Many a common misunderstanding and misconceptions abound when addressing what OSHA requires or has not explicitly ruled on. First aid requirements are ones that can often be misunderstood. First aid is addressed in OSHA’s Standard 29 CFR 1910.151 on Medical Services and First Aid. There are four basic requirements in this Standard and while seemingly limited in number, they are expansive in potential scope and apply to any employer:
- Ensure readily available medical personnel for advice and consultation on matters of plant health;
- In the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid;
- Adequate first aid supplies shall be readily available; and
- If any person’s eyes or body may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use.
While seemingly explicit, there is a lot of room for ambiguity and interpretation of these. In this article, we will address requirement number one (1) on “readily available personnel”.
The exact wording of the OSHA requirement [1910.151(a)] is:
“The employer shall ensure the ready availability of medical personnel for advice and consultation on matters of plant health.”
What OSHA has interpreted this to mean is that an employer must ensure prompt treatment for any injured employee at its facility. This is commonly addressed in one of two ways (or both if desired): by (a) having personnel onsite that are trained to render first aid to the injured person or, (b) by ensuring that emergency treatment services are within reasonable proximity of the worksite.
OSHA has stated in opinion letters that an employer must ensure that “… adequate first aid is available in the critical minutes between the occurrence of an injury and the availability of physician or hospital care for the injured employee.” 
The “reasonable proximity” component of what OSHA expects is also not explicitly defined by OSHA, but OSHA has provided some clarification in subsequent interpretations, namely that “… OSHA has long interpreted the term 'near proximity' to mean that emergency care must be available within no more than 3-4 minutes from the workplace.” 
OSHA further states in the same interpretation that “… in workplaces where serious accidents such as those involving falls, suffocation, electrocution, or amputation are possible, emergency medical services must be available within 3-4 minutes, if there is no employee on the site who is trained to render first aid.” 
OSHA has noted that in workplaces, such as offices, where the possibility of such serious work-related injuries is less likely, a longer response time of up to 15 minutes may be reasonable.
It should be noted that this Standard applies to all businesses, but more strict requirements do exist for unique special work conditions (logging, electrical power industry, etc.), where employee first aid training is mandatory, and a complete reliance on outside emergency responders is not allowed.
There are no exemptions for small employee or worker population sizes for compliance with this Standard.
As a major action step, employers should evaluate their operations and activities on a routine basis for the potential of serious injuries to occur and the availability of medical personnel within either the 3-4 minute window or the 15-minute window as identified in OSHA’s clarifications. This is particularly important if no onsite first aid responder is available. These time windows apply whether the employer has an ambulance or medical professionals come to its facility or plans to transport the injured person to a medical facility itself.
We will discuss first aid training in our next article on OSHA’s First Aid Requirements.
Mr. DiNitto is a co-founder and Managing Partner of The Isosceles Group with over 30 years of
years of environmental and safety consulting and business operations experience, with emphasis on the design and implementation of ESH management systems for business operations, and the analysis and reporting of international regulations for environmental and occupational health and safety that affect industry and commercial enterprises. He can be reached at firstname.lastname@example.org.