Work place Safety I | ORHB

Work Place Safety I

Learning Module
Module Code: HLT PRA2-M-05 1217 V1

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Preface
In response to the critical shortage of pharmacy/Medical laboratory personnel in Oromia National
regional state, a group of experts from universities and colleges in the region have developed an
Outcome based TVET Model curriculum for Pharmacy Level II-IV programs in October, 2017
with the initiative of Oromia Regional Health Bureau.

The outcome based curriculum was developed in reference to the level based 2011 Ethiopian
Occupational standard. The guiding principle in the development of the outcome based curriculum
was to train Pharmacy professionals in focused, time efficient and outcome based approach, and
to fill the existing pharmacy works force shortage with competent professionals.

The key features of the outcome based curriculum include: use of variety of teaching/learning
methods, repeated exposure of trainees to skill laboratories, practical attachment/cooperative
training and the delivery of the training in standardized learning modules (information sheets) and
skill lab manual/checklists (Operation sheets).

This learning module was developed by a diverse group of experts from higher teaching
institutions in Oromia region, experts from Oromia Regional health bureau, Oromia TVET,
Oromia COC agency and professional associations.

This Work place Safety I learning Module covers 3 unit of competencies in the level II pharmacy
program. The learning module covers both theoretical and practical aspects of the competencies.

Dear Trainee, you are expected to read the information presented in the learning module, attempt
all the self-check questions and perform skill activities as per the skill lab learning guide/checklist.

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Acknowledgment

This Work place Safety I learning module and skill lab manual for Retail Pharmacy assisting Level
II Program was developed by experts from Universities and Colleges in Oromia National
Regional State.

Oromia Regional Health Bureau and Oromia TVET Bureau would like to acknowledge the
following individuals and their organization for their dedication, kind participation, and expert
contributions in the development of this training material.

Abay Kasa AHMC

Abdi Leggese ORHB
Abdurazak Jemal Tura Arsi University
Asrat Hordofa AA Uniersity
Biranu Motbaynor Haromaya University
Desalegn Chilo Mettu University
Dr.Worku Bedada Salale University
Edao Sado Wollega University
Ermias Mergia AHMC
Getu Melesie Ambo University
Mamo Abdi ORTETB
Mekuria Kebede OOCAA
Mustefa Ahmed Ambo University
Shibiru Tesema Jimma University
Teferi Guji Jhpiego
Tena Tilki Gimbi G.Hospital
Tesemma Sileshi Ambo University
Zerihun Ayenew ORHB

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1. Introduction to First aid

Objectives:

To assess a situation quickly and calmly and summon the appropriate help if necessary.
To assist the casualty and provide the necessary treatment, with the help of others if
possible.
To pass on relevant information to the emergency services, or to the person who takes
responsibility for the casualty.

First aid is the initial assistance or treatment given to a person who is injured or sudden illness
before emergency medical treatment is available. The first-aid provider in the workplace is
someone who is trained in the delivery of initial medical emergency procedures, using a limited
amount of equipment to perform a primary assessment and intervention while awaiting arrival of
emergency medical service personnel. The person who provides this help may be a:

 First aider,
 First responder,
 Policeman or fireman, or
 Paramedic.

The key aims of first aid can be summarized in three key points:

 Preserve life: the principal aim of first aid is to save lives.

 Prevent further harm: to prevent the condition from worsening or further injury.

 Promote recovery: first aid also involves trying to start the recovery process from the
illness or injury.

Hazard: hazard is simply a condition or a set of circumstances that present a potential for harm.

Hazards are the main cause of occupational health and safety problems. Therefore, finding ways
of eliminating hazards or controlling the risks is the best way to reduce workplace injury and
illness.

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Types of hazards

1. Biological hazard: it is due to viruses, bacteria, parasites, fungi and molds. It is also include
insects, pests, rodents, mammals and their toxins e.g. lice, bedbugs, fleas, flies, cockroaches, ticks
and mites, as well as rats and mice.

2. Chemical hazards: This is due to exposure to hazardous chemicals that may lead to damage to
body systems.

3. Mechanical hazards: It is resulting from unshielded machinery, unsafe structures in the

workplace and dangerous tools. It can be caused by exposure to a heavy physical workload, poor
working conditions, involving heavy item lifting and moving, or repetitive manual tasks.

4. Psychosocial hazards: - Psychological stress is caused by time and work pressures.

Psychological stress and work overload have been associated with sleep disturbances, burn-out
syndromes, depression, cardiovascular disorders and hypertension.

5. Physical hazards: high pitch noise, vibration, ionizing and non-ionizing radiation, electric and
electromagnetic fields, extreme cold and heat are some of physical hazards. Ultraviolet radiation
and ionizing radiation are known carcinogens

Risk: The likelihood, or possibility, that harms (injury, illness, death, damage etc) may occur from
exposure to a hazard.

First Aid Equipment

First-aid box: is a box used to keep the materials used during providing the first aid service.
All workers must be able to access a first aid kit. This will require at least one first aid kit to be
provided at their workplace
Contents of first aid kit
The first aid kit should provide basic equipment for administering first aid for injuries and the
contents of first aid kits should be based on a risk assessment. The minimum contents of a first aid
box are:
 Wound cleaner / antiseptic  Sterile gauze
 Swabs for cleaning wounds  pair of forceps
 Cotton wool for padding  pair of scissors

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 set of safety pins  First aid dressing

 triangular bandages  First aid dressings
 roller bandages  Straight splints
 roller bandages  Pairs large and 2 pairs medium
 roll of elastic adhesive disposable latex gloves
 Non-allergenic adhesive strip  CPR mouth pieces or similar devices
 Packet of adhesive dressing strips
Check first aid box regularly for boxes haven’t run out of anything, nothing has gone past the
expiry date and anything used in the first aid box is replaced immediately.

The contents of first aid kits should be based on a risk assessment. For example, there may be
higher risk of eye injuries and a need for additional eye pads in a workplace where:

Chapter Summary

Step 1 – Identify potential causes of

workplace injury and illness

Step 2 – Assess the risk of workplace injury

and illness

Step 3 – What first aid is required?

Step 4- Review first aid to ensure

effectiveness

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Activity one:

I. List the potential hazards that you may encounter during your

 Laboratory activities,

 In dispensary room and

 At drug store.

II. Forward the way how you can minimize the risk from the hazard you
identified under question (i).

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2. Basic life support

Basic life support (BLS) is the level of medical care which is used for patients with life-threatening
illnesses or injuries until the patient can be given full medical care at a hospital. BLS is generally
used in the pre-hospital setting, and can be provided without medical equipment.

Many countries have guidelines on how to provide BLS which are formulated by professional
medical bodies in those countries. The guidelines outline algorithms for the management of a
number of conditions, such as cardiac arrest, choking and drowning. BLS generally does not
include the use of drugs or invasive skills.

Basic life support consists of a number of life-saving techniques focused on "ABC"s of pre-hospital
emergency care:

 Airway: the protection and maintenance of a clear passageway for gases (principally
oxygen and carbon dioxide) to pass between the lungs and the atmosphere.

 Breathing: inflation and deflation of the lungs (respiration) via the airway

 Circulation: providing an adequate blood supply to tissue, especially critical organs, so as

to deliver oxygen to all cells and remove metabolic waste, via the perfusion of blood
throughout the body.

2.1. Respiratory Emergencies

Definition: A respiratory emergency is one in which normal breathing stops or in which breathing
is so reduced that oxygen in take is insufficient to support life.
Artificial respiration: is a procedure for using air to flow in to and out of person lungs when
natural breathing is inadequate or stops.
Cardiopulmonary Resuscitation (CPR) is an emergency procedure that is used on casualties
who are unconscious and not breathing. CPR involves chest compressions (pressing down on the
chest) and artificial respiration (rescue breathing / mouth to mouth). It has the power to restore
blood flow and oxygen to someone suffering cardiac arrest.

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Common causes of respiratory failure (problems)

Obstruction of the air way by tongue is dropping back
Inhalation of a small amount of food, smoke, irritation, foreign objects, carbon
monoxide, etc.
Compression of the neck
Respiratory disease
Drowning
Strangulation and combustible gases
Signs and symptoms
o Un able to breath
o Loss of consciousness
o General pallor (paleness)
o Difficulty in breathing and may be no visible breathing
First Aid management of Respiratory problem procedure
 Shout for help (depend on the condition)
 Determine the consciousness of the causality by taping the victim on the shoulder
and asking loudly “Are you oky!”
 Assess and ensure that patient air way is clear
 Place the patient flat on his back with the head turned to one side
 Remove any thing which is preventing the taking in of air (Remove constraints
from the neck)
 Kneel beside the patient’s head place one hand
 Under his neck and the other hand under his lower jaw extend his head and neck
gently back ward, this prevents the tongue from falling back in to the throat.
 Place your cheek and ear close to the victim’s mouth and Nose.
 Look at the victim’s chest to see if it rises, falls, and listen and fell for air to be
exhaled for about 5 seconds.
 If there is no breathing pinch the victim’s nostrils shut with thumb and index finger
of your hand that is pressing on the victim’s forehead. This action prevents leakage
of air when the lungs are inflated through the mouth.
 Take very deep breath and hold it.

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 Fit your mouth tightly over the patients open mouth and forcibly in to the lungs
 While carrying out respiration, check the patient’s pulse every 2 or 3 minutes to
ensure the heart has not stopped.
 Continue the breathing procedure at the rate 12 to 18 breaths per minute until the
chest is seen to rise and the patient is breathing for himself or until is certain his is
dead.
 Once the patient can breathe by himself/her self-place him/her in what is called the
recovery position.

2.2. First aid for wounds

A wound is any type of injury to the skin. Wounds can be classified as closed or open.

Open wounds: the skin is cracked open, leaving the underlying tissue exposed to the outside
environment, which makes it more vulnerable to bleeding and infections.

Open wounds can be classified according to the object that caused the wound. The types of open
wounds are:
Types of open wound Characteristics
Incisions caused by a clean, sharp-edged object such as a knife, razor, or
glass splinter
Lacerations irregular tear-like wounds caused by some blunt trauma
Abrasions superficial wounds in which the topmost layer of the skin (the
epidermis) is scraped off
Avulsions: Injuries in which a body structure is forcibly detached from its
normal point of insertion.
Puncture wounds Caused by an object puncturing the skin, such as a splinter, nail
or needle.
Penetrating wounds Caused by an object such as a knife entering and coming out
from the skin.
Gunshot wounds: Caused by a bullet or similar projectile driving into or through
the body.

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The following measures need to be taken in giving first aid to a victim of open wound:
1. Stop the bleeding
Put a clean cloth or bandage on the wound, and then press gently on it to apply pressure. It
may take 20 to 30 minutes to stop it bleeding. Keep the pressure on the whole time, and
don't take it off to check what's happening. Keep the area of the wound raised, if it is
possible.

2. Clean the wound: this reduces the chance of the wound becoming infected.
o Rinse out the wound with clear water.
o If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol
to remove the particles.
o To clean the area around the wound, use soap and a washcloth.
o There's no need to use hydrogen peroxide, iodine or an iodine-containing cleanser.

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3. Cover the wound: with a sterile, non-stick dressing

Cover the wound with a clean dressing and bandage.
Dressings and bandages can help keep the wound clean and keep harmful bacteria out.
A dressing:
 done by sterile pad or compress (usually made of gauze or cotton wrapped in gauze)
 Should be large enough to totally cover the wound, with a safety margin of about 2.5
cm on all sides beyond the wound.
 A bandage is used to secure a dressing in place and to apply pressure to bleeding
wounds.

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Closed wounds: the skin is intact and the underlying tissue is not directly exposed to the outside
world. Even with the skin intact, the damage can reach down to the underlying muscle, internal
organs and bones.

The types of closed wounds are:

Contusions: more commonly known as bruises, caused by a blunt force trauma that damage
tissue under the skin.
Hematomas: also called a blood tumor, caused by damage to a blood vessel that in turn causes
blood to collect under the skin.
Crush injury: is an injury that occurs because of pressure from a heavy object onto a body part
or from squeezing of a body part between two objects.

The following measures need to be taken in giving first aid to a victim of a closed wound:

1. Application of direct pressure, preferably with ice wrapped in a cloth, for several minutes, in
order to arrest the bleeding as well as to reduce the swelling.
2. Elevation of the affected region will also support in reducing the pressure as well as the re-
absorption process and it should be practiced as and when appropriate.

2.3. First aid for bone and joint injuries

Fracture Is a breakage of bone tissue or discontinuation of bone tissue due to different causes or
accidents. Injuries of bones and joints can be bone fractures or dislocations and sprains of joints.
Possible causes of fracture:
 Accident / trauma
 Pathological due to bone infection
 Tumor of the bone
There are many types of fractures, but the main categories are open, and closed.
A closed fracture is when the bone breaks but there is no puncture or open wound in the skin.
An open fracture is one in which the bone breaks through the skin. This is an important
difference from a closed fracture because with an open fracture there is a risk of a deep bone
infection.

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Figure. Closed and open fracture

Fractures can be identified by symptoms that can be represented by:

 Pain
 Swelling
 Deformity
 Numbness or tingling sensation
 Discoloration severe pain
The following measures need to be taken in giving first aid to a victim with bone injury:
1. Don't move the person except if necessary to avoid further injury. Take these actions
immediately while waiting for medical help:
2. Stop any bleeding
Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
3. Immobilize the injured area
– Don't try to realign the bone or push a bone that's sticking out back in.
– If you've been trained in how to splint and professional help isn't readily available, apply a splint
to the area above and below the fracture sites.
 Splinting reduces pain, prevents further damage to muscles, nerves and blood vessels,
prevents closed fracture from becoming open fracture and reduces bleeding and swelling.
 In an emergency, almost any firm object or material can serve as a splint such as sticks,
boards, or even rolled up newspapers. An injured body part can also be taped to an
uninjured body part in order to prevent it from moving. For example, you can tape an
injured finger to the finger next to it, or fractured leg to uninjured leg to keep it immobile
(self-splint or anatomic splint)

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A basic rule of splinting is that the joint above and below the broken bone should be immobilized
to protect the fracture site. For example, if the lower leg is broken, the splint should immobilize
both the ankle and the knee.

Figure: Examples of splinting: A - Forearm fracture, B - Upper arm fracture, C – Lower leg
fracture (board and anatomic splint), D - Upper leg fracture
4. Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive.
- Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other
material.
2.4. First aid for burns
A burn is a coagulative necrosis of the surface layers of the body caused by heat.
Causes of burn
Fire, boiled water, steam, boiled oil and milk etc;
Sun-rays;
Electric and thunder accidents; and

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Different chemicals

Effects/hazards of the burn accident

Immediate effects/hazards:-
• Burns and wounds of the body;
• Severe pain;
• Oozing and reduction of body fluid from the wound;
• Difficulty in breathing because of suffocation from smoke, severe burns around the
throat and face; and
• Drowsiness, restlessness and unconsciousness.
Delayed effects/hazards
- Infections of the wound, septicemia, and high fever;
- Disability;
- Scar;
- Contracture; and
- Tetanus infection
According to the depth of injury to the skin, we distinguish four types of burn
1. Burns that affect only the superficial skin are known as superficial or first-degree burns.
2. When damage penetrates into some of the unit is partial-thickness or second-degree burn.
3. In a full-thickness or third degree burn the injury extends to all layers of the skin
4. Sometimes we talk about a fourth-degree burn when the injury affects deeper tissues, such as
muscle or bone. If the victim is burned with fire apply cold applications, immerse the burned area
in cold water role the burned person on the ground, or cover with water socked thick cloth or
blanket and put out the fire. If the accident is of electric source, quickly disconnect at the electric
meter or check point, or use rope wooden stick, dried cloth etc. to disconnect

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For minor burns: including first-degree burns and second-degree, take the following action:

1. Cool the burn.

 Hold the burned area under cool running water for 10 or 15 minutes or until the pain
subsides.
 If this is impractical, immerse the burn in cool water or cool it with cold compresses.
 Don't put ice on the burn
If the accident is of electric source, quickly disconnect at the electric meter or check point,
or use rope wooden stick, dried cloth etc.
2. Cover the burn with a sterile gauze bandage.
– Wrap the gauze loosely to avoid putting pressure on burned skin.
– Bandaging keeps air off the burn, reduces pain and protects blistered skin.
3. Take an over-the-counter pain reliever.
– These include aspirin, ibuprofen, naproxen or acetaminophen
– Use caution when giving aspirin to children or teenagers.
– Talk to your doctor if you have concerns.

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For major burns: 2nd and 3rd degree burn

For major burns, follow these steps

1. Don't remove burned clothing.
- However, do make sure the victim is no longer in contact with smoldering materials or
exposed to smoke or heat.
2. Don't immerse large severe burns in cold water.
- Doing so could cause a drop in body temperature (hypothermia) and deterioration of
blood pressure and circulation (shock).
3. Check for signs of circulation (breathing, coughing or movement).
– If there is no breathing or other sign of circulation, begin CPR.
4. Elevate the burned body part or parts.
– Raise above heart level, when possible.
5. Cover the area of the burn.
– Use a cool, moist, sterile bandage, clean, moist cloth or moist cloth towels.

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2.5. Shock

The condition in which the body fails to circulate oxygen-rich blood to all the parts of the body is
known as shock. Shock may result from trauma, blood loss, an allergic reaction, severe infection,
poisoning, severe burns or other causes. If left untreated, shock can lead to death. Always look for
the signals of shock whenever you are giving care.

The best way to protect people from the serious damages that shock can have on the system is to
recognize the symptoms before the person gets into serious trouble.

Common symptoms for shocked are:

o Pale, cold, clammy and moist skin
o Vacant or dull eyes, dilated pupils
o Anxiety, restlessness, and fainting
o Weak, rapid, or absent pulse
o Nausea and vomiting
o Shallow, rapid, and irregular breathing
o Excessive thirst
o Person may seem confused
o Look tired and fatigue

If you suspect shock, even if the person seems normal after an injury:

1. Call the local emergency number.

2. Have the person lie down on his or her back with feet higher than the head.
3. Check for signs of circulation (breathing, coughing or movement)
4. Control external bleeding
5. Keep the person warm and comfortable by loosening any belts or tight clothing and
covering the person with a blanket. Even if the person complains of thirst, give nothing by
mouth.
6. Turn the person on his or her side to prevent choking if the person vomits or bleeds from
the mouth.
7. Seek treatment for injuries, such as bleeding or broken bone

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2.6. Choking

o Partial Airway Obstruction

o Inhalation of a foreign body can cause partial or complete airway obstruction.

Signs & Symptoms

 Coughing  Noisy breathing

 Wheezing
 Difficult breathing
First Aid
o Encourage casualty to keep coughing
o Reassurance

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3. Communicate details of the incident

The role of first aider depends on gaining and honoring the trust of casualties. Maintaining trust
requires attentiveness to body language, quality of listening and finding culturally appropriate
ways of communicating that are courteous and clear. It may sometimes be necessary to
communicate through verbal and non-verbal communication and you may need to identify issues
that may cause conflict or misunderstanding. The first aider also needs to maintain respect for
privacy and dignity and pay careful attention to client consent and confidentiality.

Relevant communication media and equipment to conveyed emergency services/relieving

personnel include:
 Mobile phone
 Flags
 Flares
 Two-way radio
 Email
 Electronic equipment

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4. Reporting and recording

While waiting for help and if time permits, make a brief written report to accompany the casualty to
hospital. This will reduce time spent at the scene for ambulance crew and further assist medical with
initial patient management. A report can be written on a space piece of paper and should including
the following:

 Date , time, location of incident

 Casualty details-name, address
 Contact person for casualty- family member, friend
 What happened-brief description of injury or illness
 First aid action taken- what you did to help the casualty
 Other health problems- diabetes, epilepsy, asthma, etc.
 Medications/allergies
 When casualty last ate or drank
 Observations of vital signs- conscious state, pulse, breathing, skin state, pupils.

Record-Keeping

A record of any first aid treatment given should be kept by the first aider and reported to managers
on a regular basis to assist reviewing first aid arrangements. First aid treatment records are subject
to requirements under Health Records legislation.

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Incident/Complaint Report

EMPLOYEE: Return this COMPLETED FORM to your SUPERVISOR as soon as possible.

Name of Person Involved: _______________________________________
Address: _________________________ City: _____________________________________
Phone Number: ______________ Age: _________ DOB: _____________ Sex: M ____ F _____
SS#: _________________________ Date of Incident: _____________ Time: ______ am/pm
Exact Location of Incident: ______________________________________________
Check Type of Accident: Check:
 Clerical/Data Entry _____ Patient
 Communications _____ Employee
 Testing Process _____ Visitor
 Result reporting _____ Volunteer
 Safety _____ Other
 Medical Device Failure
 Policy/Procedural Violations
 Adverse Drug Reaction
 Vehicle Accident
 Needlestick
 Exposure to Hazardous Substance
 Medication Error (Wrong: Route, Dosage, Medication, Schedule)
EMPLOYEE: Involved _____ yes _____ no
Were they doing their regular job duties: _____ yes _____ no Observed by employee yes
Hire Date: ___ Marital Status: _________ Situation observed only by employee yes
Employee Classification: ______________________________
Protective Equipment being used: _____ yes _____ no
If not used, Why: ______________________________________________________
Description of Incident/Complaint (Who, What, Where, How, Why, Include sequence of events,
personnel involved, body part injured, reason incident occurred) (If medication error include brand
name, manufacturer, dosage) (Use additional form if necessary)______________________
Actions Taken by Staff Members: __________________________________________
Witness Name: __________________ Phone Number: _________________________
Address: ________________________________Name: ______________________________
Phone Number: _________________________
Address: ___________________________________________________

MEDICAL FOLLOW-UP: Was Medical Attention Sought: _____ yes _____ no

Treatment Refused: _____ yes _____ no First Treatment Date:
_________________________________
Treating Physician: _____________________ Phone Number: ________Address: ________
First Day Off Work: __________ Return to Work Date: _______________________
Duties Restricted: _____ yes _____ no Explain: _

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Work place Safety I I

TVET Program Title: Retail Pharmacy Assisting

Unit of Competencies HLT PRA2 08 0611 Basic First Aid

Module Name Work place Safety I I
Module code PRA2 M4 1017
Nominal Duration 40hrs
Module Description: This module aims to provide the learners with the knowledge, skills and right attitudes for
the provision of essential First Aid in recognizing and responding to an emergency using basic life support
measures. The First
Aider is not expected to deal with complex casualties or incidents, but to provide an initial response where First
Aid is required.
Learning Outcomes:
 Assess the situation
 Apply basic first aid techniques
 Communicate details of the incident
Module Contents
1. Introduction to first Aid
2. Basic life support
2.1. Respiratory Emergencies
2.2. First aid for wounds
2.3. First aid for bone and joint injuries
2.4. First aid for burns
2.5. Shock
2.6. Choking
3. Communicate details of the incident
4. Reporting and recording
Learning Methods
 Lectures
 Practical Classes/ Demonstrations
 Discussions and explanations
 Assignments and Seminars
 Case studies
 Exercises
 Role play
 Models
 Posters
 Brochures
MODULE ASSESSMENT
 Practical assessment by direct observation of tasks through simulation/role-plays
 Written test/oral questioning on underpinning knowledge
 project-related conditions (real or simulated) and require evidence of process
 Assessment methods must confirm the ability to access and correctly interpret and apply the
essential underpinning knowledge
Assessment Criteria
- OHS

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- Risk assessment
- Emergency procedures
- Basic anatomy and physiology
- Duty of care
- Resuscitation
- Care of unconscious
- National and regional regulatory requirements relating to currency of skill and knowledge
- Decision making
- Infection control
- Legal requirements
- Airway management
- Assertiveness skills
- Communication skills

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