Building In House Capability, Part 2

Putting together an emergency response plan for your company can go a long way toward helping everyone work as a team on many levels.

• By Tom Lindtveit
• Feb 01, 2011

Part 1 of this article was published in the January 2011 issue of Occupational Health & Safety. In Part 2, we continue our discussion of minimizing the hidden costs of workplace emergencies and ensuring proper planning and training.

Step 4: Plan the work.
Here's where you lay out the plan and decide what suits your facility best. Don't be afraid to do a little "dreaming" here and include what you would like to see. Just make these items a later phase of the plan. These things don’t happen overnight and they are continuing "work in progress." In addition, you will learn things as you progress. If you in fact do handle a few medical emergencies, you will quickly find ways to make improvements and tweaks in your plan.

The plan should include what level of training is expected, what the response procedures will be, how to get the responders notified of the incident and where it is, how to make sure any incoming Services can find the location quickly, and many other things that will be company specific. Making the plan is something that many facilities struggle with and many "experts" have diverse opinions on the right way to do it. Find what works best for you, set out a plan, and tweak it as you go. As your people become trained, and begin to practice their skills, they will form opinions on what can make things better. Listen to them. There are no "right answers" here; just find what works for your company and keep re-evaluating.

Step 5: Work the plan.
Once your program has been planned, you should know what training is needed. Now you need to find a way to get it for your people. Use caution and forethought here. Many training programs are available and most are set up to meet "the requirements." Remember that your goal is to meet the needs of your facility and your co-workers. Ask potential training groups what their curriculum covers and decide if it meets your needs. Find out what the instructor's qualifications and experience is. Do these folks provide emergency care everyday, or are they just "trainers" who know the course content?

I was once in a company that had hired a trainer to come in and teach CPR for an 8 hour class. At lunch time I stopped by to speak with the instructor and as a parting remark I asked her to be sure she explained the issue of gastric distention and what to do about it should it occur. She looked at me in a quizzical manner and confessed that she had no idea what I was talking about. I explained how it occurs (blowing air into the stomach instead of the lungs) and what the result often is (expelling the built up pressure in the form of vomit which occludes the airway and compounds the challenges of resuscitation), as well as the possible ‘work-arounds’. She said "Wow, that's nice to know. I heard somebody mention that once that has actually done CPR, but I have never done it myself." I said, "You've never seen a gastric distention problem?" And she said, "No, I've never done CPR." Now, think about that for a minute. We are hiring people to teach us lifesaving techniques which they (the instructors) have absolutely no firsthand knowledge of. Choose your instructors carefully. An experienced instructor can make the class much more meaningful and pointed by sharing their first hand experience and knowledge. They can also "cut to the chase" and bring out the reality of handling emergencies in the real world. You find these folks in your local emergency services organizations, fire departments, colleges that have medical programs, hospitals, and rescue squads. Work outside the box a little here to bring in an EFFECTIVE trainer.

You will also need to purchase your equipment and supplies, AEDs, oxygen, or whatever else you have laid out in your plan. Don't forget to consider training equipment. Getting a "trainer" version of the AED you have selected will allow you to do frequent and less formal refresher sessions. Perhaps a brush up from time to time would suit your needs better than formal scheduled training sessions to keep things fresh between re-certification periods.

Step 6: Test the plan.
So now you've decided what you need, you've found a great instructor and have gotten your "core crew" trained to help respond in an emergency. You're good to go right? Well, again, if you're looking to meet the minimum requirements you are probably OK, assuming you have documented everything. But if you are truly intending to put a working program in place you have a little more to do. Your people are trained, you know that because they sat through the class, but how do you know they can do they job? More importantly, how do THEY know they can do the job? You need a drill to see what you have and again, more importantly, THEY need a drill to see what they can do and build a little confidence.

Good drills are performed separate from the training by several weeks or months. This allows time for the training and skills to soak in or possibly fade away. Either way, a good drill properly timed will provide an eye-opener for the responding personnel. This is where the "rubber meets the road." If they perform well, both you and they will know it, if they miss the mark, they will know it before you can observe it. Staging a good drill is a whole subject unto itself but some basic points are: Avoid using "live" patients until your responders are very experienced (any live patient you have will most likely be someone the rescuers know and the ensuing interaction will distract from the issue at hand), rescue mannequins are better (borrow one from the fire department). Make the scenario plausible and SIMPLE. (The goal is to evaluate basic response, not break the confidence of your responders). Have a WRITTEN PLAN which includes A) the goals of the drill, B) the scenario itself, C) the expected response, D) a check sheet listing the main points of care expected for the scenario as well as any important time stamps (ie: AED shock administered within "X" minutes), and E) Review items to be mentioned during the debriefing after the drill. Good drills are completed within 30 minutes and everybody is back to work in that time frame. This allows for minimal work disruption, but keeps the crew in good form. ALL drills should end on a positive note. Keep in mind that these people are going "above and beyond" by putting themselves "out there" to do what they can for their co-workers in a time of need. You should never take this for granted. In the beginning you should focus on the very basic points (Did we make the 911 call quickly? Did we bring the tools we needed, such as a kit or an AED? Did we send somebody to guide in the ambulance crew? If your drill was well planned and executed, the responders themselves will be their own worst critics, don’t let them go too far until they begin to get really proficient. You'll know when that is.

Putting together an Emergency response plan for your company can go a long way to helping everyone work as a team on many levels. The benefits gained by minimizing the effect of an illness or injury to an employee is just one aspect. Having everyone know that the company is doing everything they can to ‘walk the walk’ helps morale as well. In the event of a tragedy, employees will be much less likely to blame the company.

Of course, in the best case, you may have the opportunity to save an employee who otherwise might not have survived. Now how would that make you feel?

This article originally appeared in the February 2011 issue of Occupational Health & Safety.