Medical services and first aid

Under 1926.50(a), the employer must ensure that medical personnel are available to give advice and consultation on occupational health matters. The regulation states this obligation explicitly in 1926.50(a).

• Practical steps: identify and contract with a licensed occupational health provider or medical consultant; make a clear point-of-contact for employees and supervisors; document the arrangement and how to contact the medical resource.
• Why this matters: having medical personnel available helps employers evaluate workplace health concerns, advise on exposures, and support workers' medical needs related to the job.

(See 1926.50(a).)

Under 1926.50(b), the employer must make provisions before the project starts to assure prompt medical attention in case of serious injury. The rule requires planning to be completed prior to commencing the project, as stated in 1926.50(b).

• Practical actions: identify the nearest hospital/clinic with driving times, arrange transport (company ambulance vehicle, contract ambulance, or other means), set up onsite communications, and brief supervisors and workers about the plan.
• Document the plan and review it if site conditions change (e.g., new access routes, remote locations, multiple dispersed crews).

(See 1926.50(b).)

Under 1926.50(c), if there is no reasonably accessible infirmary, clinic, hospital, or physician available for treatment, the employer must have at the worksite a person with a valid certificate in first-aid training from the U.S. Bureau of Mines, the American Red Cross, or equivalent training that can be verified by documentary evidence. This requirement is set out in 1926.50(c).

• Accepted training: a valid certificate from the listed providers or documented, verifiable equivalent training (course name, trainer, syllabus, and certificate).
• “Reasonably accessible” means accessible in terms of time and distance; if a medical facility can’t promptly treat injured employees, a trained first-aid person must be available onsite.

(See 1926.50(c).)

Under 1926.50(c), "equivalent training" is any first-aid training that provides the same skills as the named programs and can be verified by documentary evidence; the employer must retain that documentary evidence. The rule requires verification in 1926.50(c).

• Practical documentation: keep the trainee’s certificate, course syllabus or lesson plan, instructor credentials, training date(s), and training provider contact information.
• Employer action: review the course content to confirm it covers essential first-aid skills (bleeding control, CPR basics if applicable, shock management, etc.) and retain records with your safety documentation.

(See 1926.50(c).)

Under 1926.50(d)(2), employers must place first-aid kit contents in a weatherproof container with individually sealed packages for each type of item and check the kit before sending it out on each job and at least weekly on each job to replace expended items. The accessibility requirement is stated in 1926.50(d).

• Practical steps: inspect kits before each shift or when moving to a new jobsite, perform a weekly checklist, replace opened/expired items immediately, and store kits in weatherproof boxes with labeled, sealed packages to prevent contamination.
• Recordkeeping: keep a simple log of checks (date, inspector, items replaced) to show compliance.

(See 1926.50(d)(2) and 1926.50(d)(1).)

Under 1926.50(d)(1), "easily accessible" means first-aid supplies must be located so they can be reached quickly when needed at the worksite. The requirement is stated at 1926.50(d)(1).

• Practical guidance: place kits where crews normally work (trailers, equipment cabs, central tool areas), mark their locations clearly, and ensure keys or locked boxes are not barriers to access during an emergency.
• For mobile crews: carry a designated kit on vehicles or with a trained responder so supplies are immediately available.

(See 1926.50(d)(1).)

Under 1926.50(e), the employer must provide proper equipment for prompt transportation of the injured person to a physician or hospital, or a communication system for contacting necessary ambulance service. This requirement is in 1926.50(e).

• Practical options: company vehicle with a trained attendant, a contract with local ambulance services, clearly assigned drivers, and radios or cell phones to summon help.
• Ensure the chosen method gets the injured worker to appropriate care quickly, and test communications regularly.

(See 1926.50(e).)

Under 1926.50(f)(1), the employer must conspicuously post the telephone numbers of physicians, hospitals, or ambulances where 911 emergency dispatch is not available. This is required by 1926.50(f)(1).

• Practical steps: post a clearly visible sign at the site entrance and in the jobsite office/tool trailer with up-to-date emergency phone numbers, addresses, and directions to the nearest medical facility.
• Keep a current list in the supervisor’s field packet and on jobsite communication devices.

(See 1926.50(f)(1).)

Under 1926.50(f)(2), the employer must (1) ensure the communication system effectively contacts emergency-medical service; and (2) when the local 911 system does not automatically provide location coordinates, conspicuously post either the worksite latitude/longitude or other location-identification information that employees can use to communicate the worksite location. These requirements are found in 1926.50(f)(2) and its subparts.

• Make sure radios/cell phones reliably reach EMS and test them before work begins.
• If 911 cannot auto-locate the caller, post latitude and longitude or other clear location details so workers can provide location information quickly.

(See 1926.50(f)(2), 1926.50(f)(2)(i), and 1926.50(f)(2)(ii)(A).)

Under 1926.50(f)(2)(ii)(A), the employer must post either the latitude and longitude of the worksite or other location-identification information that effectively communicates the worksite location to employees. This is stated in 1926.50(f)(2)(ii)(A).

• Examples of "other location-identification information": mile markers on nearby highways, nearest street intersections with directions, GPS coordinates formatted for emergency dispatch, or a marked map showing site access routes.
• Post this information conspicuously at the worksite entrance and in jobsite offices so employees can read it under stress.

(See 1926.50(f)(2)(ii)(A) and its subparts.)

Under 1926.50(f)(2)(ii)(B), the posting requirement does not apply to worksites that have readily available telephone land lines where 911 service automatically identifies the location of the caller. This exception is in 1926.50(f)(2)(ii)(B).

• Practical implication: if your site has a working landline connected to a 911 service that auto-detects the caller’s location, you do not need to post lat/long or other location-identification information.
• Still useful: keep alternative location details available in case mobile callers cannot be automatically located.

(See 1926.50(f)(2)(ii)(B).)

Under 1926.50(g), the employer must provide suitable facilities for quick drenching or flushing of the eyes and body within the work area for immediate emergency use whenever eyes or body may be exposed to injurious corrosive materials. This requirement appears in 1926.50(g).

• Practical guidance: install emergency eyewash stations and safety showers that are immediately accessible (typically within seconds/minutes), ensure they are clearly identified, unobstructed, and supplied with sufficient tepid flushing fluid.
• Maintain and test the equipment regularly, and train employees on its location and use.

(See 1926.50(g).)

Under 1926.50(c), the employer must ensure a qualified first-aid person is available whenever a medical facility is not reasonably accessible; the number of trained persons should be based on site layout, travel time to medical care, crew sizes, and the hazards present. The basic requirement is in 1926.50(c).

• Practical approach: perform a site-specific hazard and access assessment (considering number of employees, shift coverage, distances between crews, and severity of potential injuries) to decide how many trained responders are needed.
• Employers should document the assessment and placement of trained personnel; OSHA guidance on hazard assessment emphasizes evaluating workplace hazards to determine protections needed (see the PPE hazard assessment interpretation at https://www.osha.gov/laws-regs/standardinterpretations/2024-03-28).

(See 1926.50(c) and OSHA's interpretation on hazard assessment: https://www.osha.gov/laws-regs/standardinterpretations/2024-03-28.)

No; under 1926.50(c) the employer must have a person with a "valid certificate" in first-aid training available, so an expired certificate does not meet the requirement. The rule requires a valid certificate as stated in 1926.50(c).

• Practical note: employers should track certificate expiration dates and arrange timely refresher training to maintain valid certification.
• Training frequency: OSHA does not mandate a specific retraining interval for CPR and first aid in general, but in guidance OSHA recommends regular retraining (for CPR/AED many programs recommend annual refreshers); see OSHA's CPR retraining interpretation at https://www.osha.gov/laws-regs/standardinterpretations/2023-02-23 for more context.

(See 1926.50(c) and OSHA's CPR retraining interpretation: https://www.osha.gov/laws-regs/standardinterpretations/2023-02-23.)

If cellphone coverage and 911 are unavailable, the employer must provide appropriate transportation or another effective communication method and conspicuously post the phone numbers of physicians, hospitals, or ambulance services under 1926.50(e) and 1926.50(f)(1).

• Practical options: arrange a contract with a local ambulance service, station a vehicle onsite for rapid transport, provide two-way radios that reach dispatch, or designate a runner/driver with clear directions to the nearest medical facility.
• Post emergency contact numbers and the plan for summoning/transporting injured workers where they are visible to all staff.

(See 1926.50(e) and 1926.50(f)(1).)

No; 1926.50(d)(2) does not list specific items, but it does require that first-aid kit contents be in a weatherproof container with individually sealed packages and be checked before each job and at least weekly. The content specifics are not prescribed in the text of 1926.50(d)(2).

• Practical guidance: employers should follow the recommendations of qualified first-aid training providers (American Red Cross, Bureau of Mines, or equivalent) to determine appropriate kit contents based on job hazards and crew size.
• Keep a hazard-based checklist that ensures the kit contains items needed for likely injuries at that site (e.g., bandages, burn dressings, splints, gloves, and antiseptics as appropriate).

(See 1926.50(d)(2).)

Under 1926.50(b), "prompt medical attention" means that before work begins the employer has arranged a way to quickly get seriously injured workers medical care—either by ensuring a nearby medical facility is reasonably accessible or by providing onsite first-aid responders and prompt transport/communication. The requirement appears in 1926.50(b).

• Practical indicators of promptness: medical facility reachable within a short, pre-determined response time given the injury risk; immediate access to a trained first-aid person; an effective method to summon and reach EMS or transport the injured worker.
• Employers should document the plan (facility names, transport arrangements, on-site responder assignments) and revise it if site conditions change.

(See 1926.50(b), 1926.50(c), and 1926.50(e).)

No, 1926.50 does not mandate a specific retraining interval for CPR or first-aid; it requires that a person with a valid first-aid certificate be available when medical facilities are not reasonably accessible, but it does not set how often retraining must occur. This is consistent with OSHA's position in its CPR retraining interpretation (https://www.osha.gov/laws-regs/standardinterpretations/2023-02-23) and the text of 1926.50(c).

• Practical recommendation: while OSHA does not mandate a retraining schedule, many first-aid and CPR providers recommend regular refreshers (often annually) to ensure skills remain current; employers should adopt a schedule that maintains responder competence.
• If a specific OSHA standard applicable to your work (e.g., confined spaces, logging, power operations) requires training frequency, follow that standard.

(See 1926.50(c) and OSHA's CPR retraining interpretation: https://www.osha.gov/laws-regs/standardinterpretations/2023-02-23.)

Under 1926.50(f)(2)(i), employers must ensure the communication system effectively contacts emergency-medical service; testing should include real-world checks with local EMS to confirm calls or radio messages reach dispatch and that response directions are understood. The duty to ensure effectiveness is in 1926.50(f)(2)(i).

• Practical test steps: periodically place test calls or radio checks during non-emergency times, confirm that the dispatcher receives location details and estimated response times, and document those tests and any corrective actions.
• If the system fails tests, implement alternatives (backup radios, landlines, satellite phones, posted location info) until the system is reliable.

(See 1926.50(f)(2)(i) and 1926.50(f)(2).)