First Aider access to medical records

Rpj · Post by **Rpj** » Mon Jan 28, 2019 3:22 pm

I’m just after a bit of thought from a few contributors...

As HSE managers we often have access to medical information from pre-employment questionnaires to reviews of disabilities etc. however we cannot be everywhere at once... a first aider has raised the question of them having access to limited medical information for members of staff so as to limit the possibility of a historical medical issue leading to a mistreatment of an illness or injury.

My thoughts are; we should not give this access, we are very low risk with little history of workplace illnesses or injuries therefore I would feel uncomfortable providing this information “just in case” where there is no history of it ever being useful. Just wanted to hear from a few others to gain a wider opinion point.

Thanks

Post by **bernicarey** » Mon Jan 28, 2019 4:11 pm

It would be relevant for important life critical information to be available on a case-by-case basis, e.g. allergies that require Auto-injector intervention. Such info would have to be at the discretion of the employee concerned; i.e. what might a First Aider need to know in order to keep them alive.

There is probably very little info that would be relevant and life critical for the majority of workplaces and employees.

I trained a FAW course a few years ago and one delegate was that severe an anaphylactic she had an auto-injector in every FAK in her workplace so that here fellow First Aiders could treat her.
She could literally drop to the ground within 15 seconds of exposure to peanuts and she worked in food retail!!

Essex · Post by **Essex** » Mon Jan 28, 2019 11:13 pm

First aiders are exactly that - first aiders. They are not medical proffesionals. People forget this and get incredibly over-excited about their role which is nothing more than a band aid until the professionals turn up.

Post by **WillPool** » Tue Jan 29, 2019 4:18 am

Essex wrote: ↑Mon Jan 28, 2019 11:13 pm First aiders are exactly that - first aiders. They are not medical proffesionals. People forget this and get incredibly over-excited about their role which is nothing more than a band aid until the professionals turn up.

Would be amazing to see a trained first aider doing CPR with a band aid !!

Will

julietrvn · Post by **julietrvn** » Tue Feb 05, 2019 6:09 pm

the approach i use when a medical questionnaire has highlighted a medical condition that may require emergency treatment at work (such as hypo/hyperglycemia or epilepsy) is to have a confidental chat with the employee to ascertain how well controlled the condition is. If it a newly daiagnosed condition or the medication has been changed, the condition may not be very well controlled. I then ask their permission to share the relevant information with first aiders and i also ask them if there is anything that they feel the first aiders need to be aware of, they know their condition better than anybody and know what works for them. This also gives me the opportunity to ascertain if any reasonable adjustments are required, or in the case of a diabetic, do they need a quiet, clean area to check their blood sugar/administer the insulin.

And yes first aiders are not medical professionals but they have an important role in not just administrating first aid to accident victims but also for medical emergancys

Andyblue · Post by **Andyblue** » Wed Feb 06, 2019 12:20 am

In broad terms doesn't it depend on the company setup, layout, distribution of FA / workers etc rather than trying to pin down if they could or should have been primed about medical records. Many cases could be reasoned that it may be good to pre-empt the FA of an individuals medical records as much as it wouldn't.
If we provide pre-emptive medical records to FAs, are we inviting and expecting a degree of confidentiality that the FA might otherwise not want to have. They may want to provide FA but that does not mean they also want to be guardians of individual's medical records in their heads. FAs are not expected to hold confidentiality in the same way as a medical practitioner.

Essex · Post by **Essex** » Wed Feb 06, 2019 10:09 am

julietrvn wrote: ↑Tue Feb 05, 2019 6:09 pm the approach i use when a medical questionnaire has highlighted a medical condition that may require emergency treatment at work (such as hypo/hyperglycemia or epilepsy) is to have a confidental chat with the employee to ascertain how well controlled the condition is. If it a newly daiagnosed condition or the medication has been changed, the condition may not be very well controlled. I then ask their permission to share the relevant information with first aiders and i also ask them if there is anything that they feel the first aiders need to be aware of, they know their condition better than anybody and know what works for them. This also gives me the opportunity to ascertain if any reasonable adjustments are required, or in the case of a diabetic, do they need a quiet, clean area to check their blood sugar/administer the insulin.

And yes first aiders are not medical professionals but they have an important role in not just administrating first aid to accident victims but also for medical emergancys

Can I ask what your qualifications are in terms of medical practice to make an informed decision on a persona medical history?

Post by **WillPool** » Wed Feb 06, 2019 10:22 am

Essex wrote: ↑Wed Feb 06, 2019 10:09 am
julietrvn wrote: ↑Tue Feb 05, 2019 6:09 pm the approach i use when a medical questionnaire has highlighted a medical condition that may require emergency treatment at work (such as hypo/hyperglycemia or epilepsy) is to have a confidental chat with the employee to ascertain how well controlled the condition is. If it a newly daiagnosed condition or the medication has been changed, the condition may not be very well controlled. I then ask their permission to share the relevant information with first aiders and i also ask them if there is anything that they feel the first aiders need to be aware of, they know their condition better than anybody and know what works for them. This also gives me the opportunity to ascertain if any reasonable adjustments are required, or in the case of a diabetic, do they need a quiet, clean area to check their blood sugar/administer the insulin.

And yes first aiders are not medical professionals but they have an important role in not just administrating first aid to accident victims but also for medical emergancys
Can I ask what your qualifications are in terms of medical practice to make an informed decision on a persona medical history?

Doesnt mention any qualifications, however a confidential chat with an employee who has an illness (that doesnt need a band aid!!) will often give you any additional requirements for any treatment (epi-pens, glucose etc etc) these things are covered on a first aid course. Well trained first aiders will realise their limitations and always seek further help (doctor or emergency services) when required. Knowledge, training and experience, all part of Competency

Will

Essex · Post by **Essex** » Wed Feb 06, 2019 12:51 pm

WillPool wrote: ↑Wed Feb 06, 2019 10:22 am
Essex wrote: ↑Wed Feb 06, 2019 10:09 am
julietrvn wrote: ↑Tue Feb 05, 2019 6:09 pm the approach i use when a medical questionnaire has highlighted a medical condition that may require emergency treatment at work (such as hypo/hyperglycemia or epilepsy) is to have a confidental chat with the employee to ascertain how well controlled the condition is. If it a newly daiagnosed condition or the medication has been changed, the condition may not be very well controlled. I then ask their permission to share the relevant information with first aiders and i also ask them if there is anything that they feel the first aiders need to be aware of, they know their condition better than anybody and know what works for them. This also gives me the opportunity to ascertain if any reasonable adjustments are required, or in the case of a diabetic, do they need a quiet, clean area to check their blood sugar/administer the insulin.

And yes first aiders are not medical professionals but they have an important role in not just administrating first aid to accident victims but also for medical emergancys
Can I ask what your qualifications are in terms of medical practice to make an informed decision on a persona medical history?
Doesnt mention any qualifications, however a confidential chat with an employee who has an illness (that doesnt need a band aid!!) will often give you any additional requirements for any treatment (epi-pens, glucose etc etc) these things are covered on a first aid course. Well trained first aiders will realise their limitations and always seek further help (doctor or emergency services) when required. Knowledge, training and experience, all part of Competency

Will

With respect that is not what was posted. What was posted was asking employees what medication they take. How they manage their illness, are they managing it effectively and then asking to share this information with the first aiders.

So my question is a valid one. Who is my manager to ask me those questions and what guaruentees do I have that 1. That information is being used correctly and 2. The person making a judgement based on that information is qualified to actually make an informed judgement?

I have no issue withbthe recruitment process meaning a proffessional occupational health proffessional is brought in but I have a huge problem with untrained management and first aiders thinkibg they have some right to this information and that they are competent to use it effectively.

Stick to first aid. You are not a doctor.

witsd · Post by **witsd** » Wed Feb 06, 2019 4:14 pm

"What are your symptoms?"

"Are you taking medication to manage your symptoms?"

"Does your medication completely control your symptoms?"

"Do you ever forget to take your medication?"

I don't see how asking pretty basic questions such as these necessitates a medical degree. No-one is suggesting that the first aider would be assessing the medication itself, or any other action that would require expertise.

I can't build an FD60 fire door, but I can tell that the propped-open FD30 is unlikely to do the job.

julietrvn · Post by **julietrvn** » Thu Feb 07, 2019 5:30 pm

Essex:

I did not say in my post that i ask employees how they manage their illness or what medication they take, i said (and i quote)

'have a confidental chat with the employee to ascertain how well controlled the condition is'

If insulin has only recently been prescribed or had to be changed for a medical reason, it can take up to 6 months to achieve the correct dose and you may not be aware, but hypo and hyperglycemia are very serious conditions and can even be fatal if not treated immediately. If first aiders are aware of this, they are in a position to ensure the emergency responders are fully aware of the condition and any required treatment is administered immediately.
The same applies to epilepsy, anticonvulsant medication is not a quick fix and again it can take a few months for the correct dosage to be determined, and yes i know this due to 16 years’ experience as a qualified and practicing nurse before i changed careers.

So asking an employee if their condition is well controlled or still in the stabilizing period is a relevant and important question in my opinion.

i dont need to ask what medication they take. if they are type 1 diabetic, i know that they need to inject insulin and so will require both the time and space to undertake this, other than that, what medication they take is not my concern unless they take the decision to inform me of any potential side effects they think may be relevant or are prescribed an anticoagulant medication, which has a detremental effect on how even a simple cut is treated. (trust me, a band aid is not applicable in this situation!)

i never share any information unless i have full permission from the employee and i only ever share information that the employee wants me to share.

You may not agree with my approach, but judging on the positive feedback i have received from employees i have undertaken this process with, and knowing that even a few seconds may save somebody's life in a medical emergency, i am going to continue.

Brett Day SP · Post by **Brett Day SP** » Tue Mar 05, 2019 4:52 am

I suffer from OSA (Obstructive Sleep Apnoea), and have no qualms about discussing my condition. However, if the worst happens I have an ICE tag on my hardhat and wear an SOS Talisman.

I have had guys on site with serious medical conditions who do not want to discuss them, what I have done is recommend that they get an SOS Talisman and/or fill out the ICE tag that we give to everybody on induction and ask they keep the details up to date (I'm happy to provide additional tags as required).

This means that Information is with the casualty and to hand without the concerns of the individual that their condition is being discussed by persons they wouldn't want it discussed with.