful consumption.

Undesired incidents.

4

A useful tool for your working day Once you have read this handbook, you will know what we expect from you and what you should expect from the management in terms of HSE. We want Malthus to be an excellent place to work, and our vision is zero accidents and undesired incidents. If you make a commitment in your working day, every day will bring us closer to our goal.

Important! Take two steps back and think before you act It is never wrong to notify your supervisor if you feel uncertain in a work situation. It is never wrong to report an undesired incident.

Thank you for being a committed employee and colleague!

Espen Ingebretsen CEO

5

Definitions: HSE is short for Health, Safety and the Environment.

But what is our definition of these three words?

Health means we must focus on preventing any work-related illnesses, short-term or long-term. It also means that nobody must be exposed to chemicals or harmful radiation at work.

Safety means that everybody should be able to perform their daily duties without being exposed to danger. Many work tasks involve a certain degree of risk. Malthus has drawn up a set of rules and safety instructions that everybody must follow.

The Environment refers to three important areas: 1) Your working environment. Whether you work in an office, or in a factory or workshop, or outdoors on building sites, etc., it is important that your working conditions are good, that things are kept clean and tidy and that you are not exposed unnecessarily to noise and dust.

2) Psychosocial working environment. Everybody should look forward to going to work. We want people to enjoy working for us and to have a safe working environment. Bullying or harassment is completely unacceptable and will not be tolerated.

3) The external environment. Malthus will not cause any damage or pollution. We will also recycle as much as possible.

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Different roles within HSE You are ultimately responsible for yourself and your own safety. As a Malthus employee, you are expected to contribute to creating a healthy and safe working environment both for yourself and your colleagues. You must wear personal protective equipment, stop a work operation if you feel it is hazardous and give notification if you see something that is or could become dangerous.

Your immediate supervisor has an HSE responsibility for you.

This means that he or she must facilitate working conditions and ensure that you are not exposed to danger during your working day.

The supervisor must assess the risk elements in the work that is planned. He or she must ensure that a Safe Job Analysis (SJA) is carried out with the involved parties when and as necessary.

In addition to your supervisor, there are several other players involved in the working environment and our methodical work to improve all aspects of health, safety and the environment.

These are defined as follows: the Employer, Employee, Safety Delegate, the Working Environment Committee (AMU), the Occupational Health Service and the Labour Inspection Authority. If you have any questions about who does what at your workplace, ask your supervisor.

The Safety Delegate is the employee representative in HSE issues, and a go-to person for all concerned.

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The Safety Delegate’s duties include: • Ensure compliance with laws and regulations.

• Ensure everybody’s best interests.

• Provide advice.

The Safety Delegate is authorized to stop ongoing work if it is considered to be hazardous to life and health.

Health, Working, Environment & Safety (HWES)

inspections are the responsibility

of the manager.

8

Distribution of responsibility: We are all responsible The Malthus management is responsible for facilitating work in a safe manner for our employees. All of us who work in Malthus are responsible to take active part in the actions and measures that are introduced in order to create a healthy and safe working environment, as established by Chapters 2 and 3 of the Norwegian Working Environment Act. The Working Environment Act establishes strict requirements to all enterprises. If you are interested in studying the applicable laws and regulations in more detail, look up the following Norwegian websites - or go to similar international sites: www.regelhjelp.no A guideline to the regulations relating to enterprises. www.hms-portalen.no Acts and regulations, definitions of words and terms, plus facts etc. www.lovdata.no This is where you will find all applicable Norwegian laws.

In addition to laws, we must comply with many regulations.

These are the Internal Control Regulations which govern systematic health, environment and safety activities in Malthus, the Builder’s Regulations, relating to safety and health requirements on construction sites, among others.

Think before you act - it is better to be safe than sorry.

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USE YOUR INITIATIVE! Your contribution is an important part of the big picture.

This is certainly also true for HSE! • Care about what goes on.

• If you see something that may lead to hazardous work situations: Do something.

• Take active part in measures that are introduced.

You have a duty to notify if work is done unsafely.

Everyone wants undesirable incidents to be reported.

This is the only way we can work to prevent the same thing from happening again.

Ask! Speak to the responsible supervisor or safety delegate if you have any questions about HSE.

Every time somebody blows the whistle, we all stand to learn something important.

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New workplace?

Whether you are working on a project or you will be working at a customer’s site for a period, it is important to make a note of the following before you get started: Who is in charge?

Who is the safety delegate?

How is the health and safety work organised here?

Which partners are there?

What is the rank between the various parties?

What special HSE requirements are there for this specific workplace?

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HWES inspections

(Health, Working Environment, Safety)

PURPOSE: To survey working conditions at the workplace.

OBJECTIVE: To prevent accidents and eliminate hazardous conditions.

METHOD: Fixed plans are outlined in Antenor and the project management system.

WHO TAKES PART: The responsible manager HSE lead Foreman Work supervisor/site manager Safety delegate and others as needed.

The HWES report must be prepared in writing.

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Undesirable incidents Malthus has a vision of zero accidents and injuries. To achieve our goal as far as possible, it is vital that everybody takes the time to report any irregular events.

Hazardous working conditions/violations of the HSE requirements. You probably know what we mean by this, but for the sake of clarity we will give a few examples: If unclear working routines or attitudes mean that some of us “forget� to use personal protective equipment, support gear/lifting tools or neglect safety measures, this is what we call risky behaviour. Risky behaviour can lead to accidents and should therefore always be reported. All ideas for improvement are greatly appreciated.

Hazardous working conditions mean that there is a clear and present risk of undesired incidents. In such instances, an hazardous situation has not occurred (yet), but how long will your luck last? Examples of such situations, include unsecured cut outs, tools lying about at heights, reinforcement rods sticking out of formwork, slippery surfaces, etc.

Damage to material assets and/or major environmental damage. The risk of polluting the environment/building land from unsecured paint buckets and oil drums would also be classified as an undesired incident and must be reported. The same is true for damages to modular structures/mobile huts, faulty windows, doors, etc.

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Near accidents that might have caused personal injury or damage to material assets or the environment. Luckily it all went well, but somebody almost got hit by that hammer ...

Or maybe the lift was a little bit tilted, so that it nearly tipped over with people in the basket high above the ground ... Or maybe somebody had forgotten to secure the safety catch on the trailer ... Things may seem insignificant, but they should be reported nonetheless so we can learn from our mistakes.

(One lesson learned by all is far better than a hundred lessons learned by one).

Injuries or minor accidents that only need first aid A crushed hardhat which saved the man when the hammer fell from the scaffolding onto his head, or a nail gun that slipped ...

All incidents must be reported - regardless.

Accidents involving lost time or medical treatment Accidents can be minor or major. For HSE-purposes, an accident covers everything, from a sprained wrist or broken arm to situations involving fatalities. Our rule is to avoid work-related accidents at any cost. In addition, we pledge to learn from everything that happens in order to prevent new incidents.

To ensure a better and safer working day we have to be honest and willing to learn from the mistakes made by others - and our own. We can’t do anything about problems we don’t know about. We might not be as lucky next time. And that is a risk we are not willing to take.

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OI-Raport The little notepad �WHAT DID I SEE - WHAT DID I DO� should be used frequently. Carry it with you, and take it out every time you see something undesirable. If you have access to a computer, you can submit the report directly electronically through our Management System, at malthus.no (HSEQ).

Environmental damage, as well as damage to material assets, materials and tools should also be reported. Every single time. The report should be submitted to your immediate supervisor who is responsible for forwarding the report.

This is about your safety. Take no chances!

If you have doubts about an assignment, talk to your supervisor.

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Emergency Preparedness All worksites should be equipped with the following: • An emergency response plan.

• First aid kit for minor injuries.

• First aid kit for major injuries.

• Stretcher.

• Firefighting equipment.

• Clearly marked emergency exits.

A good habit: Read the emergency response plan every time you are at a new site. Find out where the emergency exits are, and ask where they keep the emergency equipment. That way you will be better prepared in the event of an emergency.

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Notification - WHO, WHAT, WHERE, WHEN When calling for help, try to keep calm.

Take deep breaths.

Provide the following information: • • • •

WHO you are WHAT happened WHERE it happened WHEN it happened

The emergency call centres are staffed with experienced professionals. Listen to what they tell you, and answer their questions as calmly and clearly as possible. Tell them also what you have done/are doing with the casualty/ casualties.

A clear and correct message means that the people in the ambulance/helicopter can prepare themselves and their equipment so they are able to provide the best possible care and assistance when they arrive.

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Never talk to the media!

Should there be an undesired incident at work, or in a workrelated situation, it is not permitted for anybody - under any circumstances whatsoever – to speak with journalists or any member of the media.

All communication regarding an accident/undesired incident will be handled by the management. Your points of view/ input can be communicated directly to the relevant authority in Malthus.

Only the person that has been assigned to this task is allowed to speak to the press.

Internal notification Should anything serious happen, you must notify your supervisor or Malthus management immediately, so that they are informed and able to handle the situation.

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Preventive health and safety measurements Repeating the same movement time and time again is called static work, and can lead to musculoskeletal disorders.

Whether you work at a desk or do more physical work, it is important to vary your working posture or tasks as much as possible throughout the day.

Only you can take responsibility for yourself Start with your workstation. Take a critical look. Think through how you perform your work. What can you do better? If you are mostly stuck behind a desk, the magic words are: Variation and movement.

If you have a physical job, a correct working position is incredibly important. No matter how many technical aids we buy, the way you work can make the biggest difference. Health personnel agree that we can heal more than half of our ailments if only we learn to know our own bodies better. That way, we can introduce preventive measures at an earlier stage. This is important!

Be conscious of how you sit, stand, walk, lift, carry, push or pull. Use correct lifting techniques and forget the macho attitude. Technical aids are there to be used.

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Personal protective equipment (PPE) It is important to use the protection and technical aids that are available to you at work. A real Malthus hero is the person who uses his or her PPE correctly. Where needed, always wear: Hardhat Hearing protection Protective glasses/goggles Fall arrest equipment High visibility garments Protective shoes/boots Gloves

Never mind if it is busy, hot or uncool. You must never start up a job without the correct PPE in place.

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Some good advice Rest your eyes If you are constantly working at an arm’s length distance, make sure you rest your eyes by getting some variation. There is a simple exercise: Every half hour, move your eyes to look at something in the distance. This helps you relax the muscles in the retina, and sharpens your vision.

Fresh air Air out the room - at least twice a day. Notice how much more clear-headed you feel. The ideal room temperature is actually just below 20 degrees centigrade.

Tidy up!

Working in tidy surroundings is just so much less stressful than having to work in a messy environment.

Office work Even if you are not constantly stuck behind your computer, it is important to sit correctly. Use varied positions, but sit well.

Do you do a lot of typing at times? Take short, but frequent, breaks, and stretch your muscles.

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Reduce stress in less than five minutes Here are some relaxation techniques. Remember to take deep diaphragmatic breaths and keep your movements calm and controlled. Never jerk or pull.

Part 1 - loosen up Shoulder - Exercise 1 Lift both shoulders up towards your ears, and lower them again slowly. Remember to breathe. Breathe in when you lift - breathe out when you lower. Repeat 10 times.

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Shoulder - Exercise 2 Let your arms hang straight down. Roll your shoulders in circles and remember to breathe throughout the exercise.

10 times forwards 10 times backwards

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Shoulder - Exercise 3 Place your left hand on your left shoulder, and your right hand on your right shoulder. Make large circles with your elbows.

10 times forwards 10 times backwards

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Part 2 - Stretching Perhaps the most important two minutes at work Remember to breathe well and make easy, controlled movements, - never jerk or pull.

Side stretch Sit on a chair. Keep your back straight. Place your left hand on your head and your right ear. Pull calmly and evenly so that you feel your neck is getting stretched. For a better result you can push your right hand down towards the floor. Hold this position for 15 seconds. Repeat twice to the right and twice to the left.

Recommended several times a day 26

Neck stretch Fold your hands around the back of your head. Slightly bend your upper body forwards and pull your head so that you feel the neck muscles stretching. Hold for about 15 seconds and repeat twice.

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To counteract computer-related Repetitive Strain Injury (RSI) - Exercise 1 Fold your hands and turn them inside out (palms facing out).

Stretch your arms until you have a good stretching sensation in your underarms. Hold. Push your arms as far to the left as you can. Hold. Stretch back to the middle and hold. Stretch to the right and hold. When you stretch sideways, you should get a good sense of stretching the muscles in your shoulders.

Remember: calm and controlled movements and breathing.

Repeat three times to each side.

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To counteract RSI - Exercise 2 Stretch out your right arm and bend the wrist while twisting the palm of your hand inwards. Use your left hand to apply additional pressure on your right-hand palm for an even better stretching exercise. Breathe and hold for fifteen seconds.

Repeat before doing the same twice with your left arm, too.

That feels good, doesn’t it?!

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Particular work situations At the building site It is mandatory to wear hardhats, protective boots, glasses, high visibility garments and gloves at most building sites.

Personnel who are caught not wearing a hardhat may be given an oral warning, followed by a written notification, and finally expulsion from site. The same is true if protective/ welding goggles are not worn when using angle grinders and welding. It has now also become mandatory in Norway to carry an approved company ID card on building sites. This should be visible at all times. Malthus runs the risk of sanctions unless we all comply with these rules, and this in turn would reflect on the employee in question.

Machinery and special equipment Everybody who operates machinery must have valid certificates, driver’s licences, trade certificates, user certificates or other applicable approval/certification. In addition, such personnel must have received proper training in how to operate the relevant machine/or the operation in question. Manuals on how to use and maintain them are mandatory, as well as attending to the machine in a satisfactory manner.

Work at heights Even if you may feel safe because you have done the same task lots of times, it is never acceptable to take safety lightly.

The rule is that there must be a protective handrail (at least 0.9-1 metres high), a kneeboard and toeboard when working at heights. Everybody working for Malthus must use a safety harness with a lanyard if you are working at a site without 30

railing, or if you need to remove parts of the railing to gain access. This applies to all sites with an elevation of more than 2 metres.

It is also important to properly signpost the area: “Work at heights in progress�. When using a lift, all the established safety rules must be complied with in full, each and every time.

Malthus holds dedicated safety courses for use of lifts, and as a Malthus employee, you represent the company when you are working at a customer site. It is therefore of the utmost importance that you always behave correctly - in addition to doing your utmost to look after your own safety and that of others.

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Correct use of scaffolding • Take great care to install the scaffolding correctly.

• For scaffolding higher than five metres, qualified personnel is needed. This applies to installation, extensions, changes and dismantling.

• All scaffolding must be inspected and approved prior to use.

• Approved scaffolding must be tagged with a green sign stating the name of the owner, principal, the person who installed the scaffolding, and the maximum load permitted.

• Scaffolding that has not been approved must be marked with a special warning sign.

• All those who work on the scaffolding must have received work instructions covering use, overload, change of the construction and signposting.

• It is prohibited to stay on a rolling scaffolding when this is moved.

Remember that if you change/move parts of a scaffolding, you may put others at risk. The same is true if you remove railings/covers over cut-outs, etc., without putting them back again. All scaffolding must be approved.

It is especially important to secure loose objects when working at heights.

Never walk below a hanging load.

Use padding if there are sharp edges that might damage the lifting gear.

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Personnel lifts and work platforms Never use a work platform unless you have the proper training and approval to do so. The person performing the work is responsible for his/her own safety and that of others nearby. How the platform is placed on the ground is of the utmost importance. All types of lifting tools must be placed on a solid and level ground (never on a slanting or uneven foundation). It is important to be familiar with the individual possibilities and restrictions of each machine in terms of working height and reach, to ensure that the person who will perform the work has a good starting point for the work.

Approved lifting equipment MUST be labelled with a certificate number and the maximum load permitted.

Defective/repairable lifting equipment must be tagged with a WHITE colour - and removed from the worksite.

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Securing a ladder Careless use of ladders represent the single most important cause of falls. Ladders must be secured against sliding, and may only be used for temporary work/access. The top of the ladder must be one metre higher than the edge. For work at heights above two metres, only scaffolding or personnel lifts may be used.

Nail guns The age limit for these tools is 18 years, and they may only be used by trained and certified personnel.

Pay special attention when using a bolt gun:

• The tools must be kept in a locked room, box or cabinet when not in use.

• Clean and check the bolt gun after use - every time.

• Never put an unreliable tool back in place without a tag

indicating the fault.

• If the gun does not work properly, make sure you have it repaired.

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Hot work Hot work includes construction, installation, assembly, dismantling, repair, maintenance, etc., involving the use of open flame, heating, welding, cutting, soldering or grinding. All personnel handling such tasks must have taken and passed the approved training course. Be particularly aware of the potential risk of explosions, development of smoke and fumes, dust, sharp light, etc. and take all precautions seriously.

Winter work During winter, we must pay special attention to slippery and difficult access conditions. Good lighting is important to ensure safe access. Contribute to everybody’s safety by replacing defective light bulbs.

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Hazardous substances Make sure that you have the necessary PPE at hand when handling hazardous substances and chemicals. Some of the substances used can cause discomfort and physical ailments, both acutely and in the long term. Be careful!

• Read the safety data sheet carefully before handling the substances.

• Always use the recommended PPE. • Contact your supervisor if in doubt.

• When disposing of chemical substances and/or its associated packaging, make sure these are treated as hazardious waste in accordance with the recommendations on the safety data sheet.

Hazardous substances must always be stored in a safe manner.

They must always be put back into place after use!

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Soap and water Wash off any chemicals from your hands and skin before eating, smoking or using the restroom. Work clothes that have been stained with oil, inflammable liquids or chemicals, must be changed and cleaned as soon as possible. It is especially important that such work clothes are changed/washed frequently, preferably daily.

Important routines • Cleanliness and tidiness are two of the most important factors in terms of wellbeing, health, safety and the working environment.

• Tidy up as you go - every time.

• All equipment not in use, must be put back in place - every time.

• Waste must be properly disposed of - every time.

Good routines for tidiness and cleanliness can save lives When the light is out, and the room is pitch black, or the smoke is thick and you’ve only got seconds to get out, it is too late to start clearing a path. Make sure that all escape routes are kept open and accessible.

NEVER EVER place boxes, materials or tools so that they block the emergency exits.

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Risk of burns/fire Special precautions are necessary at all sites where machinery or equipment can cause sparks, fires or burns. In Malthus, this means having the appropriate firefighting and first aid equipment readily available.

If you detect a fire: • Take responsibility • Activate the fire alarm • Alert the others, so that everyone makes a safe escape • Call the fire brigade • Remember to tell them:

WHO you are

WHAT has happened

WHERE the fire is As far as possible: Shut doors and windows leading to the place where it is burning.

110 112 112 911

NORWAY SWEDEN UK CANADA

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A minor fire If possible without putting yourself at risk: Try to put out the fire by choking the flames with a fire blanket or by directing the spray from the fire extinguisher at the base of the flames.

Fire extinguishers: All the approved types have been labelled with the type of fires they are intended for.

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Power tools Installation, modifications or repairs of electrical tools and temporary systems may only be carried out by professionals.

We shouldn’t have to say this, but: • Never insert wires without sockets into plugs.

• Always use professional fuses.

• All faulty tools, cables and plugs must be handed in for repairs without delay.

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Drugs and alcohol are prohibited at work In Malthus, we have taken a clear stand on drug and alcohol use. Regardless of where you work; whether it is in an office, factory, construction workers’ camp or construction site, intoxication during working hours is strictly prohibited. We expect all our employees and contracted personnel to comply with this rule at all times. In order to be able to do a good job for our customers, and to contribute to a good working environment characterised by inspiration and teamwork, it is essential that we all keep our minds clear and focused. It is as simple, reasonable and invariable as that. A person who is under the influence at work may expose oneself and ones colleagues to unacceptable risks. The consequences could be serious and must be avoided at all cost.

Ask for help Are you going through a difficult time? Do you have problems in your personal life, or are you beginning to develop difficulties with intoxicating substances? Give us a chance to help.

Even if the situation might appear deadlocked to you, we have methods to support you and propose solutions.

Be a good colleague If you suspect that somebody at work is having a hard time, might be intoxicated or out of control, you should send a notification of concern to the safety delegate, HSE manager or contact the HR manager. A concern note only shows you care and act responsibly.

All notifications will be treated confidentially!

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Protection of the external environment Malthus is aware of our environmental responsibilities. We are constantly working to reduce consumption and find solutions for improvements.

If you spill oil, chemicals or similar, the spill must be removed/ cleared up immediately, and the incident reported.

During construction work, we are all obliged to protect the external environment to the best of our ability. This also applies to the local vegetation, cultural heritage and wildlife.

These matters are generally regulated with specific requirements. We have a responsibility to investigate whether such requirements are in place, and to comply with them at all times.

With regard to construction site waste generation we comply with “Regulation relating to sorting of waste at construction sites�. Even if we achieve a high degree of waste segregation in the module manufacturing halls, we must focus on waste management in the assembly stages as well.

Fuel filling/draining must only take place in designated areas.

Left-over paint shall be handled as hazardous waste.

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Noise We are committed to avoid generating unnecessary noise for our neighbours. Construction machinery must only be operated inside the agreed hours.

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Waste separation at source Everybody at Malthus must help to reduce our waste quantities as far as possible.

Nobody may empty, leave behind, store or transport waste in a way that is unsightly or detrimental or harmful to the environment.

Packaging should (if possible) be returned with the freight carrier.

Recyclable waste such as steel, cardboard/paper, wood, plastics and glass must be collected separately and returned for recycling.

Hazardous waste such as spent oil, left-over paint, spray cans, larger batteries, solvents, etc., shall be collected and returned to a certified recipient, together with a completed declaration form.

Non-conformities such as acute pollution or a danger of acute pollution must be reported to the fire brigade immediately. (cf. Section 39 of the Norwegian Pollution Control Act)

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Take two steps back...

• • • • •

Use your head Be considerate Carefully follow the instructions Take all necessary precautions Report all undesired incidents

Workplace accidents can be prevented: The Norwegian Labour Inspection Authority recorded 38 fatalities on workplace accidents per December 15. 2012.

We do not want to be part of those statistics.

The fact is that for every lost-time injury, statistics show there have been as much as 29 accidents requiring first aid.

Behind every first-aid incident, there has been 300 undesirable/ dangerous actions or undesirable/dangerous conditions.

Let us minimise risk!

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Pre-job checklist: 1. Stop and think.

2. Get an overview over the worksite.

3. Do a step-by-step review of the tasks.

4. Check to see whether other things are going on in the same area at the same time.

5. Think about safety.

6. Identify hazards/weaknesses.

7. Find methods for controlling potentially dangerous situations. Assess the soundness of your solution before you start.

8. Make sure that any potentially dangerous situations are under control before you start working.

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Checklist during work: • Notice any changes in the tasks/ undesirable incidents along the way.

• If in doubt; stop.

Consider the situation carefully.

You always have the time to do so.

• Ask yourself the following control questions:

1. Do I feel safe doing this work?

2. Is the job done by others around me safe?

Write a report if there are non-conformities or you find cause for worry.

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We depend on you All those who report in near accidents, potential accidents and dangerous conditions contribute to an improved and safer working environment for Malthus. Even if things turned out right this time, the outcome could be far worse in the future, unless we get a chance to learn from experience and improve conditions and practices.

If you make a report, others won’t have to experience what you did!

Be responsible.

If you have access to a computer, you can submit the report directly electronically through our Management System, at malthus.no (HSEQ) or use the OI-Report, and submit a report on undesirable conditions/incidents to your supervisor or the safety delegate.

THANK YOU VERY MUCH!

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First aid in a hurry

FIRE BRIGADE

NORWAY SWEDEN UK CANADA

110

POLICE

112 112 112 911

MEDICAL EMERGENCIES

113

My HSE booklet / First aid in a hurry 2013 C Malthus sitert.no - Illustrator: StĂĽle Ă…dland

First aid Immediate administration of first aid may help to: • Save lives • Prevent permanent injury • Prevent the casualty from going into a coma • Relieve pain • Promote faster recovery As the first person at the scene, you should: • Take charge • Secure the accident site • Get an overview of the situation • Get assistance - call for help If more people arrive at the scene: • Organise the first aid efforts • Tell people what to do - be clear and specific - keep it simple It is only natural to feel scared, but try to stay as calm and firm as possible

Do you know where the first aid kit is kept?

That knowledge can save lives!

The first three minutes: Get an overview of the situation. Who can wait until later?

Concentrate on casualties with life-threatening injuries, but who can be helped.

It is important to keep the patient conscious and as calm as possible.

Talk It is not what you say that matters.

The important thing is to keep the person conscious.

Look Eye contact can help keeping the casualty conscious.

Touch

Touch has a calming effect.

Think about your own safety: In the dark, use a high visibility vest to avoid getting hit by passing vehicles.

Wear gloves and/or a mask if blood/bodily fluids are involved.

4

Lifesaving first aid: What you do from your first evaluation of the situation, until medical personnel arrive at the scene. Use common sense. Doing something is better than doing nothing at all. Here are some suggestions for a checklist: If there is no risk of injuries to the neck or back, find the correct position. The recovery position (when the person is lying on the side) might be good or, if the patient is conscious, lying on the back with raised legs.

Is the patient breathing? (Tilt the head backwards to open up respiratory passage).

Stop any bleeding.

If there is a risk that the patient may suffer from spinal injuries (broken neck/back) - DO NOT move the body. Administer first aid where and as the casualty lies.

Start resuscitation of unconscious casualties who are not breathing (cardiopulmonary resuscitation - CPR). Check the mouth and remove any blood, teeth and vomit from the oral cavity before you start CPR. If there are more people at the scene of the accident - take turns.

Tuck the patient in with blankets/coats. This promotes a sense of safety and prevents hypothermia.

People who have suffered burns/major blood loss, must NOT be given anything to drink.

If there are enough first aiders, tell one person to sit by each injured person and talk to, stroke and calm the casualty. It does not matter what you say, as long as you manage to keep the patient conscious until the ambulance arrives.

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Conduct the examinations gently. Check if there is any blood under the casualty. Take care of yourself, too: Try to avoid any contact with blood and bodily fluids. Use protective equipment such as gloves and masks from the first aid kit.

If the patient is unconscious • Check breathing and pulse.

• Try to wake the casualty.

• If the casualty wakes up, check for injuries while trying to keep the person conscious.

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How to stop severe bleeding Arterial bleeding If bleeding comes in spurts, and involves arteries, it could be a life-threatening situation. Immediate action is vital!

1. Apply direct pressure on the wound.

2. Elevate the wound above heart level.

3. Apply a pressure bandage.

It does not matter what you use to apply pressure. A flat stone, tool, or anything would do. If you do not have any bandages tear up a shirt, curtains or similar into strips. Elevation of the wounded body part is preferable.

Talk to the casualty in a comforting way, to prevent the patient from going into shock.

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A small stroke can cause severe damage If someone suddenly stumbles for no reason, starts to fumble or seems to fall out of the situation, please ask the person: 1. Can you LAUGH? 2. Can you LIFT THE ARMS above the head?

3. Can you SAY A SIMPLE SENTENCE? (eg: The sun is shining today).

If you feel uncertain that everything is fine (even though the person claims it is) call the emergency number

When a neurologist treats a person who has suffered a stroke within the first 3 hours of impact, the unwanted effect of the incident can be removed completely.

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Providing care in an emergency situation A casualty must be given good care and attention, so that you are able to detect any deterioration in the casualty’s condition.

It can be good to place a jacket or blanket over the casualty. If there is massive loss of fluids in connection with bleeding or burns, there is a risk that the blood circulation may deteriorate or fail. Make sure the lower part of the body is elevated, and that the casualty is kept warm.

Never give a person with failing blood circulation anything to drink

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Injuries caused by electric shock Injuries caused by electric shock. Electricity can cause burns on the skin and damage to internal organs. The heart is particularly vulnerable, whether the current has gone from arm to arm or from arm to leg. Electrical injuries can be lethal, so be careful!

Anyone who has been exposed to an electrical shock must ALWAYS go to hospital for a 24-hour observation period. This because arrhythmia might occur even several hours after the incident.

Remember that a person could act as a conductor if you touch him or her. Before you help the person, make sure the main switch is disconnected, or use something made of a non-conductive material (e.g. a wooden broom), to remove the electrical source before you touch the casualty. If the clothes have burned into the skin, do not make any attempts to remove them. Call the emergency number, and use your time to provide life-saving first aid.

Something in the eye?

Do not remove any foreign objects that are lodged in the eye. Transport the patient to the medical services WITH the foreign object still in the eye.

If a person has had liquids sprayed onto the eye – wash with copious amounts of clean water and contact medical assistance.

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Something stuck in the throat?

If the patient is coughing/breathing, do not slap the person between the shoulder blades. Thumping somebody on the back will only serve to reduce the effect of the coughing reflex. If the patient is choking, and not coughing, apply the Heimlich manoeuvre.

This is easier to learn by practicing, but the procedure is as follows: • Place yourself behind the patient and place your arms around the victim’s waist.

(The procedure can also be performe lying down.)

• Make a fist with both hands just above the navel. Press into the abdomen with a quick upward thrust. Apply the procedure firmly and with an upward movement. Make sure you keep a proper distance to the sternum, to prevent injury.

• Repeat if necessary.

Note! The first attempt is most important, as this is when there is most air in the lungs. It is therefore important to exert sufficient pressure so that the air in the lungs contribute to dislodge the foreign object from the throat.

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Heart attack?

If a co-worker collapses and you suspect heart failure, it is important to keep the casualty warm and calm while waiting for the ambulance and medical assistance to arrive. Loosen tight and restrictive clothing, and do not offer the casualty anything to drink even if the person may be thirsty.

If the casualty is unconscious and with a dropping pulse, it is vital that CPR is started immediately. This is a combination of chest compressions (firm pressure applied to the chest) and mouth-to-mouth.

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Cardiopulmonary resuscitation (CPR) can be highly strenuous, so it would be an advantage to have more people on the scene to take turns.

If the casualty resumes breathing unaided, you should take a break. Observe the casualty, while lying on his/her back, to check whether he/she is breathing evenly. When breathing returns to normal, place the patient in the recovery position. Keep the patient under observation, so that CPR can be resumed quickly if needed.

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