Originally published on the 1st August 2017
One of my pet frustrations is going into a workplace and being told by the staff, OH/S coordinator or manager that they don’t keep ANY medications onsite as it’s ‘illegal’. This mantra is something my staff and I hear every day, and it’s entirely false, misleading and dangerous. This misinformation has come from a certain interpretation of a phrase in the Safe Work Australia 2016 Code of Practice and similar state-based codes. It states, “Medication, including analgesics such as paracetamol and aspirin, should not be included in first aid kits because of their potential to cause adverse health effect in some people…”
Firstly, let’s discuss the above paragraph, the term ‘should’ refers to a recommendation, if it said ‘must’, ‘requires’ or ‘mandatory’ it would indicate a legal requirement under the WHS Act and Regulations which must be complied with. Details on this can be found in the Foreword Section of the Code(1). Now lets discuss the life-saving benefits of Aspirin, Ventolin (Salbutamol) and Adrenaline.
1. Aspirin Saves Lives
Aspirin works by slowing the progression of a heart attack, and if administered early it significantly reduces the chance of a victim dying. In 2016, the Australian Resuscitation Council (ARC) changed their guidelines, now advising the administration of one 300mg Aspirin tablet to someone having a suspected heart attack(2). Even if the first aiders forget to do so, it will be one of the first things that the 000 call taker will request to be done.
2. Ventolin Saves Lives
In asthma, the major cause for the difficulty breathing is the tightening of the muscles lining the airways. Ventolin (Salbutamol) acts by relaxing these muscles and subsequently opening up the airways. Although those who suffer asthma should take their own puffers to work, sometimes they forget. Furthermore, in places like a gym I believe the workplace has an obligation to provide this life-saving drug to those who forget their puffer or whose puffer runs out. The ARC guidelines recommend Ventolin be used as an immediate first aid treatment by first aiders from the first aid kit if the person does not have their own. It goes on to say, “No harm is likely to result from giving a reliever inhaler to someone without asthma”, further stressing the safety and importance of giving Ventolin, even when unsure whether or not it is in fact an asthma attack(3).
3. Adrenaline Saves Lives
In my opinion this is a no brainer, Anaphylaxis can cause death in minutes. Adrenaline in the form of an EPIPEN® can save that person’s life. Even if the victim has their own EPIPEN, it may be damaged, locked away or a second dose may be needed if the first one doesn’t work. I only recommend workplaces to keep spare EPIPEN’s if they have workers in their care who have Anaphylaxis, or places like a restaurant or school where there is a higher risk. The evidence and guidelines are extremely clear, it will save someone’s life(4)!
It is my opinion that the terms in the Safe Work Australia and similar state-based codes are overzealous and don’t consider strong evidence and recommendations by the ARC. Regardless, it is just a recommendation, and the power of Aspirin, Ventolin and Adrenaline to save a life requires workplaces to re-think their policies of having these three medications onsite.
· If you are worried about the statement in the Work Safe text recommending medications should not be kept in the first aid kit, don’t keep them in the first aid kit. Keep them in a separate bag next to the kit, with the first aider or with the defibrillator.
· To back your staff up, have them obtain 000 permission to provide these three medications in the event of a suspected heart attack, asthma attack or anaphylaxis event.
1. Safe Work Australia, 2016, First Aid in the Workplace Code of Practice.
2. Australian Resuscitation Council, 2006, ANZCOR Guideline 9.2.1 – Recognition and First Aid Management of a Heart Attack, https://resus.org.au/guidelines/viewed on the 5th November 2016.
3. Australian Resuscitation Council, 2006, ANZCOR Guideline 9.2.5 – First Aid for Asthma, https://resus.org.au/guidelines/viewed on the 5th November 2016.
4. Australian Resuscitation Council, 2006, ANZCOR Guideline 9.2.7 – First Aid of Anaphylaxis, https://resus.org.au/guidelines/viewed on the 5th November 2016.
The information in this article is for your information and interest only. It is not intended to be comprehensive, and does not constitute and must not be relied on as legal or medical advice. You must seek specific advice tailored to your circumstances and workplace.