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Issued March 30, 2004; Revised November 1, 2004; Revised January 1, 2010
First aid attendants are an essential part of the first aid services required for workplaces under Part 3 of the Occupational Health and Safety Regulation ("OHSR"). This standard explains how a person becomes certified to act as an attendant, the terms and conditions of certification, the general responsibilities of the attendant in the workplace, and the disciplinary actions the Workers' Compensation Board of B.C. ("Board") may take if an attendant does not meet his or her responsibilities.
Section 3.14 of the OHSR defines "first aid attendant" as
a person who holds a valid first aid certificate issued by the board or by a person recognized by the board and who is designated as a first aid attendant by the employer
The Board recognizes three types of Occupational First Aid attendants: Level 1, Level 2, and Level 3. There is also a Transportation Endorsement available to Level 1 and 2 attendants.
The Board has recognized certain training agencies throughout British Columbia as being authorized to teach first aid training programs and certify attendants who successfully complete the programs. A list of these agencies may be found on the WCB web site: www2.worksafebc.com/PDFs/FirstAid/ FirstAid_training_providers.pdf
Section 3.15 of the OHSR sets out first aid attendant qualifications:
The employer must ensure that a person who is designated as a first aid attendant
(a) is at least 16 years old,
(b) has successfully completed the first aid training course or first aid examination developed or approved by the board,
(c) has a first aid certificate in good standing at the required level issued by the board or a person recognized by the board, and
(d) meets any other requirements determined by the board for designation as a first aid attendant.
To qualify for a Level 1, 2, or 3 certificate, a person must be at least 16 years old.
A person 16 years or older and under 19 years may obtain a Level 2 or 3 certificate in the same way as a person 19 years or older. However, until the holder reaches the age of 19, the Board does not recognize that certificate as qualifying the person to act as a designated attendant in the workplace. That person may provide first aid while under the supervision of the designated attendant at the workplace.
Proof of age may be required by a person or organization authorized by the Board to examine candidates. If a candidate under 16 years of age takes the examination and is successful, the examination will be considered void and any certificate cancelled. The candidate will have to repeat the certification process when of age.
To qualify for a Level 1 certificate or a certificate endorsement a candidate must successfully complete the training course or its equivalent as taught and evaluated by a person authorized by the Board. The Level 1 and the Transportation Endorsement courses are each 7 hours in length.
To qualify for an initial Level 2 or 3 certificate, a candidate must successfully complete a Level 2 or 3 training course or its equivalent, and achieve a grade of at least 70% on each of the written, oral, and practical portions of the examination conducted by a person authorized by the Board. The length of the Level 2 course is 36 hours and the Level 3 course is 70 hours.
Failure in any part of the written, oral, or practical examination or failure to complete an examination is considered a failure of the whole examination. Candidates will be required to sit the examination again in its entirety (written, oral, and practical), regardless of marks obtained in various segments in the first exam.
Persons holding a current advanced first aid certificate (a first aid or pre-hospital emergency care course consisting of approximately 70 hours) may challenge the exam. Candidates are advised that, depending on the nature of the course, there may be equipment, protocol, and procedure (e.g. patient record) differences that impact exam results.
Should the second examination also result in failure, the candidate must undergo a full course of instruction prior to being eligible for another examination.
On written request from an employer of a health care facility, a Level 2 certificate may be issued to a physician or registered nurse who has
(a) at least 6 months experience in an emergency department, or
(b) successfully completed a recognized course of training in emergency procedures.
The physician or registered nurse to whom a Level 2 certificate is issued must be licensed to practice in B.C.
The experience or training required must have been completed not more than 24 months before the request for certification. A "recognized course of training in emergency procedures" for physicians includes advanced trauma life support. For registered nurses, it includes post-graduate emergency nursing and critical care nursing. The Level 2 certification granted is restricted for use in health care facilities and is not transferable to other industries.
On written request from an employer, to a person or organization authorized by the Board, a Level 1 or 2 certificate will be issued to a firefighter who holds an EMA FR Licence as follows:
(a) EMA FR Level II Licence = Level 1 certificate
(b) EMA FR Level III Licence = Level 2 certificate
"EMA FR" means an Emergency Medical Assistant First Responder licence issued under the Health Emergency Act.
The certificates granted are restricted to the fire service industry and are not transferable to other industries. "Fire service industry" means municipal fire departments. It does not cover crews engaged in forest fire fighting.
Level 1 certificates and certificate endorsements are valid for three years from the date of completion of a training course.
Level 2 and 3 certificates are valid for three years from the date of the examination.
Extensions of the duration of certificates are not permitted.
Except as stated below, to renew a certificate or Transportation Endorsement a candidate must meet the same training and examination requirements as for initial certificates.
A candidate for renewal of a Level 2 or 3 certificate may take the examination without retaking the initial certification course if less than 2 years has elapsed since the expiry of the certificate. Another option for Level 3 attendants is to take a 35-hour refresher course before taking the examination.
An application for certification as an attendant, or renewal of certification, may be denied or a restricted certificate may be granted on the grounds of
(a) the findings of a medical examination by a physician,
(b) the performance of the candidate in the first aid examination, or
(c) past failures to comply with the terms and conditions of certification or to properly fulfill the responsibilities of an attendant.
The attendant must
(a) follow the principles of first aid treatment as outlined in the Board's Occupational First Aid training programs that are provided to the attendant when he or she participates in the training program,
(b) comply with the OHSR, and the other responsibilities of attendants in this standard, and
(c) comply with any other terms and conditions provided to the attendant by the training agency when granted certification, or provided to the attendant by the Board at any other time.
Section 3.21 of the OHSR sets out the main responsibilities of attendants as follows:
(1) The first aid attendant must
(a) promptly provide injured workers with a level of care within the scope of the attendant's training and this Part,
(b) objectively record observed or reported signs and symptoms of injuries and exposures contaminates covered by this Regulation, and
(c) refer for medical treatment workers with injuries considered by the first aid attendant as being serious or beyond the scope of the attendant's training.
(2) A first aid attendant must be physically and mentally capable of safely and effectively performing the required duties, and the board may at any time require the attendant to provide a medical certificate.
(3) A first aid attendant is responsible, and has full authority, for all first aid treatment of an injured worker until responsibility for treatment is accepted
(a) at a place of medical treatment,
(b) by an ambulance service acceptable to the board, or
(c) by a person with higher or equivalent first aid certification.
(4) The first aid attendant does not have authority to overrule a worker's decision to seek medical treatment or the worker's choice of medical treatment.
In addition to the attendant's general responsibilities, there are several specific responsibilities:
The attendant's certificate must be shown to the employer or the employer's representative before the attendant begins first aid duties.
The attendant must have his or her certificate at the workplace and must produce the certificate for inspection at the request of an officer of the Board.
A photocopy or other reproduction of a certificate is not acceptable as proof of certification.
Section 3.18 sets out requirements for communication and availability. There must be an effective means of communication between the attendant and the work areas served. There must also be an effective means for the attendant to call for additional assistance. An attendant must not be assigned or undertake activities that will interfere with the ability to receive and respond to a request for first aid service.
In order to comply with the requirements of "prompt care," first aid attendants must be able to:
(a) quickly wash hands with soap and water;
(b) either take off a pair of coveralls or don a pair of clean coveralls; and
(c) be ready to depart to where they are required with the appropriate level of first aid kit within 3 to 5 minutes.
An attendant must be physically and mentally capable of safely and effectively performing the required duties. A self-disclosure declaration, the "Occupational First Aid Statement of Fitness" must be completed by all candidates for Level 2 and Level 3 certification.
Certification of medical fitness may be required by WorkSafeBC. If required, a medical certificate of the attendant's or candidate's fitness must be submitted from a physician on a form acceptable to the Board. The certificate must not be older than 6 months prior to the date received.
Payment for the medical examination is the responsibility of the attendant or candidate.
Conditions evaluated for the purpose of considering an attendant's or candidate's fitness include:
*Disease conditions evaluated include insulin dependent diabetes, respiratory disease, heart disease, drug or alcohol addiction, epilepsy, multiple sclerosis, and communicable diseases.
Candidates for certification or attendants who have had a drug or alcohol addiction must submit medical verification of one year's abstinence prior to examination for initial certification and renewal of certification.
Exceptions may be granted upon written request from the candidate or attendant or employer. The request must document the efforts of the candidate or attendant to overcome the addiction. There will be consultation with the candidate or attendant, the candidate's or attendant's employer, and the candidate's or attendant's physician or counselor before granting an exception.
Candidates for certification or attendants who have experienced epileptic symptoms are required to submit a report from a neurologist which verifies:
(a) absence of seizures in the past 12 months;
(b) ability to function normally; and
(c) suppressed epileptiform activity based on a current EEG.
Prior to renewal of initial certification, a report from a physician must be submitted verifying that the candidate or attendant has had no seizures within the immediate 12-month period preceding the renewal examination.
Candidates or attendants must submit an annual report from a physician. These reports should verify that the candidate or attendant is able to perform the duties of a first aid attendant.
A candidate or attendant suffering from a communicable disease will not be granted an initial certificate or renewal of a certificate until medical information has been received verifying that the candidate or attendant can perform first aid duties without transmitting the disease to a patient.
The medical certificate of fitness should also contain a candidate's statement of confirmation of the information provided to the physician during the assessment.
The attendant is in complete charge of all first aid treatment of an injured worker until responsibility for treatment is accepted at a place of medical treatment or by a person with higher or equivalent certification in first aid.
The first aid attendant must not send the injured or ill worker back to work prematurely. The attendant must do the assessments and apply the treatments, such as wound cleansing and bandaging for protection, necessary to adequately prepare the worker for return to work. In determining whether treatment is complete, the first aid attendant must follow first aid assessment and treatment techniques consistent with his or her training. The treatment for an injury or illness may involve follow-up care by the attendant after the worker has returned to work.
If the attendant may have to provide ongoing treatment he/she should accompany an injured worker to a hospital or place of medical treatment unless the worker is being transported by the B.C. Ambulance Service or other ambulance service acceptable to the Board.
Prevention Policy Item D12-195-1 states:
A first aid certificate issued to a first aid attendant may be suspended, cancelled or have conditions placed upon its use where the first aid attendant engages in inappropriate conduct, including:
- smoking while assessing or treating an injured or ill worker and/or while handling oxygen therapy equipment, or permitting others to do so;
- failure to use the assessment and injury treatment techniques outlined in first aid training courses unless conditions precluded them;
- conduct that poses an unreasonable threat to the safety and well-being of other workers or the public;
- removing themselves from being able to see or hear any summons for first aid at a workplace;
- abandonment of an injured worker after beginning assessment or treatment;
- refusal to treat an injured worker when acting as the designated attendant; or
- treating or transporting an injured worker while impaired or under the influence of drugs or alcohol.
If the Board has reasonable grounds for believing that a person who holds a first aid certificate has breached a term or condition of the certificate or has otherwise contravened a provision of the Workers Compensation Act or the Regulations, the Board may, under section 195 of the Workers Compensation Act,
(a) cancel or suspend the certificate, or
(b) place a condition on the use of that certificate that the Board considers is necessary in the circumstances.
The Board will consider the nature of the violation, the circumstances surrounding the incident, and the past history of the attendant in determining the action to be taken. In order of severity, the possible actions that may be taken are:
(a) a warning is issued,
(b) a condition is placed on the use of the certificate,
(c) the certificate is suspended for a period that ends before the normal expiry of the certificate, or
(d) the certificate is cancelled.
In addition to or instead of these actions, the Board may direct that applications of the attendant to renew the existing certificate or obtain a different certificate be subject to a condition or be denied for a period of time.
An order to cancel or suspend a certificate may be appealed. Section 96.2(1)(c) of the Workers Compensation Act provides that a person may request a review officer to review "a Board order, a refusal to make a Board order, a variation of a Board order or a cancellation of a Board order respecting an occupational health or safety matter under Part 3."
An attendant may, within 90 calendar days of the order issue date, in writing, request the Review Division of the WCB to conduct a review of the order.
A final decision made by a review officer in a review under section 96.2, pertaining to an order made under section 195 to cancel or suspend a certificate, may be appealed to the Workers' Compensation Appeal Tribunal.
An attendant may, within 30 calendar days of the final decision of the Review Division, in writing, request the Workers' Compensation Appeal Tribunal to conduct a review.