The AED – A Real-Life Rescue

The Automatic External Defibrillator

In 1978, the first portable Automated External Defibrillator (AED) was designed. This was the first design which allowed the AED to be used in emergency cases by minimally trained people. Since then AEDs have been researched and evolved into extremely light, user-friendly equipment that can be used anywhere, by anyone.

AEDs automatically detect whether the person (in layman’s terms) is alive, provide CPR instructions and decide on the provision of a shock. When the AED is used within a minute of the cardiac arrest, the survival rate is 90%. However, time is of the essence as the survival rate decreases by 10% every minute. Furthermore, it records the data and heart rhythms at the time of its use, assisting medical practitioners in the diagnosis of any heart conditions which may be present.

AEDs in Malta is becoming more popular. Local councils, clinics, schools, football grounds and shopping Malls are some of the sites which are most likely to have an AED.

An application called “AED Malta”, shows a number of AEDs which has been registered with the NGO running the application. The application shows the location of the nearest AED in your position.

Subsidiary legislation 424.13, regulates the requirements of first aid at the workplace in Malta. This legislation is quite simple, outlining the need for first aiders, a first aid room and first aid boxes, all depending on the number of workers employed. However, there is no mention of AED requirements. The decision to implement one is up to the company’s discretion and the H&S practitioners managing the safety provisions at the workplace.

We spend 8 hours a day at work, not at places of service and recreation, that’s one-third of our lifetime. And where we need it most, the AED might not be readily available.

It is a significant investment to procure the AED, train the personnel to use it and upkeep both the training and the equipment. However, I believe it is more important when a person survives an emergency requiring its use and returns home.

The following picture is data extracted from the use of an AED, showing the moment when regular heart rhythm was established by delivering CPR and using the AED following a sudden cardiac arrest caused by an irregular heartbeat. I was involved in this event, and within 5 minutes, due to the availability of the AED, and trained personnel, we were able to save this person.

AED Extract - Malta Safety Lens
AED Extract – Malta Safety Lens

I am sharing this information to raise awareness of the importance of AEDs at the workplace, and to show that they do actually save lives.

Doesn’t the above event justify the investment in an AED or several AEDs in bigger workplaces?

Put forward the idea to management, share this event, get approval, and have one at your workplace. Hope the need for it never arises, but if it is required, it’s invaluable to have one.

Safety Glasses

“In-Nuccalijiet”

The human eye is one of the most vulnerable and exposed organs in our body. Most of the other organs are protected behind the human skeleton, however, the eye only has the eyelids and the eyelashes as natural protection. In conjunction with our natural reflex to blink our eyelids protect our eyes from dust, wind, intense light and small flying objects such as insects.

However, this protection is natural and only protects against natural sources of harm. At the workplace, we have several industrial processes which bypass such natural protection due to their excessive speed, forces, radiation and/or light. It is often observed that grinding, rock breaking, metal work, polishing, lathework and other work processes which may create flying particles or intensive radiation/light (such as welding) are carried out without the required collective protection.

Usually, the first thing that comes to mind as protection for the eyes is safety glasses. However, as per the hierarchy of controls in health and safety, these are the last item to consider when implementing control measures. Safety glasses offer only individual protection and should they fail, they do not fail to safety, meaning the individual will be harmed. Other collective protective measures should be considered prior to the provision of safety glasses.

We’ll be using a pipe-cutting machine as an example to outline what some of these measures are.

  • Elimination: Is it possible to remove the process of using the pipe-cutting machine? For example by purchasing pipes of the correct length?
  • Substitution: Is it possible to change your equipment or process to use lesser hazardous equipment? Will a hand operated pipe cutter do the required work?
  • Engineering Control: Does the machine has the required guards to make sure that in case of failure the hazard does not reach the user? Can the machine be completely isolated from the worker by enclosing it?
  • Administration controls: Is the pipe cutting machine subject to a periodic maintenance regime? Have the personnel been trained on the use of this equipment? Are safety signs posted and rules implemented?

After considering the above, PPE is to always be implemented when using industrial high-risk equipment. All the above-mentioned measures reduce the risk significantly, but some residual risk will always remain as we can never be completely safe and this is mitigated by PPE, more specifically safety glasses in this case.

Different types of eye protection are available depending on the hazard one needs to protect against. Amongst others, these include safety glasses, safety goggles, hood and face shields.

The type of eye protection made available to the employees should be based on a risk assessment, based on manufacturer guidelines and certification.

The main types of certification for safety glasses are EN166 (European standard) and ANSI Z87.1 (American standard). Such certification would be outlined on the safety glasses frame and also on the lenses.

For employees who wear prescriptive glasses, there are two options, either safety over-glasses or prescriptive safety glasses. Over glasses, as the name implies, are safety glasses which are designed to be worn over normal prescriptive glasses. Prescriptive safety glasses are specifically designed safety glasses which have integrated certified prescriptive lenses.

Regardless of the type of safety glasses chosen, it should always be ensured that these are manufactured to the previously mentioned standards. I have come across situations where suppliers provide frames which are certified but fitted with normal non-certified prescriptive lenses. Personally, I do not accept or recommend these types of glasses within my workplace and practice the rule “no certification means not allowed”.

For any equipment to be certified, this has to be manufactured according to a standard, as such the only local shops which provided these prescriptive safety glasses are PPE importers who order the glasses directly from the PPE manufacturer.

When a grinder wheel is spinning up to 2000 RPM, all safety features fail and it detaches, you want to be sure that the personal protective equipment provided to the employees is certified as safety equipment. PPE is always the last line of defence.

(Picture by Gillian S: Safety Glasses Save Lives (bulksafety.com))

Have a look at the safety glasses used by yourself or at the workplace, are these adequate and certified? Are the employees who use prescriptive glasses offered the same level of protection as all other employees? Are you making use of safety glasses to reduce the level of residual risk?

Management of Change

“L-Immaniġjar tal-Bidla”

Articles, blogs, entrepreneurs and business leaders all state that change is required for a company to grow and maintain a competitive edge against its competitors. Changes may occur in the product being provided, the company’s branding, management of people and technological changes. Such changes can promote the company’s profits, increase employee engagement and growth, and lead to a safer workplace. However, they can also lead to uncertainty, additional financial costs, reduced performance and the introduction of new hazards and risks.

The effectiveness of a change depends entirely on the management of the said change.

Management of change is a process by which the changes are systematically analysed to identify inherent environmental, health, safety and business risks which may be introduced in the process of implementation. It is so important in health and safety that it is an identified clause required to be implemented for ISO45001 Occupational Health and Safety Management Systems certification. Furthermore, although not mentioned directly in legislation, the General Provisions for Health and Safety (S.L. 424.18), places an obligation on the employer to evaluate the risks arising from equipment, chemicals, work processes and the workplace. As such, it can also be said that a procedure for the management of change helps the employers stay compliant.

Management of the change process would usually involve the following steps:

  • A request for a change
  • An evaluation of risks and hazards related to the change
  • An evaluation of compatibility with current work equipment, infrastructure, chemicals and work processes.
  • Identification of any changes required
  • Training on the change and
  • Implementation

A concept which goes hand in hand with “Management of Change” is “Safety by Design”. Which, as defined by Worksafe is “the process of managing health and safety risks throughout the lifecycle of structures, plant, substance or other products”, perfectly illustrated in the picture below.

(WorkSafe New Zealand, 2018)

Should a change not be managed correctly, and safety not be given importance at the designed stage, the costs to remedy the risks introduced and the possibility of harm increase significantly.

When considering environmental, health and safety, quality and business requirements, change is not a matter of procuring and implementing equipment. It requires time, careful planning and proper evaluation. The personnel leading the change must make sure that the following pitfalls are avoided:

  • Lack of communication and consultation with the stakeholders who may be affected by the change
  • Tackling a big or several small changes all at once without the adequate resources
  • Think that the change will affect only its immediate surroundings, without giving due consideration to secondary equipment, processes, legislative and standard requirements.
  • Beliving that the change has been fully implemented, without proper long-term monitoring of its effectiveness.

In today’s fast-paced industry, change is no longer optional to stay ahead within your sector but is most often imposed by legislative changes, technology advancements and stakeholder requirements. As such, having a robust system to manage such changes is as important as any other day-to-day procedure required to keep the company afloat.