First-aid training not only makes good safety sense, but various compliance requirements call for rapid first-aid response. Compliance requirements come through the U.S. Department of Labor for both OSHA and its sister agency, the Mine Safety and Health Administration (MSHA). For those working in maritime occupations, there is the U.S. Standards of Training, Certification, and Watchkeeping for Seafarers (STCW), issued by the National Maritime Center of the U.S. Coast Guard. Additionally, British Columbia, Canada, has a Health Emergency Act, Emergency Medical Assistants regulation, that outlines the requirements for first responder and industrial first-aid training with various levels of competency.

Each agency has its own standards and its own time-oriented limits (rather than performance-oriented) for certification or completion. The standards are national in scope for the specific industry. There is no one national "standard" for all industries.

Overall, the intent is to ensure timely and rapid response to anyone injured in the workplace. OSHA requires a 3-4 minute response time to any emergency on-site. It can be by outside agencies if the response time can be met. Otherwise, the employer must train employees to respond. Should there be designated responders, the bloodborne pathogen standard must be addressed by the employer, as well.

The MSHA standards require that there be at least one person certified in first-aid on a mine site but that first-aid training must be made available, at the employer's expense, to any other employee desiring to be trained. This requirement applies even if there is only one person working, such as a maintenance person after regular business hours or a loader operator at a small site loading over-the-road trucks.

Topics, hours vary

Training topics and hours vary by agency. OSHA does not directly require CPR training as part of the first-aid outline, but the standard states that, "in the absence of an infirmary, clinic or hospital in near proximity (three minutes) 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." It then becomes obvious that CPR is a necessary part of the training package. To address the training requirements, including CPR, the training must follow nationally recognized standards, such as American Red Cross (ARC), National Safety Council (NSC), etc. This places the training at a minimum of eight hours.

MSHA does not require CPR training at all, but does require training in artificial ventilation. For a person with no first-aid background, the minimum acceptable timeframe is six hours. This matches the industrial first-aid requirements provided by the NSC and other similar agencies.

The STCW standard requires a minimum of 12 hours to be taught in the classroom and includes information related to water-related events in addition to basic first-aid.

Quality and costs

Quality of first-aid training is the biggest issue throughout the instructor selection process by the different agencies. Designated "commercial" instructors may have varying levels of proficiency in skills. Some instructors are trained emergency medical technicians or paramedics with response experience. Some are simply "certified" by a certifying agency and have little or no experience or poor communication skills.

First-aid training in the United States is very competitive. The cost of a six-hour industrial first-aid course can vary, depending on the provider. A company needing training should make at least two to three phone bids. Keep in mind, however, that "lowest bid" does not necessarily constitute the best deal.

Books and material replacement costs may be extra, depending on the instructor and certification. For example, the ARC certifies instructors and requires them to purchase and use ARC materials to provide a certificate. The NSC has similar requirements for its instructors. Though the federal standards do not require certification from a specific agency, some employers will request a specific certifying course for their employees. This requires the instructor to be certified by that agency and use the agency's textbooks and materials. This does not suggest quality of presentation or instruction, but it will follow the agency's outline and use the agency's textbook.

Instructor skills

Some agencies certify the instructor skills of the person and allow the instructor to obtain materials from other sources. For example, MSHA certifies instructors through a three-day minimum certification course. Once certified, the first-aid instructor may use the MSHA first-aid materials or use books and materials from other first-aid publishing sources, such as Brady Publishing. Brady is just one example of an agency that publishes its own first-aid and emergency medical technician textbooks, following nationally recognized standards. The first-aid text also comes with course completion cards that the instructor can issue to the participants at the end of the course.

The employer must find an instructor, based on instructor credentials, knowledge, skill level, etc. The instructor may be dynamic, or could be a "snoozer" that issues a certification card from a sponsoring agency simply because he/she is certified by that agency. Having the credentials to instruct does not constitute skill or quality of presentation. And for some, knowledge levels may vary, as well. For this reason, many employers seek instructor credentials for an employee so training can be done at their convenience with their own quality standards in place, at a cost of materials only.

Other options for locating instructors is to contact the ARC area chapters (first-aid and CPR), the American Heart Association (AHA) area chapters (CPR-certified instructors), or commercial vendors (try the local phone book). Another option is to contact the state agency that certifies Emergency Medical Technician Instructors and get a list of those who are within your local area. They will have the enhanced knowledge and skill level with actual response experience since they must already be EMTs to be certified as instructors and run with their local rescue or fire department(s).

Compliance within reach

As long as the instructor knows and meets the industry requirements for which he/she is providing first-aid training, the opportunities for compliance are well within the reach of employers. Issues such as cost, quality and materials vary greatly between instructors, and going through a certifying agency is no guarantee the employer will get what it pays for in these areas. If an employer does a little homework, there could easily be qualified instructors within the community that will provide the level of skills, knowledge and ability necessary to conduct a quality course.

With a quality instructor, the employer gains direct and indirect benefits that can be far greater than the "cost" of conducting the training to meet compliance requirements.

SIDEBAR: Why have first-aid training?

• Inexpensive way to increase employees' safety awareness.
• Ensures prompt emergency care in case of an injury or illness in the workplace.
• Enhances employees' response and reaction to other workplace emergencies.
• Increases the survival/recovery rate of the injured person(s).
• Enables the trained person to better respond to family emergencies.
• Can potentially lower employer's insurance costs.
• Increases compliance with workplace standards.