OHS Code Explanation Guide

Published Date: July 01, 2009
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Part 11 First Aid

Section 180 Emergency transportation

This section requires employers to ensure that transportation is available for transporting injured or ill workers to a health care facility when needed. This section applies to all work sites, regardless of any service, supply or equipment requirements specified elsewhere in this Part.

Subsection 180(1) Arrangements

This subsection requires employers to ensure that transportation arrangements are in place for transporting injured or ill workers from a work site to the nearest health care facility. For the purposes of this Part, “arrangements” are considered to be a plan that includes procedures for transporting injured or ill workers. Section 8 of the OHS Regulation requires the plan and procedures to be in writing and available to workers.

Transportation arrangements must be in place before an employer sends workers to any work site and work begins. This condition applies at all times while work is being performed at the worksite. Guidance on what to consider when developing the arrangements and what an officer will look for during the review is presented under the heading “Transportation Plan”.

Subsections 180(2) and 180(3) Transportation requirements

Subsections 180(2) and 180(3) offer employers two potential options when deciding the type of transportation to have available for injured or ill workers. The first is that an employer can use a provincially licensed ambulance service under the Emergency Health Services Act (formerly the Ambulance Service Act). It is recommended that the service be capable of arriving at the work site within 40 minutes of being called.  If this is not possible, the second option available to employers is to have a means of transportation from the work site that meets all the requirements listed in subsection 180(3), namely:

(a) it must suit the distance to be travelled and the types of injuries or illnesses that may occur. The means of transportation must make transport of the ill or injured worker safe and comfortable. It should be clean and if serious injuries are likely to occur, as in high hazard work, then the means of transportation needs to accommodate a seriously injured worker in a manner that prevents additional injuries and provides timely transport;

(b) the available transportation must protect the injured worker and an accompanying person from the weather. If workers are at an isolated work site and work is done during cold, wet or inclement weather, then the means of transportation should be enclosed or covered and provide sufficient heat to keep both individuals warm;

(c) the means of transportation must be equipped with a means of communication that allows occupants to communicate with the health care facility to which the injured or ill worker is being taken. This could be a cellular telephone, vehicle-based two-way radio or whatever is most practicable as long as it permits communication with the health care facility; and

(d) the means of transportation must be large enough to accommodate a stretcher and accompanying person. Many stretchers are 200 or more centimetres long so the available space must accommodate this. Stretchers must be secured during transport to protect the safety of the injured worker and the accompanying person.

If a provincially licensed ambulance service is not available, the employer may decide to provide an emergency conveyance vehicle. It is recommended that this vehicle be able to arrive at any work site it is intended to serve within 40 minutes of being called. Otherwise, there must be a means of transportation from the work site that meets the four requirements listed above. This means of transportation should be maintained in a clean condition and be available to respond when called.  The vehicle could be a van, truck, boat, aircraft or any other means that meets all the requirements.

Subsection 180(4) Means of communication

The employer must have a means of communication in place at the work site that allows an ambulance or other means of transportation to be summoned. The particular means of communication provided is at the employer’s discretion but it must be capable of summoning an ambulance or transportation service quickly and reliably. Communication may be through the use of a telephone, cellular telephone, satellite telephone, portable two-way radio or any other means that is effective.

Subsections 180(5) and 180(6) Accompaniment

If a worker is acutely injured or ill, or needs to be accompanied during transport to a health care facility, the worker must be accompanied by at least one first aider, other than the operator of the means of transportation. This requirement does not apply if there are three or fewer workers at the work site.

The accompanying person must be a first aider, but the level of first aid training required of this first aider is not stipulated. To determine which first aider should accompany the injured worker, consider the level or type of injury or illness, the distance to be travelled, the mode of transportation used and the level of first aid services that must continue to be offered at the work site.

Transportation Plan

Factors to consider

When developing the transportation arrangements, employers must keep in mind the need to get injured workers to medical care as quickly as possible keeping in mind the “golden hour”. As it pertains to life-threatening injuries, the golden hour is the first hour after a person is injured. The hour is golden because if a seriously injured worker makes it to the health care facility within this hour, the chances of survival are greatly increased. The sooner the first aider calls for medical help and medical care is provided, the better the chances that the injured worker will survive.

Before an employer sends workers to any work site and work begins, the employer must have arrangements (the transportation plan) in place to transport injured or ill workers from the work site to a health care facility. The transportation plan must consider the following factors, many of which are the same as those considered when developing the complete First Aid Program:

(a) the types of injuries or illnesses likely to occur given the hazards inherent to the work and the ages and limitations of the workers;
(b) the number of workers at the work site;
(c) the distance to be travelled from the work site to the health care facility;
(d) the availability of a provincially licensed ambulance service;
(e) ambulance or emergency vehicle response times;
(f) the time(s) of day that the work site is in operation;
(g) the means of transportation needed to get to the work site;
(h) transportation routes;
(i) seasonal or weather changes that may affect the means or routes of transportation; and
(j) travel times.

When developing a plan, prospective provincially licensed ambulance services should be contacted in advance to find out the processes involved in responding to a call and the expected response times. Response times at isolated work sites may vary considerably depending on the type of day, the weather and other factors. If a work site’s plan involves calling an emergency response centre that dispatches local air ambulances for example, consider that local helicopter services may not have the equipment to navigate after dark and may not be able to accommodate a stretcher. Also, if a call centre is used as an emergency contact number and the call is re-routed to a local ambulance service, then the service must determine the location of the work site, resulting in a possible response delay that may exceed the 40 minute recommended time.

Ask specific questions of the emergency services provider being considered when developing a plan e.g. service capabilities and likely response times.  Find out whether the service provider will dispatch a helicopter or ground ambulance. If the work site is accessible by road, it is reasonable to expect that a ground ambulance will service it and this may add considerable time to the response.

Once all factors particular to the industry and the work site have been considered, the plan must be written out, finalized and communicated to the workers it applies to.

What Officers look for in a plan

The written plan must be available to occupational health and safety officers upon request. Officers will look for the following in a transportation plan:

(1) Who to call – list of the transportation provider(s) that is to be used to transport injured or ill workers. The plan must specify whether a provincially licensed ambulance service is used, whether a transportation provider is summoned from a different location or whether on-site transportation is available.

(2) How to call – a clear statement of how the transportation provider will be summoned. List telephone numbers or radio channels as appropriate. The employer must ensure that telephone numbers are current and correct.

(3) Who makes the call – a clear statement of who may summon the emergency means of transportation.

(4) What to say – a listing of the information that the caller must give to the ambulance service so that the service can respond quickly. Location coordinates for example may be important when trying to reach a work site in an isolated area.

(5) What to expect – a description of what will happen in the event that

(a) the transportation cannot arrive at the work site within 40 minutes. If this is the case, it is recommended that other transportation be available that meets the transportation requirements of section 180; and
(b) another worker becomes injured while the first one is being transported to a health care facility. Workers and first aiders remaining at the work site must know what to do and who to call if work continues and another worker becomes injured. The transportation requirements of this Part apply at all times while work is being performed at the work site.

(6) Communication of the plan – evidence that the plan has been communicated to workers, including all designated first aiders. Officers may verify this by talking to workers and asking what the workers would do if they had to summon a provincially licensed ambulance or other transportation provider.

(7) Date of plan completion – the plan should be dated to show when it was completed and how current it is.