Oxygen therapy in workplace

ectoraige · 29-04-2014 9:05am #1

I'm an EFR with an auxiliary service and so have been trained in airway management and oxygen therapy. In my workplace of almost 300 people we also have a number of OFAs. I was chatting with the H&S manager and on mentioning the extra skills I had and he started wondering about the feasability of maintaining medical O2 on-site. We found one of the main gas suppliers in Ireland actually does a yearly rental service which is aimed at responders in the workplace. We've since seen online that there are a number of courses out there that offer specific modules in O2 therapy.

I'm a bit vague though concerning the legalities of this. I know we don't do legal advice here, but I'd like to know if my understanding is shared by others and whether it's worth exploring further.

My belief is that in theory you need to be a 'registered practitioner' to prescribe medication - i.e. EMT and above, doctors, etc., and that the reason CFRs, OFAs, and EFRs can provide aspirin and (for EFRs) other medications is through the authorisation of their organisations medical officer.

If we kept O2 onsite would I be covered to use it, given that it wasn't supplied by my org?

If we did have it and trained OFAs in airway management/O2 therapy, would they be authorised to use it?

For the professionals out there, is this something you encounter on calls where businesses have their own O2 onsite, and if so, have you noticed if it's practioners or not?

sjb25 · 29-04-2014 12:56pm

ectoraige wrote: »

I'm an EFR with an auxiliary service and so have been trained in airway management and oxygen therapy. In my workplace of almost 300 people we also have a number of OFAs. I was chatting with the H&S manager and on mentioning the extra skills I had and he started wondering about the feasability of maintaining medical O2 on-site. We found one of the main gas suppliers in Ireland actually does a yearly rental service which is aimed at responders in the workplace. We've since seen online that there are a number of courses out there that offer specific modules in O2 therapy.

I'm a bit vague though concerning the legalities of this. I know we don't do legal advice here, but I'd like to know if my understanding is shared be others and whether it's worth exploring further.

My belief is that in theory you need to be a 'registered practitioner' to prescribe medication - i.e. EMT and above, doctors, etc., and that the reason CFRs, OFAs, and EFRs can provide aspirin and (for EFRs) other medications is through the authorisation of their organisations medical officer.

If we kept O2 onsite would I be covered to use it, given that it wasn't supplied by my org?

If we did have it and trained OFAs in airway management/O2 therapy, would they be authorised to use it?

For the professionals out there, is this something you encounter on calls where businesses have their own O2 onsite, and if so, have you noticed if it's practioners or not?

I'm an phecc EMT with a voluntary service and I work in a factory with about the same amount of people as you I am a first aider and part of the factory emergency team but when I'm working in the factory I would not have or ask for 02 or any other meds or any EMT equipment I only provide first aid and would not do anymore to practice EMT skills you must be working for a phecc registerd organisation so unless you're workplace is willing to put you and whoever on a course and also provide you with insurance cover and will stand over you if something goes wrong I'd stick with just occupational first aid. Just my opinion

sgthighway · 29-04-2014 1:07pm

I'm in the same boat as sjb25.
I do know of other people in other companies and they add EMTs to some sort of Insurance Policy to cover them. I think its all above board then.
Just regarding the actual Oxygen; You can get a fixed one for your OH Room and a CD one as a portable from BOC Gases.

sjb25 · 29-04-2014 2:04pm

sgthighway wrote: »

I'm in the same boat as sjb25.
I do know of other people in other companies and they add EMTs to some sort of Insurance Policy to cover them. I think its all above board then.
Just regarding the actual Oxygen; You can get a fixed one for your OH Room and a CD one as a portable from BOC Gases.

Yes have heard some places do that alright iv never realy asked to be honest getting gettin oxygen be no problem really as I said all I'd be worrying about is who is covering me to use it

ectoraige · 29-04-2014 3:07pm

This is something that's bugged me for a while. For an EMT/EFR/CFR trained by a voluntary organisation, should they encounter an incident while off-duty they aren't covered to provide any first aid whatsoever. They are told however that so long as they stay within their training, that they should be okay. It's a bit of a grey area, but does it extend to medications?

I stopped at a three-car collision some time ago. All I could do once the EMS were called was provide manual stabilisation for a casualty with severe back pains. This is a trained skill though so in theory I was not authorised to do this. Likewise, if a neighbour had cardiac chest pains, I would not be authorised to give aspirin. They'd both be in the same 'grey area' as far as I can tell.

sgthighway wrote:

I do know of other people in other companies and they add EMTs to some sort of Insurance Policy to cover them. I think its all above board then.

Any idea if this would be above board for EFRs/CFRs+ though, given that they are not practitioners?

civdef · 29-04-2014 3:20pm

Ye're over-thinking this, other than medications there's really nothing to stop you to helping someone in accordance with your training.

And on the subject of medications, and back to the OP, can anyone list the legislation controlling supply of oxygen? Hint - it's not mentioned in either S.I. No. 510 of 2005 or S.I. No. 512 of 2008.

Insurance is a separate issue, if you're employed to provide first aid cover you probably need to be insured. As for helping someone on your own time - try this:
http://www.irishstatutebook.ie/2011/en/act/pub/0023/sec0004.html

ectoraige · 29-04-2014 4:21pm

Is it the case so that as Aspirin is not controlled, it's okay to prescribe to a patient once it is in accordance with your training? Presumably the same applies to Glucose Gel then, so the only medication then that is problematic at EFR level is Oxygen, due to it being controlled.

I'm reading it then that as I am trained to administer oxygen, I can do so provided I have it in the first place and do so in accordance with my training. However due to it being a controlled medication I can only access it when on-duty with an org, and this is authorised by the organisations' Medical Officer. In the workplace environment then, I've no authorisation to obtain O2 as I'm not a practitioner, and don't have a practioner on-hand to authorise my use? Presumably workplaces that do have an EMT to obtain it.

Does this seem an accurate reflection of things? It's seems an inconsistency that EFRs and CFRs+ are trained to use it, but are prevented from obtaining it, unlike the other medications. I'm thinking of one EFR I know who drives for a living and has stumbled across three major incidents in the last 18 months.

I assume insurance-wise it's not a major additional cost to cover EMTs compared to the cost of covering OFAs.

sjb25 · 29-04-2014 4:31pm

civdef wrote: »

Ye're over-thinking this, other than medications there's really nothing to stop you to helping someone in accordance with your training.

And on the subject of medications, and back to the OP, can anyone list the legislation controlling supply of oxygen? Hint - it's not mentioned in either S.I. No. 510 of 2005 or S.I. No. 512 of 2008.

Insurance is a separate issue, if you're employed to provide first aid cover you probably need to be insured. As for helping someone on your own time - try this:
http://www.irishstatutebook.ie/2011/en/act/pub/0023/sec0004.html

This is more or less what I'm trying to say in a roundabout way noting stoping you helping out within youre training but providing a service or working as an efr/emt is different and you got to be sure of insurance for you're own sake o and as for asprin that is on the OFA/CFR so nobody going to fault you giving that as long as you are trained and coming across an incident as long as you stick to what you are trained and can justify what you did no problems I suppose the jist of what I'm sayin is when I'm not on an ambulance all I have in my personal kitbag in the car would not be a lot more than a basic first aid kit and iv never needed more and iv stopped at many incidents

sjb25 · 29-04-2014 5:03pm

ectoraige wrote: »

This is something that's bugged me for a while. For an EMT/EFR/CFR trained by a voluntary organisation, should they encounter an incident while off-duty they aren't covered to provide any first aid whatsoever. They are told however that so long as they stay within their training, that they should be okay. It's a bit of a grey area, but does it extend to medications?

I stopped at a three-car collision some time ago. All I could do once the EMS were called was provide manual stabilisation for a casualty with severe back pains. This is a trained skill though so in theory I was not authorised to do this. Likewise, if a neighbour had cardiac chest pains, I would not be authorised to give aspirin. They'd both be in the same 'grey area' as far as I can tell.

Any idea if this would be above board for EFRs/CFRs+ though, given that they are not practitioners?

What more could you have done for the casualty in the car other than take manual stabilisation I'm assuming you didn't have collars and surely not a backboard in you're car so all you could do is just what you did perfect!

donkey balls · 30-04-2014 12:09am

The company I work for have AED's/first aid stations placed around the facility along with an oxygen therapy kit,I don't think that there is anyone qualified to EMT level in the company a part from my self.
Now the company I work for take H&S to the extreme due to the nature of the business,So I would be sure that they have every box ticked off regarding policy & procedures.

ectoraige · 30-04-2014 9:48am

sjb25 wrote: »

What more could you have done for the casualty in the car other than take manual stabilisation I'm assuming you didn't have collars and surely not a backboard in you're car so all you could do is just what you did perfect!

No, there wasn't anything else to do, my point there was that I was using a trained skill outside of duty. civdef's link to the legislation cleared that up for me though.

On the subject, there's not really much point carrying a collar in the car, is there? You're still going to have to maintain inline stabilisation until the bus arrives with the backboard. It might save 30 seconds, that's all.

ectoraige · 30-04-2014 9:51am

donkey balls wrote: »

The company I work for have AED's/first aid stations placed around the facility along with an oxygen therapy kit,I don't think that there is anyone qualified to EMT level in the company a part from my self.
Now the company I work for take H&S to the extreme due to the nature of the business,So I would be sure that they have every box ticked off regarding policy & procedures.

That's interesting, presumably the company OFAs there receive specific training in it's use. I wonder where the authorisation to hold the oxygen comes from then - presumably they didn't use your PIN?

sjb25 · 30-04-2014 10:01am

ectoraige wrote: »

No, there wasn't anything else to do, my point there was that I was using a trained skill outside of duty. civdef's link to the legislation cleared that up for me though.

On the subject, there's not really much point carrying a collar in the car, is there? You're still going to have to maintain inline stabilisation until the bus arrives with the backboard. It might save 30 seconds, that's all.

Exactly there is no point but I no of people that do feel the need and more but that's a hole other discussion ha suppose what I was getting at is if you not on an ambulance all u realy need is a basic kit and have your skills you've learnt call an ambulance and provide basic care till they arrive that's what I do anyway and iv been at several serious incidents in my job and just came across them and have done just that and never needed more glad all cleared up for you anyway

ectoraige · 30-04-2014 12:08pm

Yeah, my car kit stays in the glove box so it's just the "standard" plus a few family-related items. It's a slippery slope once you start adding things - throw in an OPA? Now you need suction. I imagine most of the more "advanced" meds either require extra diagnostic equipment too, or cost a bomb anyway.

Getting back on topic, I think the summary is that to have Oxygen in the workplace, the company will have to provide the training and insurance and find a doctor to sign-off on it so that it can be supplied to them.

donkey balls · 01-05-2014 1:03am

ectoraige wrote: »

That's interesting, presumably the company OFAs there receive specific training in it's use. I wonder where the authorisation to hold the oxygen comes from then - presumably they didn't use your PIN?

To be honest I don't know what training the company OFA get plus the company does not know my pin number:D ,I must ask the guys who oversee the H&S what they have in place regarding the use of the oxygen.

crackcrack30 · 01-05-2014 12:04pm

Ambulance control will advise Pt/people who phone with symptoms of cardiac chest pain to admin/chew 300 of Aspirin.......

You can assist with this request IMO. There is also the good Samaritan stance....... as in doing your best (in your judgement) to assist in a time of need.

limericklad87 · 27-05-2014 1:06pm

Is there any definitive to the question of administering oxygen while at work, being a trained EFR with a voluntary service

flazio · 28-05-2014 12:15pm

I reckon another factor that work places that wouldn't store gases as part of their business would have to consider is would having a pressurised gas tank on the premises have any effect on their property insurance.

iceage · 28-05-2014 2:37pm

Also O2 is classed as a drug lads, another issue is PCR's how are you going to deal with that? The paperwork and insurance issues are a minefield there has to be a designated qualified signatory for the upkeep, issue and recording of said drug. If the company that you work for had decided that O2 was a requirement for their First aid I'm sure they would already have it in place, also keep it simple, if you don't have it, you can't use it. Refer back to the basics of ABC and you'll be fine.

As far as airway management is concerned in a first responders role for most incidents up to and including full CPR you should be able to manage just fine with a facemask or a BVM if it's available until ALS arrives.

donkey balls · 28-05-2014 9:45pm

flazio wrote: »

I reckon another factor that work places that wouldn't store gases as part of their business would have to consider is would having a pressurised gas tank on the premises have any effect on their property insurance.

I don't think it would as a lot of places would have compressed gas on site ,Like pubs/fast food restaurants+ food manufacturing companies & transport companies using fork lift trucks.

Oxygen therapy in workplace

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