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  The complexity of modern workplaces and the laws of physics entails that accidents at work are more or less inevitable. Given that we lack foreknowledge of the future, the way that we design and organise our workplaces to ensure the safety of all who use them requires careful attention to hazards and the...

The complexity of modern workplaces and the laws of physics entails that accidents at work are more or less inevitable. Given that we lack foreknowledge of the future, the way that we design and organise our workplaces to ensure the safety of all who use them requires careful attention to hazards and the likely consequences of workplace practices. One of the best examples of a safety measure designed with this wide coverage in mind is the humble first aid kit. Precisely because we don’t know exactly what kinds of injuries may occur at a workplace, the first aid kit is designed to be stocked with the resources needed to treat injuries which are reasonably likely to occur in any workplace, albeit in a basic way. For example, all first aid kits should include, among other things:

Gauze and saline (for dressing and cleaning wounds)

Cotton bandage (to treat bleeding)

Tweezers/forceps (for removing foreign objects)

Furthermore, different workplaces have a higher likelihood of certain kinds of injuries than the baseline, either due to location, the nature of the work done, or both. While there are certain things that all first aid kits should contain, the specific contents will depend upon these factors; for example, kits in a metalworking plant may require more materials to treat burns, and workplaces involving the frequent use of chemicals may require more saline and eye pads in their kits, etc. Importantly, pain-relief medications (like paracetamol) should not be included in first aid kits, and this for two reasons. First, pain relief does not fall under the scope of first aid, which is more narrowly concerned with the immediate treatment of injury, and second, allergic reaction to analgesic medications are not uncommon. For ease of use, first aid kits should include a list of their contents inside. An example of a detailed content list can be found in Appendix C of Worksafe’s 2016 Compliance Code for first aid in the workplace.

The provision of first aid kits falls under the duty of care of the owner/operator(s) of the workplace, as expressed in Worksafe’s Guide to workplace amenities and first aid 2017, 2^nd Edition: “Those who manage or control things that create health and safety risks in the workplace are responsible for eliminating or reducing the risks, so far as is reasonably practicable”. More specific guidelines for this provision can be found in the 2008 Compliance Code for First Aid in the Workplace, also by Worksafe. Under their ‘proscribed approach’, first aid kits should be supplied at the following rate:

In low-risk workplaces (in which severe injuries are not likely): 

• 1 kit for the first 10-50 employees
• 1 additional kit for every 50 employees up to 200
• 1 additional kit for every 100 employees above 200

For high-risk workplaces:

• 1 kit, including specific first aid modules, for up to 25 employees
• 2 kits including specific modules for up to 50 employees
• 1 additional kit including specific modules for every 50 employees after this threshold

For workplaces without timely access to emergency services:

• At least 1 kit for every 25 employees

Maintenance of the contents and condition of first aid kits is another vital element in securing workplace health and safety. Replenishment of contents should be undertaken after use and any reusable equipment (such as metal tweezers) should be thoroughly cleaned as soon as possible. Even if kits are not used, regular inspection and maintenance should take place every 12 months to ensure that they can perform their function when needed.

The placement of first aid kits is also a vital matter for consideration. Since first aid is the initial treatment offered to someone who has been injured, it is important that they are installed in areas in which injuries are most likely to occur (e.g. in rooms or areas around plant with sharp edges or with a high chance of chemical exposure) in addition to locations which are easy to access generally. Ease of access can be further ensured by highlighting locations of first aid kits on site maps and floor plans, and through storing kits in unlocked containers (typically painted white with a green cross for quick identification). Worksafe’s 2016 Compliance Code points out that for sites with multiple buildings or multi-storey offices, first aid kits can function as a supplement to more centrally-located first aid facilities – such as a first aid room with installed equipment like eye sinks and examination beds.

Mobile workers and tradespeople might assume that the obligation to provide a safe workplace doesn’t travel with them, but that is not the case. Even a sole trader is required to obtain and store a first aid kit in their vehicle if that vehicle functions as their workplace (as is the case for taxi drivers, inspectors, and sales representatives, etc.). Vitally, the kit must stored in such a way that it does not become a projectile and potentially injure someone in the event of a collision.

Since employers and site managers lack a crystal ball by which to divine the accidents that will occur at their workplace, the next best approach is to intelligently and thoroughly prepare for those accidents which might occur. The provision, proper maintenance, and clear labelling of first aid kits is one of the best proactive measures one can take to deal with workplace injures before they happen.

  The Danish philosopher Søren Kierkegaard is known for his remark that death is an ‘uncertain certainty’; that we will die is certain, but when our death comes is another matter. Our mortality is not something typically given much consideration throughout life, particularly in youth. To paraphrase a joke Kierkegaard makes about this, we...

The Danish philosopher Søren Kierkegaard is known for his remark that death is an ‘uncertain certainty’; that we will die is certain, but when our death comes is another matter. Our mortality is not something typically given much consideration throughout life, particularly in youth. To paraphrase a joke Kierkegaard makes about this, we don’t accept an invitation to go out for drinks with the caveat that we shall sadly be unable to attend if we are hit by a bus on the way. As we grow older, however, the uncertain certainty of death becomes an increasingly urgent reality, and so we begin to take steps to ready ourselves and our families for the event of our death.

When considering preparation for death, the classic image is of someone managing their estate, usually by writing or updating a will. However, an element of the process just as vital as this is reflection on the manner in which one dies. If a person becomes so ill or impaired that they cannot express their preferences for treatment, these preferences can be made known and honoured by writing an ‘advanced care plan’ (ACP) beforehand. The process of drafting an ACP is by no means a standardised one, given the heavy influence of the author’s idiosyncratic or cultural values upon their content; as such, all parties relevant to the care and well-being of a patient/aged care resident engage in discussion with the person regarding their wishes. In a residential aged care context, these would include:

• Medical professionals (GPs and specialists)
• The family of the resident
• Care staff at the residential aged care facility (RACF)

In addition to the selection of a medical treatment decision maker to act as a legal proxy for the resident, ACPs also afford the option of specifying advanced care directives (ACD). The directives are of two kinds: instructional directives and values directives. The latter involves the resident specifying the cultural, spiritual, or other values which are important to them, and directs relevant medical professionals and their nominated treatment decision maker to act in accordance with these values. Instructional directives consist of the explicit permission or refusal to engage in certain types of medical intervention should the author become incapacitated, and are considered legally binding upon medical professionals.

Possibly the most well-known type of instructional directive is a DNR (do-not-resuscitate) or DNAR (do-not-attempt-resuscitation) order.  In essence, a DNR is an order not to carry out CPR upon a person if their heart stops beating or if they cease breathing. In an aged care context, DNRs are binding upon both medical professionals and care staff; performing CPR upon a person with a DNR may be regarded as a kind of battery (or, as Will Cairns has written in a recent article, as ‘grievous bodily harm’). Whilst a resident authorising a DNR may be interpreted as a sign that they wish to die, this is not necessarily the case. In most instances, the desire for a DNR flows from a frank acknowledgment of the potential pain and health complications that CPR can cause in someone approaching the end of life. As such, the desire expressed is typically not to hasten death but to spend the rest of their lives in relative peace and comfort.

The issuance of a DNR order as part of ACP practice may indicate a shift in treatment focus to a ‘palliative approach’ (that is, one in which the chief objective is the management of symptoms and the minimisation of suffering rather than seeking cures), particularly as it relates to complications in the aging process. While much palliative work is performed by GPs and medical specialists, it falls to care workers to provide relief more broadly, both in the ‘day to day’ management of symptoms and in the provision of emotional support for residents and their families. Having been consulted during the formation of an ACP, care workers must sustain the dialogue between themselves and the resident in order to ensure that their values are expressed and respected in their treatment. The RACGP’s 2006 ‘Silver Book’ highlights the necessity of continued communication between all parties to palliative treatment of aged care residents: “Lack of clarity among the aged care team members or a lack of openness with residents and families may lead to conflict and confusion about care goals”.

The role of the care worker only becomes more vital when treatment shifts towards end-of-life care. End-of-life care can be particularly beneficial in an RACF as a consequence of the familiarity of the environment, other residents, and care staff, encouraging the resident to feel more ‘at home’ than they would receiving the same treatment in a hospital, for instance. The Silver Book cites a British Medical Journal supplement entitled ‘What is a good death?’, the 12-point summary of which could easily serve as a standard of service for end-of-life care:

1- To have an idea of when death is coming and what can be expected.
2- To be able to retain reasonable control of what happens
3- To be afforded dignity and privacy
4- To have control of pain and other symptoms

5- To have reasonable choice and control over where death occurs
6- To have access to necessary information and expertise
7- To have access to any spiritual or emotional support required
8- To have access to ‘hospice style’ quality care in any location
9- To have control over who is present and who shares the end
10- To be able to issue advance directives to ensure one’s wishes are respected
11- To have time to say goodbye and to arrange important things
12- To be able to leave when it is time, and not to have life prolonged pointlessly.

As with any issue concerning life and death, there are ethical issues at stake concerning DNRs in the context of a RACF. For instance, there is the potential for conflict between family members who are not peace with a resident’s decision to issue a DNR order, and care workers are likely to bear the brunt of this opposition. Recent legislative changes now prevent family members from contravening a DNR, but the task of moving them to reconcile themselves to the resident’s decision will require patience and continuous engagement by care workers and medical professionals. Furthermore, some care workers may be disquieted at the notion of not medically intervening to save a life, even if the person expressly refuses the treatment; this discomfort may stem from the idea that not performing CPR in the case of heart or respiratory failure is a form of what James Rachels refers to as ‘passive euthanasia’. However, quite apart from the legal distinction made by the Standing Committee on Legal and Social Issues between euthanasia and adhering to a DNR order, Bonnie Steinbock has argued that if the aim of not providing treatment is not to kill the patient but to ensure that a dying patient is as comfortable as possible in their final days, this can hardly be considered a form of euthanasia. Adhering to the wishes of a resident with a DNR certainly fulfils this requirement, and this thought may comfort those anxious about the issue.

The reader will, I hope, be convinced at this point of the necessity and complexity of the relationship between RACF workers, residents, and medical professionals in drafting and implementing advanced care plans and directives. The tendency of the Australian population’s life expectancy to increase only underlines the value of a robust and well-staffed aged care system.

Imagine the following scenario: one day, you go out for a walk along a path which overlooks a pond. You look out at the pond, noticing that a child has fallen in and is in danger of drowning. No-one else is coming to their aid; however, you’re wearing your brand new (and very expensive)...

Imagine the following scenario: one day, you go out for a walk along a path which overlooks a pond. You look out at the pond, noticing that a child has fallen in and is in danger of drowning. No-one else is coming to their aid; however, you’re wearing your brand new (and very expensive) Adidas exercise gear, and rescuing the child is certain to ruin it. Should you save the child? Almost everyone introduced to this thought experiment – made famous by philosopher Peter Singer in a classic argument for foreign aid – says ‘Yes’ when asked the same question. No item of clothing, no matter how expensive, is worth more than a human life.

Let’s alter the scenario somewhat and see if your answer changes. The child in the pond is now an old man, suddenly overcome by cardiac arrest in a car park. The key distinction between this situation and the other is that here, it is not your willingness to save a life but your capacity that matters. Immediate application of CPR could save this man’s life, but if you don’t know how to perform CPR, all you can do is call an ambulance and hope they arrive in time. What is at stake for you in this instance is not the value of your exercise gear in the present, but the cost of becoming trained in CPR in the past, the element which makes you capable of saving lives.

In contrast to the relative rarity of children drowning in ponds, out-of-hospital cardiac arrest (OHCA) is alarmingly common. According to the Victorian Ambulance Cardiac Arrest Registry 2015-2016 report, 5,899 instances of OHCA were attended to by Victorian ambulances, putting the rate of OHCA at just over 99 events per 100,000 people. This average obscures the gap in occurrences between metropolitan and rural Victoria, with incident rates of 89.7 per 100,000 and 128.6 per 100,000 respectively. Dr. Ben Beck, writing on behalf of the Managing Committee of the Australian Resuscitation Outcomes Consortium (Aus-ROC), points out that a culture of continuous improvement in the care of OHCA patients has emerged, and with it a re-evaluation of the effectiveness of care methods. Bystander CPR has amassed considerable evidence for its efficacy under this scrutiny: OHCA sufferers who received bystander CPR both survived the event (29%) and were discharged from hospital alive (12%) at rates significantly higher than those who didn’t (23% and 6%), and were 11 times more likely to present with a shockable rhythm (which is associated with higher survival outcomes).

Despite the effectiveness of bystander CPR for improving the prospect of surviving OHCA, only 40% of OHCA sufferers receive bystander CPR. Significantly, recent research by Monash University academics indicates an association between areas with lower bystander CPR rates and lower levels of CPR training. Of those surveyed who were not trained in CPR, most cited two reasons for not undergoing training: 1) never having thought about it, and 2) lacking the time to do it. However, just under half of these respondents indicated that they were willing to learn CPR through training kits. The researchers conclude from these considerations that increasing rates of CPR education will potentially exert a positive influence upon OHCA survival rates. This is unsurprising, given that bystander CPR is recognised by many professional bodies as an ‘early link’ in the ‘chain of survival’; bystanders intervening with CPR upon recognising OHCA increases the likelihood that the patient can undergo defibrillation (as aforementioned), which thereby increases their likelihood both of surviving the incident and leaving medical care alive. If that early link is severed, the likelihood of those which follow it occurring falls away too.

Almost all who read this recognised at the outset that the cost of a ruined tracksuit is worth a human life saved. The cost of becoming trained in bystander CPR, therefore, pales into insignificance when you consider both how often OHCA occurs and how effective bystander CPR is at preventing it from resulting in death. The benefits go beyond the individual; the more people who know how to administer CPR, the higher the general chance of survival for OHCA sufferers. Learning this key skill is a very small way of making a major impact upon the world.

Using a heart rate monitor application is a fantastic method of keeping track of your heart rate when exercising or at rest. When used correctly, these apps can assist in maximizing your exercise routines, giving you the opportunity to be much more efficient. Whether you are doing cardio to build up your stamina or...

Using a heart rate monitor application is a fantastic method of keeping track of your heart rate when exercising or at rest. When used correctly, these apps can assist in maximizing your exercise routines, giving you the opportunity to be much more efficient. Whether you are doing cardio to build up your stamina or pacing yourself for an upcoming competition, a heart rate monitor is a good friend to have by your side.

You can decide whether to use a stand-alone monitor or one that works along with a fitness tracker. You’ll have your choice between apps that use optical technology to determine your heart rate and others that use an armband or a chest strap. Most modern fitness apps can assist in estimating your heart rate zone so that you’ll know the general range you fall into.

Determining your heart rate during exercise and at rest is just as an important part of monitoring your progress as the recovery of your heart rate following intense activity. It offers more insight into your heart’s health. Once you start monitoring all of these aspects, you’ll be able to understand for yourself the healthy benefits that you are gaining from your exercise routines.

There are many free apps on the App Store and the Google Play store that can detect your heart rate directly from your smart-phone, however, external heart rate monitors that can pair with an app are much more effective and concise. Some of the most popular Bluetooth heart monitor options available today include the iWatch, Fitbit etc. If you haven’t used a monitor before to determine your heart rate, you’ll be surprised to see just how easy they are to operate.

Learning more about your heart health gives you more control over your body and gives you the opportunity to make intelligent choices regarding your exercise routines. Learn more about your heart and how to manage mild and severe heart related problems through the CPR and first aid courses offered by the Australian Pacific Institute of Technology.

Would you be aware of the signs and symptoms of a stroke if it were happening to someone in your close vicinity? Did you know strokes are one of the leading causes of death? While many people are aware of the warning signs pertaining to a heart attack, not many are able to recognise...

Would you be aware of the signs and symptoms of a stroke if it were happening to someone in your close vicinity?

Did you know strokes are one of the leading causes of death?

While many people are aware of the warning signs pertaining to a heart attack, not many are able to recognise the symptomatology that takes place during a stroke. These are the major warning signs that will indicate that a stroke might be happening:

Facial Drooping – If a person is not able to smile properly or you can notice that one side of the face is drooping, this is a major alarm bell that a stroke may be occurring

Weakness in the arms – If one of the arms sags downwards when both arms are raised it can also be a sign of a stroke taking place

Speech difficulty – If you notice that the person is finding it difficult to speak or that his speech is slurred, this is a major warning signal, it’s time to take action immediately.

In many common occurrences, a person experiencing a strong will encounter many of the symptoms, whilst in other cases the individual may only encounter or two of these signs.

If you see one of these symptoms occur, you need to call 000 immediately.  Dealing with strokes has only one approach, the quicker the treatment, the better possibility of survival for the patient. You need to understand, minutes count, so observe the warning signs and act rapidly.

Other common symptoms that may go with a stroke includes:

• Unexpected weakness or numbness in the leg, arm or the face, especially when it comes to only the left or right side of the body
• Serious sudden headache without an apparent reaonsing
• Abrupt vision problems in both eyes or only one
• Sudden confusion
• Trouble with dizziness, walking, coordination, or balance that comes on suddenly

In many cases strokes can be prevented through healthy lifestyle decisions, as well as attending medical screenings that have been recommended by a physician. Most importantly, a person with first aid training can provide real help to a stroke victim while waiting for the ambulance to arrive

Learn more about first aid in our First Aid & CPR classes, you never know when it might help save a life

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