The program should use hands-on practice and visual aids so trainees build real skills through practice and observation. The guideline in 1918AppV recommends using manikins and trainee partners for hands-on work, videos or slides to show acute settings, and a workbook that discusses first-aid principles and workplace-specific situations.
Training time should be long enough to emphasize the situations likely to occur at that specific workplace. 1918AppV advises tailoring course duration so instructors can focus on incidents workers are most likely to face.
Training must cover injury/acute illness, how to work with local emergency services, triage principles, and legal aspects of giving first aid. The guideline in 1918AppV lists these as core instructional topics so responders know when to call for help, how to prioritize victims, and the legal issues involved.
Trainees should learn to assess scene safety, estimate number of injured, identify helpers, and perform primary and secondary victim surveys. 1918AppV specifies instruction on general scene safety, likely event sequence, airway/breathing/circulation checks, taking a victim history, and checking vital signs and body systems during a secondary survey.
Basic adult CPR training should be included and retesting should occur every year. The guideline in 1918AppV recommends yearly retesting for CPR skills and procedures.
Trainees should learn how to open and maintain an adult airway, perform breathing and circulatory resuscitation, handle choking, and resuscitate drowning victims. 1918AppV lists these items as required components of basic adult CPR instruction.
Trainees should be taught bandaging for head, chest, shoulder, arms, legs, hands, feet, fingers, toes, and knees and splinting for common fractures and injuries from fingers to femur. 1918AppV specifies specific body sites and splint types that the program should cover so responders can immobilize and protect injuries.
Training should teach safe one- and two-person lifts, ankle and shoulder pulls, and blanket pulls for moving victims. The guideline in 1918AppV recommends these techniques so rescuers can move victims without causing further injury when necessary.
Trainees must learn what universal precautions are, which body fluids are potentially infectious, the value of precautions for diseases like AIDS and hepatitis B, and the need to keep gloves and protective equipment available. 1918AppV also calls for providing a copy of or information on OSHA’s bloodborne pathogens standard and training on proper disposal of contaminated sharps and blood-soaked materials.
The designated first aid provider is responsible for determining the type, amount, and maintenance of supplies, and these supplies must be kept in a convenient area for emergency access. 1918AppV sets this expectation so supplies are appropriate for the worksite and available when needed.
Competency should be assessed by instructor observation of hands-on skills and written performance tests, and skills and knowledge should be reviewed every three years. The guideline in 1918AppV requires both practical and written assessments and periodic review to maintain readiness.
The training program should be periodically reviewed and updated to reflect current first aid techniques and knowledge, with outdated material removed or replaced. 1918AppV emphasizes regular program updates to keep training current.
Trainees should be instructed on shock from injury and allergic reactions and how to assess and treat a person who has fainted. 1918AppV lists these topics so responders can recognize shock signs and apply appropriate first aid measures.
Training should teach recognition of bleeding types (arterial, venous, capillary, internal/external) and interventions like direct pressure, pressure points, elevation, and pressure bandaging. 1918AppV requires these techniques so responders can stop life-threatening blood loss.
Trainees should learn infection precautions, how to identify wounds that need medical attention, and when tetanus prophylaxis is necessary. The guideline in 1918AppV includes wound care principles and guidance on recognizing wounds requiring professional medical follow-up.
Training should cover alkali/acid/systemic poisons, inhaled poisons (CO, smoke, chemical fumes), topical poisons (poison ivy, pesticides), and drugs of abuse; and trainees must know when and how to contact the local Poison Control Center. 1918AppV also advises instruction on plant-specific chemicals, MSDS locations, and antidote supplies.
Trainees should learn to assess the toxic risk to themselves and understand the potential need for respiratory protection before entering a contaminated area. 1918AppV specifically calls out inhaled poisons and the importance of rescuer safety and respirators when needed.
Trainees should be taught how to assess burn severity (first, second, third degree) and to differentiate thermal, electrical, and chemical third-degree burns, with special emphasis on chemical burns and workplace-specific chemicals. 1918AppV highlights chemical burns because they often need unique interventions.
Instruction should include cold exposure (frostbite, hypothermia) and heat exposure (heat cramps, heat exhaustion, heat stroke) and their first aid care. The guideline in 1918AppV recommends teaching recognition and treatment for both heat- and cold-related emergencies.
Programs should teach care for open and closed fractures and splinting, recognition of dislocations vs. fractures, joint sprains, muscle strains, contusions, cramps, and head/neck/spinal injury precautions. 1918AppV emphasizes splinting and differentiating injuries to avoid causing further harm.
Trainees should learn first aid for human/animal bites and insect bites/stings, recognize signs of anaphylactic shock, and know responses including emergency care and when rabies or tetanus prophylaxis is required. 1918AppV includes these topics to prepare responders for potentially severe allergic reactions.
Training should cover heart attacks, strokes, asthma attacks, diabetic emergencies (including hyper- and hypoglycemia), and seizures, including the importance of not placing objects in a person’s mouth. 1918AppV lists these common medical crises and appropriate first-aid responses.
First aid personnel must be trained on the danger of entering confined spaces without proper respiratory protection and must receive additional training if they will assist with evacuations from confined spaces. 1918AppV warns that confined-space rescues require more training and protective equipment.
Trainees should learn to manage foreign bodies, corneal abrasions, lacerations, and chemical burns, and the importance of flushing the eye thoroughly and not applying antibiotics without a physician’s supervision. 1918AppV highlights immediate irrigation for chemical exposures and appropriate referral.
Trainees should be instructed on how to properly handle and transport amputated fingers, hands, or feet and on identifying local hospitals with amputation care capability. 1918AppV recommends preparing responders so the victim and amputated part receive proper, timely care.