Posts Tagged ‘first aid’

Member input leads to access to life-saving emergency training

When an accident occurs and one of our members is on site — be it a bus operator or rail conductor — it often falls on that SMART Transportation Division member to provide assistance as the FIRST responder to the situation.

The member must assess and relay information about the incident to rescue crews and law enforcement personnel who are dispatched and, if able, provide potentially life-saving aid and comfort to any victims.

When dealing with accidents involving buses or trains, victims often have traumatic injuries as a result. These incidents are not going away, especially with all the distractions posed by smartphones or a reduction of situational awareness due to headphones or earbuds to members of the public who go near roadways or the rails.

In 2017 and 2018, there were more than 1,000 trespasser-related casualties (injuries and deaths), according to Federal Railroad Administration data. Through the third quarter of 2019, there have been nearly 900 casualties reported.

Grade-crossing accidents involving vehicles and pedestrians reported to FRA occurred at a rate of more than 2,000 annually each year from 2016 through 2018. Through the third quarter of 2019, FRA reports more than 1,600 of these incidents.

But it’s not just the lives of trespassers and drivers who encounter a grade crossing potentially in danger from an unexpected emergency.

Having two people in the locomotive cab of a freight train leaves just one person left to assist the other should they be in need of help. Train crew members can have a medical event while performing service. Bus and rail passengers also can have such an event due to an accident or a violent incident that occurs in the presence of our members. And let’s not forget that a medical emergency can happen anytime and anywhere to anyone at home or out in public.

Preparation and training in these situations are invaluable.

With this in mind, member David Herrmann of Local 446 (Cheyenne, Wyo.), a Union Pacific conductor since 1990, wrote to the SMART-TD President’s Office with a suggestion:

“One of the conductor’s responsibilities is to walk back after a train hits a car on a crossing,” he wrote. “Since 1988, I have been CPR qualified. I think it would be a good idea for every conductor to be CPR qualified to be a first responder, just in case.

“Even if the tracks are right near the highway, which in Wyoming they are not, a response team could take a long time to get there.”

The suggestion from Brother Herrmann to learn CPR and first aid, a sensible and potentially life-saving one, applies to all members regardless of where they work.

Just ask Thomas E. Baker, a conductor for Veolia/Tri-Rail and a member of Local 33 (Fort Lauderdale, Fla.), who put his knowledge of CPR and first aid into action during an incident February 15, 2014.

SMART Transportation Division conductor Thomas E. Baker, second from right, is presented a crystal “distinguished service award” by South Florida Regional Transportation Authority Commissioner Steven L. Abrams, far right, for his life-saving action in performing CPR on a passenger in distress in February 2014.

On that day, he saw a woman collapse and fall down a stairwell onto a station platform in south Florida. With a background in the military and law enforcement, Baker was equipped with the knowledge and training needed to save the 65-year-old woman’s life.

“It was something that came natural to me,” he said. “I knew that she was in major trouble.”

He rushed down to the platform and performed CPR for 15 to 20 minutes before emergency responders arrived. The defibrillator on the train was not functional, but his exhaustive efforts saved a life. The woman survived.

Baker said his carrier now requires employees to be certified every two years in CPR, but that is not the case for all carriers, and he reminds his fellow members that the knowledge from taking a CPR/emergency first aid course is useful always and everywhere.

“You don’t bring just a hammer to a jobsite. The more tools you have in the toolbag, the more useful you are,” Baker said. “The more we know, the better off we are — it could be one of your co-workers whose life you save.

“It’s something I’ve always embraced.”

SMART-TD recognizes this as well. Within days of receiving conductor Hermann’s suggestion, Ralph Leichliter, an administrative assistant in the TD President’s Office, had reached out to Emergency University, which provides online training geared towards transportation employees, including courses on CPR, first aid, and additional training on the topics of blood-borne pathogens, heat-related illness and sleep and fatigue management.

Emergency University was established by highly trained emergency response professionals to educate people on life-saving measures in situations where immediate action is needed.

Multiple online course options are available through them, starting as low as $29.95. Choose the course you’d like and then enter the promotional code SMARTUNION at checkout. Successful completion of the online courses provides national certification for two years in CPR and first aid, meeting and exceeding the standards set forth by OSHA, the American Red Cross and the American Heart Association.

The descriptions for discounted packages, including the course package for rail/transportation workers, are available below:

By going through the Emergency University online training or taking part in CPR or first-aid training offered by organizations such as the American Red Cross or the American Heart Association, we can continue to prove every day, without a doubt, that the public, our co-workers and America’s roads and rails are safer with SMART-TD members aboard.

OSHA’s guide to working in cold weather

Winter weather presents hazards including slippery roads/surfaces, strong winds and environmental cold. Employers must prevent illnesses, injuries, or fatalities, by controlling these hazards in workplaces impacted by winter weather.

OSHA and National Oceanic and Atmospheric Administration (NOAA) are working together on a public education effort aimed at improving the way people prepare for and respond to severe weather.

Cold stress

It is important for employers to know the wind chill temperature so that they can gauge workers’ exposure risk better and plan how to safely do the work. It is also important to monitor workers’ physical condition during tasks, especially new workers who may not be used to working in the cold, or workers returning after spending some time away from work.

The NOAA Weather Radio is a nationwide network of radio stations broadcasting continuous weather information from the nearest NWS office. It will give information when wind chill conditions reach critical thresholds. A Wind Chill Warning is issued when wind chill temperatures are life-threatening. A Wind Chill Advisory is issued when wind chill temperatures are potentially hazardous.

Who is affected by environmental cold?

Environmental cold can affect any worker exposed to cold air temperatures and puts workers at risk of cold stress. As wind speed increases, it causes the air temperature to feel even colder, increasing the risk of cold stress to exposed workers, especially those working outdoors, such as recreational workers, snow cleanup crews, construction workers, police officers and firefighters. Other workers who may be affected by exposure to environmental cold conditions include those in transit, baggage handlers, water transportation, landscaping services, and support activities for oil and gas operations.

Risk factors for cold stress include:

  • Wetness/dampness, dressing improperly and exhaustion
  • Predisposing health conditions such as hypertension, hypothyroidism and diabetes
  • Poor physical conditioning

What is cold stress?

What constitutes cold stress and its effects can vary across different areas of the country. In regions that are not used to winter weather, near freezing temperatures are considered factors for “cold stress.” Increased wind speed also causes heat to leave the body more rapidly (wind chill effect). Wetness or dampness, even from body sweat, also facilitates heat loss from the body. Cold stress occurs by driving down the skin temperature, and eventually the internal body temperature. When the body is unable to warm itself, serious cold-related illnesses and injuries may occur, and permanent tissue damage and death may result. Types of cold stress include: trench foot, frostbite and hypothermia.

For more information, see OSHA’s Cold Stress Safety and Health Guide.

Types of Cold Stress

Immersion/Trench Foot

Trench foot is a non-freezing injury of the feet caused by prolonged exposure to wet and cold conditions. It can occur in temperatures as high as 60°F if feet are constantly wet. Injury occurs because wet feet lose heat 25-times faster than dry feet.

What are they symptoms of trench foot?

Reddening skin, tingling, pain, swelling, leg cramps, numbness and blisters.

First Aid

  • Call 911 immediately in an emergency; otherwise seek medical assistance as soon as possible.
  • Remove wet shoes/boots and wet socks.
  • Dry the feet and avoid working on them.
  • Keep affected feet elevated and avoid walking. Get medical attention.

Frostbite

Frostbite is caused by the freezing of the skin and tissues. Frostbite can cause permanent damage to the body, and in severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures.

What are the symptoms of frostbite?

Reddened skin develops gray/white patches in the fingers, toes, nose, or ear lobes; tingling, aching, a loss of feeling, firm/hard, and blisters may occur in the affected areas.

First Aid

  • Follow the recommendations described below for hypothermia.
  • Protect the frostbitten area, e.g., by wrapping loosely in a dry cloth and protect the area from contact until medical help arrives.
  • DO NOT rub the affected area, because rubbing causes damage to the skin and tissue.
  • Do not apply snow or water. Do not break blisters.
  • DO NOT try to re-warm the frostbitten area before getting medical help, for example, do not use heating pads or place in warm water. If a frostbitten area is rewarmed and gets frozen again, more tissue damage will occur. It is safer for the frostbitten area to be rewarmed by medical professionals.
  • Give warm sweetened drinks if alert (no alcohol).

Hypothermia

Hypothermia occurs when the normal body temperature (98.6°F) drops to less than 95°F. Exposure to cold temperatures causes the body to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up the body’s stored energy. The result is hypothermia, or abnormally low body temperature. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or immersion in cold water.

What are the symptoms of hypothermia?

An important mild symptom of hypothermia is uncontrollable shivering, which should not be ignored. Although shivering indicates that the body is losing heat, it also helps the body to rewarm itself. Moderate to severe symptoms of hypothermia are loss of coordination, confusion, slurred speech, heart rate/breathing slow, unconsciousness and possibly death. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know what is happening and won’t be able to do anything about it.

First Aid

  • Call 911 immediately in an emergency.
  • Move the worker to a warm, dry area.
  • Remove any wet clothing and replace with dry clothing. Wrap the entire body (including the head and neck) in layers of blankets; and with a vapor barrier (e.g. tarp, garbage bag) Do not cover the face.

If medical help is more than 30 minutes away:

  • Give warm sweetened drinks if alert (no alcohol), to help increase the body temperature. Never try to give a drink to an unconscious person.
  • Place warm bottles or hot packs in armpits, sides of chest, and groin. Call 911 for additional rewarming instructions.

Basic Life Support (when necessary)

Co-workers trained in cardiopulmonary resuscitation (CPR) may help a person suffering from hypothermia who has no pulse or is not breathing:

  • Call 911 for emergency medical assistance immediately.
  • Treat the worker as per instructions for hypothermia, but be very careful and do not try to give an unconscious person fluids.
  • Check him/her for signs of breathing and for a pulse. Check for 60 seconds.
  • If after 60 seconds the affected worker is not breathing and does not have a pulse, trained workers may start rescue breaths for 3 minutes.
  • Recheck for breathing and pulse, check for 60 seconds.
  • If the worker is still not breathing and has no pulse, continue rescue breathing.
  • Only start chest compressions per the direction of the 911 operator or emergency medical services*
  • Reassess patient’s physical status periodically.

*Chest compressions are recommended only if the patient will not receive medical care within 3 hours.

Wind Chill Temperature

Outdoor workers exposed to cold and windy conditions are at risk of cold stress, both air temperature and wind speed affect how cold they feel. “Wind chill” is the term used to describe the rate of heat loss from the human body, resulting from the combined effect of low air temperature, and wind speed. The wind chill temperature is a single value that takes both air temperature and wind speed into account. For example, when the air temperature is 40°F, and the wind speed is 35mph, the wind chill temperature is 28°F; this measurement is the actual effect of the environmental cold on the exposed skin.

National Weather Service (NWS) Wind Chill Calculator: With this tool, one may input the air temperature and wind speed, and it will calculate the wind chill temperature.

The American Conference of Governmental Industrial Hygienists (ACGIH) developed the following Work/Warm-up Schedule for a 4-hour shift that takes both air temperature and wind speed into account to provide recommendations on scheduling work breaks and ceasing non-emergency work.

Dressing Properly for the Cold

Dressing properly is extremely important to preventing cold stress. When cold environments or temperatures cannot be avoided, the following would help protect workers from cold stress:

  • Wear at least three layers of loose-fitting clothing. Layering provides better insulation.
    • An inner layer of wool, silk or synthetic (polypropylene) to keep moisture away from the body. Thermal wear, wool, silk or polypropylene, inner layers of clothing that will hold more body heat than cotton.
    • A middle layer of wool or synthetic to provide insulation even when wet.
    • An outer wind and rain protection layer that allows some ventilation to prevent overheating.
  • Tight clothing reduces blood circulation. Warm blood needs to be circulated to the extremities. Insulated coat/jacket (water resistant if necessary)
  • Knit mask to cover face and mouth (if needed)
  • Hat that will cover your ears as well. A hat will help keep your whole body warmer. Hats reduce the amount of body heat that escapes from your head.
  • Insulated gloves (water resistant if necessary), to protect the hands
  • Insulated and waterproof boots to protect the feet

Safety tips for workers

  • Your employer should ensure that you know the symptoms of cold stress
  • Monitor your physical condition and that of your coworkers
  • Dress appropriately for the cold
  • Stay dry in the cold because moisture or dampness, e.g. from sweating, can increase the rate of heat loss from the body
  • Keep extra clothing (including underwear) handy in case you get wet and need to change
  • Drink warm sweetened fluids (no alcohol)
  • Use proper engineering controls, safe work practices, and personal protective equipment (PPE) provided by your employer

Winter driving

Although employers cannot control roadway conditions, they can promote safe driving behavior by ensuring workers recognize the hazards of winter weather driving, for example, driving on snow/ice covered roads; are properly trained for driving in winter weather conditions; and are licensed (as applicable) for the vehicles they operate. For information about driving safely during the winter, visit OSHA’s Safe Winter Driving page.

Employers should set and enforce driver safety policies. Employers should also implement an effective maintenance program for all vehicles and mechanized equipment that workers are required to operate. Crashes can be avoided. Learn more at the Motor Vehicle Safety (OSHA Safety and Health Topics Page) .

Employers should ensure properly trained workers inspect the following vehicle systems to determine if they are working properly:

  • Brakes: Brakes should provide even and balanced braking. Also check that brake fluid is at the proper level.
  • Cooling system: Ensure a proper mixture of 50/50 antifreeze and water in the cooling system at the proper level.
  • Electrical system: Check the ignition system and make sure that the battery is fully charged and that the connections are clean. Check that the alternator belt is in good condition with proper tension.
  • Engine: Inspect all engine systems.
  • Exhaust system: Check exhaust for leaks and that all clamps and hangers are snug.
  • Tires: Check for proper tread depth and no signs of damage or uneven wear. Check for proper tire inflation.
  • Oil: Check that oil is at proper level.
  • Visibility systems: Inspect all exterior lights, defrosters (windshield and rear window), and wipers. Install winter windshield wipers.

An emergency kit with the following items is recommended in vehicles:

  • Cell phone or two-way radio
  • Windshield ice scraper
  • Snow brush
  • Flashlight with extra batteries
  • Shovel
  • Tow chain
  • Traction aids (bag of sand or cat litter)
  • Emergency flares
  • Jumper cables
  • Snacks
  • Water
  • Road maps
  • Blankets, change of clothes

Preventing slips on snow and ice

To prevent slips, trips, and falls, employers should clear snow and ice from walking surfaces, and spread deicer as quickly as possible after a winter storm. When walking on snow or ice is unavoidable workers should be trained to:

  • Wear footwear that has good traction and insulation (e.g. insulated and water-resistant boots or rubber over-shoes with good rubber treads)
  • Take short steps and walk at a slower pace to react quickly to changes in traction

Water. Rest. Shade. – OSHA’s campaign to keep workers safe in the heat

The Campaign

OSHA’s Heat Illness Prevention campaign, launched in 2011, educates employers and workers on the dangers of working in the heat. Through training sessions, outreach events, informational sessions, publications, social media messaging and media appearances, millions of workers and employers have learned how to protect workers from heat. OSHA’s safety message comes down to three key words: Water. Rest. Shade.

Dangers of Working in the Heat

Every year, dozens of workers die and thousands more become ill while working in extreme heat or humid conditions. More than 40 percent of heat-related worker deaths occur in the construction industry, but workers in every field are susceptible. There are a range of heat illnesses and they can affect anyone, regardless of age or physical condition.

Heat-related Illnesses and First Aid

Heat stroke, the most serious form of heat-related illness, happens when the body becomes unable to regulate its core temperature. Sweating stops and the body can no longer rid itself of excess heat.

Symptoms: Signs include confusion, loss of consciousness and seizures.

First Aid: Heat stroke is a medical emergency that may result in death! Call 911 immediately. While waiting for help place the worker in a shady and cool area; loosen clothing and remove outer clothing; fan air on the worker and place cold packs in armpits; wet the worker with cool water; provide fluids (preferably water) as soon as possible and stay with the worker until help arrives.

Heat exhaustion is the body’s response to loss of water and salt from heavy sweating.

Symptoms: Signs include headache, nausea or vomiting, dizziness, weakness, light headedness, irritability, thirst and heavy sweating.

First aid for heat exhaustion includes: have the worker sit or lie down in a cool, shady area; give the worker plenty of water or other cool beverages to drink; cool the worker with cold compresses or ice packs; if symptoms worsen or do not improve within 60 minutes, take the worker to a clinic or emergency room for evaluation; the worker should not return to work that day.

Heat cramps are caused by the loss of body salts and fluid during sweating. Low salt levels in muscles cause painful cramps. Tired muscles—those used for performing the work—are usually the ones most affected by cramps. Cramps may occur during or after working hours.

Symptoms include muscle spasms, pain usually in the abdomen, arms or legs

First aid for heat cramps include: have worker rest in a shady, cool area; worker should drink water or other cool beverages; wait a few hours before allowing the worker to return to strenuous work; have worker seek medical attention if cramps don’t go away.

Heat rash, also known as prickly heat, is skin irritation caused by sweat that does not evaporate from the skin. Heat rash is the most common problem in hot work environments.

Symptoms include clusters of red bumps on the skin, often appearing on the neck, upper chest and in folds of skin.

First aid includes keeping the worker in a cooler, less humid environment when possible and keeping the affected area dry.

Employer Responsibility to Protect Workers

Under OSHA law, employers are responsible for providing workplaces free of known safety hazards. This includes protecting workers from extreme heat. An employer with workers exposed to high temperatures should establish a complete heat illness prevention program.

  • Provide workers with water, rest and shade.
  • Allow new or returning workers to gradually increase workloads and take more frequent breaks as they acclimatize, or build a tolerance for working in the heat.
  • Plan for emergencies and train workers on prevention.
  • Monitor workers for signs of illness.

Resources

OSHA’s Occupational Exposure to Heat page explains what employers can do to keep workers safe and what workers need to know – including factors for heat illness, adapting to working in indoor and outdoor heat, protecting workers, recognizing symptoms and first aid training. Also look for heat illness educational and training materials on OSHA’s Publications page.