PART 6First Aid and Medical Care
Marginal note:Operator’s obligations
31 Every operator must ensure that
(a) a physician who has specialized knowledge in the treatment of illnesses and injuries that may arise at the workplace is readily available at all times to provide medical advice, remotely from a location in Nova Scotia, to any medic or first aider at the workplace and to be transported to the workplace, if necessary, to provide medical care, unless the workplace has a medic who is a physician with that knowledge;
(b) an emergency medical evacuation service is available at all times for transporting an injured or ill person from the workplace to a hospital onshore using a means of transportation that
(i) is equipped with appropriate first aid and medical supplies,
(ii) is capable of accommodating and securing an occupied stretcher, and
(iii) has one or more competent persons available on board to provide first aid or medical care to the injured or ill person during transportation; and
(c) persons at the workplace have a means of quickly summoning the emergency medical evacuation service.
Marginal note:Employer obligations
32 (1) Every employer with control over a workplace must
(a) when assessing the risk of illness or injury at the workplace for the purpose of the occupational health and safety program, consult with a medic, if one is required at the workplace, and take into account
(i) the location of the workplace and the expected delay in obtaining emergency medical services,
(ii) the layout of the workplace, and
(iii) environmental factors, including thermal considerations;
(b) develop, in consultation with a medic, if one is required at the workplace — and with a specialized dive physician, if a dive project is to be carried out from the workplace — a written medical emergency response plan that addresses all reasonably foreseeable emergencies at the workplace and takes into account the location of the workplace, the time of year at which the work is to be carried out, the expected number of persons at the workplace during normal operations and the workplace’s maximum capacity;
(c) determine, in consultation with a medic, if one is required at the workplace — and with a specialized dive physician, if a dive project is to be carried out from the workplace — the type and quantity of first aid and medical supplies and equipment, medication and facilities needed to respond to all reasonably foreseeable injuries and illnesses at the workplace and ensure that those supplies, that equipment, those medications and those facilities are provided, maintained, replenished and replaced as necessary;
(d) establish and make readily available to all persons at the workplace written procedures for promptly obtaining first aid or medical care for any injury or illness, including procedures to follow while awaiting that care;
(e) keep a diagram indicating the location of all first aid kits and medical rooms conspicuously posted at the workplace;
(f) keep an up-to-date list of telephone numbers for use in emergencies conspicuously posted near every fixed telephone at the workplace;
(g) keep a list of all medics and first aiders who are present at the workplace, as well as information on how and when they may be contacted and where they may be located, conspicuously posted in every medical room at the workplace;
(h) keep a list of all medics who are present at the workplace — or, if no medic is required, of the first aiders who hold the highest level of first aid certificate held by any first aider at the workplace — as well as information on how and when they may be contacted and where they may be located conspicuously posted
(i) on the bridge, if the workplace is a vessel, or
(ii) at the location where the installation manager referred to in section 198.2 of the Act is expected to be during an emergency, if the workplace is not a vessel; and
(i) ensure that the number of first aiders and medics set out in columns 2 to 4 of the following table that correspond to the number of persons at the workplace set out in column 1 are present at the workplace and readily available to provide prompt and appropriate first aid or medical care to persons at the workplace:
Item Column 1 Column 2 Column 3 Column 4 Number of persons at the workplace Number of first aiders with standard first aid certificate or higher Number of additional first aiders with advanced first aid certificate or qualifications equivalent to those of a medic Number of medics 1 6–10 1 plus 1 for every 2 persons in excess of 6 0 0 2 11–30 3 plus 1 for every 2 persons in excess of 10 1 0 3 31–40 13 plus 1 for every 2 persons in excess of 30 1 0 4 More than 40 17 plus 1 for every 2 persons in excess of 40 2 plus 1 for every 10 persons in excess of 40 1
Marginal note:First aid kits
(2) The first aid supplies referred to in paragraph (1)(c) must include first aid kits that
(a) conform to CSA Group standard Z1220, First aid kits for the workplace;
(b) contain only the supplies necessary for rendering first aid, which are maintained in a clean, dry and serviceable condition;
(c) are inspected at least monthly; and
(d) are clearly identified by conspicuous signs and readily accessible at various locations throughout the workplace.
Marginal note:Automated external defibrillators
(3) If the workplace is a marine installation or structure, the first aid equipment referred to in paragraph (1)(c) must include
(a) at least one automated external defibrillator in a common area accessible to all persons at the workplace; and
(b) additional automated external defibrillators in the quantities and locations that are necessary, having regard to the risk assessment carried out by the employer for the purpose of the occupational health and safety program.
Marginal note:Medical rooms
(4) If the workplace is a marine installation or structure, the facilities referred to in paragraph (1)(c) must include a medical room
(a) whose location is clearly identified by conspicuous signs;
(b) that is supervised by a medic or, if no medic is required at the workplace, a first aider who holds the highest level of first aid certificate held by any first aider at the workplace;
(c) whose location and design allow patients on stretchers to be easily transported to it from other locations at the workplace and from it to any deck from which patients may be transported from the workplace;
(d) that allows for optimum ease of access to persons carrying a patient on a stretcher;
(e) that is maintained in an orderly and sanitary condition and in which all surfaces are easily cleaned and disinfected;
(f) that contains or is located adjacent to a washroom;
(g) that contains
(i) a rectangular treatment table that is accessible from both long sides and at least one short side,
(ii) a medical lamp with an adjustable arm,
(iii) a means of securing a stretcher in place when it is occupied by a patient,
(iv) a handwashing facility supplied with running hot and cold water,
(v) a hand-held shower head that can easily reach the patient,
(vi) a storage cupboard and counter,
(vii) a separate cubicle or curtained-off area with a cot or bed equipped with a moisture-protected mattress and two moisture-protected pillows,
(viii) a table and at least two chairs,
(ix) a lockable medical chest or cabinet,
(x) a waste receptacle and a means of safely disposing of biohazards and sharp objects,
(xi) sufficient electrical outlets of the appropriate voltage for the equipment to be used in the room, and
(xii) all other medical supplies and equipment that are determined to be necessary under paragraph (1)(c);
(h) in which information is accessible regarding
(i) first aid procedures in respect of any reasonably foreseeable injury or illness at the workplace,
(ii) all hazardous substances at the workplace, including the procedures for treating exposure to them and, in the case of hazardous products, their safety data sheets, if any, or other documents containing hazard information in respect of them, and
(iii) procedures for transporting injured or ill persons within and from the workplace; and
(i) that contains an effective means of hands-free electronic communication with the physician referred to in paragraph 31(a) and other emergency contacts, as well as an up-to-date list of the names and contact information of those persons for use in emergencies.
33 (1) An employer may designate a person as a medic if that person
(a) has experience with helicopter or fixed-wing aircraft evacuation for medical purposes;
(b) holds an advanced cardiac life support certificate or basic cardiac life support instructor’s certificate issued by an entity that bases its training on International Liaison Committee on Resuscitation guidelines; and
(c) meets one of the following requirements:
(i) they hold a licence to practise medicine in Canada and have at least two years’ clinical experience in intensive care or emergency practice,
(ii) they hold a registered nursing certificate recognized by a provincial regulatory body and have at least two years’ clinical experience in intensive care or emergency practice, or
(iii) they hold an advanced care paramedic certificate or critical care paramedic certificate issued by a college in Canada and have at least three years’ experience as an advanced life support provider.
Marginal note:Designation in writing
(2) The designation under subsection (1) must be made in writing.
Marginal note:No other duties
(3) The employer must not assign to the medic any other duties that will interfere with the prompt and adequate provision of first aid and medical care.
(4) When providing first aid or medical care to an injured or ill person, a medic
(a) must not be overruled by anyone other than the physician referred to in paragraph 31(a); and
(b) must follow any directions given by the physician referred to in paragraph 31(a).
Marginal note:First aiders
34 (1) Every employer must allow any first aider — and any other employee that the first aider needs for assistance — to provide prompt and adequate first aid to an injured or ill person and ensure that they have adequate time to do so, with no loss of pay or benefits.
(2) When providing first aid to an injured or ill person, a first aider
(a) must not be overruled by anyone other than a physician, a medic or, if they hold a standard first aid certificate, a first aider with an advanced first aid certificate; and
(b) must remain in charge of the person’s care until the first aid is complete or the person is under the care of a physician, a medic or, if they hold a standard first aid certificate, a first aider with an advanced first aid certificate.
Marginal note:Treatment records
35 (1) Every first aider or medic who provides care to an injured or ill person or from whom treatment is sought must make and sign a record containing the following information:
(a) the full name of the injured or ill person;
(b) a brief description of the injury or illness — and of the occurrence that gave rise to it, if any — including, as applicable, the date on which and the time and location at which the injury or occurrence occurred or the date on which and the time at which symptoms of the illness were first experienced;
(c) a brief description of any treatment provided by the first aider or medic, including the date on which and time at which it was provided; and
(d) a brief description of any arrangements made for the treatment or transportation of the injured or ill person.
(2) The employer with control over the workplace at which the record is made must retain it, from the day on which the injury or illness is first documented, for
(a) 40 years, in the case of treatment for an occupational disease or exposure to a hazardous substance;
(b) 10 years, in the case of treatment for an injury resulting from an incident, other than exposure to a hazardous substance, or for a musculoskeletal injury, as defined in subsection 41(3); and
(c) five years, in any other case.
PART 7Employee Well-being
Marginal note:Occupational health and safety program
36 Every occupational health and safety program must set out measures for promoting mental health and healthy lifestyles and must address substance abuse, the effects on mental health of working in a remote location and the management of mental illness.
37 (1) Impairment, including as a result of fatigue, stress, injury, illness, another physical or psychological condition, alcohol or drugs, is a prescribed risk for the purpose of paragraph 210.02(2)(a) of the Act and every occupational health and safety program must
(a) set out the roles and duties of all workplace parties in identifying and preventing the consequences of impairment on the health and safety of employees;
(b) identify factors that may contribute to impairment or its causes, such as work and workplace conditions, work scheduling and task type and length;
(c) require that the factors referred to in paragraph (b) be regularly monitored at the workplace and taken into account, in conjunction with incident reports, employee complaints, workplace committee reports and records of excess work hours kept under paragraph (e) or subsection 39(3), to identify any potential impairment;
(d) require the development, maintenance and implementation of an appropriate work shift design that allows adequate rest periods;
(e) require records to be kept of hours worked by an employee beyond their usual shift or rotation; and
(f) require that the risk of fatigue be taken into account in developing all workplace procedures.
Marginal note:Working while impaired
(2) Every employer must ensure that no employee at a workplace under its control is permitted to work if their ability to do so is impaired in a manner that is likely to be hazardous to their health or safety or that of any other person at the workplace.
Marginal note:Investigation of incidents
(3) Impairment must be considered as a potential causal factor in the investigation of all incidents at the workplace.
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