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Inviting Injury
EMTs Joe and Lisa respond to a motor vehicle collision involving entrapment. Before leaving the station, Lisa dons her protective coat, pants, helmet and gloves. Joe, as usual, jokes with Lisa about her wearing the PPE. Lisa informs Joe that the PPE is for their protection and he should wear the gear, but he just shrugs off her comments. On scene, Lisa and Joe enter the same vehicle to extricate a patient. During rescue operations, Joe is hit on the head by a piece of car being removed by the rescue team and sustains a scalp laceration that eventually requires sutures. After the incident, Lisa confronts Joe about not wearing his helmet (let alone any other PPE); Joe tells Lisa that his injury is just part of the job.
Too often, responders fail to use PPE. Perhaps they think they won’t be injured, or that putting on the PPE takes too much time. Neither of these beliefs could be further from the truth.
Scope
Personal protective equipment offers a single objective: to provide for the safety of the emergency responder. Often referred to as PPE, it provides responders resounding protection from the elements and the many hazards confronted during daily activities. The most familiar PPE includes coats, helmets, gloves, eye protection and footwear. From clinical regimens and collision-scene operations to infectious disease exposure, PPE use should be stressed. When responders fail to wear PPE, or wear it inappropriately, they invite injury. The most important questions every emergency responder must ask themselves are:
- Do you wear the right PPE gear?
- Do you wear the right PPE the right way?
Many standards exist for PPE design, construction and use, including OSHA 1910.32 and 1910.1030 and National Fire Protection Association (NFPA) 1500 and 1581. The Centers for Disease Control and Prevention (CDC), the National Institute for Occupational Safety and Health (NIOSH) and the American National Standards Institute (ANSI) also have national PPE standards.
Whether or not you are required to comply with any of these standards is not as important as the possibility that you or your organization will be benchmarked against them. For instance, OSHA requires employers to use personal protective equipment to reduce employee exposure to hazards. Thus, employers are required to determine all exposures to hazards in their workplace and determine if PPE should be used to protect their workers.
OSHA also states that if PPE is to be used to reduce employee exposure to hazards, a PPE program should be maintained that identifies and evaluates hazards in the workplace and determines whether PPE use is an appropriate control measure. In addition, OSHA specifies that employers must provide training to employees using PPE and be vigilant in determining the program’s effectiveness for preventing employee injury or illness.
The general requirements for OSHA 1910.132 state that: “Protective equipment, including personal protective equipment for eyes, face, head and extremities, protective clothing, respiratory devices and protective shields and barriers, shall be provided, used, and maintained in a sanitary and reliable condition wherever it is necessary by reason of hazards of processes or environment, chemical hazards, radiological hazards, or mechanical irritants encountered in a manner capable of causing injury or impairment in the function of any part of the body through absorption, inhalation or physical contact.” This statement can be applied to much of what emergency response personnel do on a daily basis.
The OSHA standard also addresses hazard identification, employer vs. employee-provided PPE, design and construction, maintenance, fit-testing, how to handle damaged PPE and training.
The CDC also offers a PPE program on its website (referenced below) that addresses: hazard assessment and PPE selection; responsibilities of employees and supervisors; employee training and recordkeeping.
Summary
PPE equals one thing: personal safety. Employers must ensure that responders are provided with applicable PPE and taught how to use it for the incidents and environments they may encounter. Responders who fail to wear PPE or wear it inappropriately invite injury. Employers should not assume that responders know how or even when to use certain PPE—regular in-service training should be provided.
As a responder, you have a responsibility to always undertake safe actions. If you follow this monthly column, you have no doubt heard me say repeatedly that nothing, absolutely nothing, supercedes safety. You are not an expendable resource. Wear your PPE and, most important, wear it the right way.
Resources
- www.osha.gov/SLTC/personalprotectiveequipment/.
- www.cdc.gov/od/ohs/manual/pprotect.htm#protective%20devices.
