E FIRST AID MEDTRAB Consulting in Quality and Productivity S / C Ltda. Rua Major Freire, 244 - sala 2001 - São Paulo - SP 5093.5616 (fax) - 275.1607 - 5589.4435 (fax) Email: grupomedtrab@uol.com.br CONTENTS INTRODUCTION PAGE • • • ENVIRONMENTAL HAZARDS STATEMENT OF ACCIDENT HAZARDS OF W ORK • • • CAUSES OF ACCIDENTS SAFETY INSPECTION OF ACCIDENT INVESTIGATION • • PR OTECTIVE EQUIPMENT - PPE • COMMISSION INTERNAL PREVENTION OF ACCIDENTS - CIPA CI PEIROS • • POWERS OF PREVENTION AND FIGHTING • FIRST AID TO FIRE 016 020 009 010 011 013 014 007 008 003 004 005 INTRODUCTION 2 Legislation on Safety and Occupational Health in Brazil is relatively new. After the publication of Decree Law No. 5452 of 1943, which created the Consolidation of Labor Laws - CLT, we highlight the following facts are most striking: Crea tion of the Internal Commission for Accident Prevention - CIPA, by Decree Law No . 7036 of 10 November 1944. Creation of the National Center for Safety and Occ upational Health, today Jorge Duprat Figueiredo Foundation for Occupational Heal th and Safety-FUNDACENTRO established by Law No. 5161 of 21 October 1966. Inte gration of Labor accident insurance to Social Security by Law No. 5316 of 14 Sep tember 1967. Creating mandatory Specialized Services in Safety Engineering and Occupational Medicine by the companies through the issue of Ordinance No. 3237 of July 17, 1972. Approval Regulating NR-Chapter V, Title II of the Labor Code , by Ordinance No. 3214 of 08 June 1978. edition of Ordinance No. 8, February 23, 1999 which amended the Standard Regulator No. 5 - CIPA, currently in force. ENVIRONMENTAL HAZARDS 3 Environmental risks are considered the physical, chemical, biological, ergonomic and accidents / mechanics who can bring or cause harm to workers' health in the workplace, due to their nature, concentration, intensity and duration of exposu re. Such agents are: • PHYSICAL HAZARDS noise, vibration, ionizing and non-ion izing radiation, cold, heat, humidity and abnormal pressures. • CHEMICAL HAZARDS mineral dust, dust plant, alkaline dust, metal fumes, fog, mist, gases, fumes and chemical products. BIOLOGICAL HAZARDS • Viruses, bacteria, parasites, ric kets, fungi and bacilli. • ergonomic hazards Monotony, incorrect postures, int ense pace of work, fatigue, worry, heavy physical work and repetitive. • RISKS O F ACCIDENTS / MECHANICAL inappropriate physical arrangement, machinery and equ ipment without protection, defective or inadequate tools, inadequate lighting, e lectricity, probability of fire or explosion, inadequate storage, venomous anima ls and lack of signage. STATEMENT OF RISKS What is Risk Map? 4 Consists of the graphical representation of the health risks identified by CIPA, in each of the various workplaces in a company. Objectives Risk Map gather the information needed to establish the diagnosis of the health and saf ety at work in the company. possible during its development, exchange and diss emination of information among employees and encourage their participation in pr evention activities. Who prepares the Risk Map? It is prepared by members of the Internal Commission for Accident Prevention - C IPA, after listening to employees of all productive sectors of the company, with advice from SESMT - Specialized Services in Safety Engineering and Occupational Medicine, where one exists. Stages of Development of Risk Map know the process of working on-site review; Identify risks in the property a ssessed; Identify existing preventive measures and their effectiveness; Iden tify health indicators (most frequent complaints, accidents, occupational diseas es, etc.). ; Knowing the environmental surveys already carried out on site. graphic representation of the Risk Map The risks are represented by circles of various sizes and colors shall be affi xed on the plant (layout) of the site analyzed. The size of the circle will in dicate whether the risk is high, medium or small (the larger the circle, the gre ater the risk). 5 For each type of risk the circles will be represented by a different color, as follows: • • • • • Physical risks: green; chemical risks: red; biological hazards: brown; ergonomic hazards: yellow; risk of accidents / mechanical: blue. Some examples: • At one warehouse was found that there are a lot of dust: Risk large (dusty) Color Red (chemical hazard) • In an office area were found some f ixed chairs, used to operate the microcomputer: Risk (average fixed seating) Col or Yellow (ergonomic risk) • In the canopy was found a canister of gas: Risk sma ll (cooking gas) Color Blue (risk of accident / mechanical) WORK ACCIDENT LEGAL CONCEPT Law No. 8213 of 07.24.1991 of Social Welfare which defines its ARTICLE 19: Occ upational Accident is the case by the exercise of work for a company, causing in jury or functional disorder that 6 cause death, or loss, or permanent reduction or temporary capacity for work. CONCEPT PREVENCION An unplanned event, unexpected or not, that interrupts or interferes with the normal process of an activity causing loss of time and / or injuries to employee s and / or property damage. So even the occurrences that do not result in injury or property damage must be considered as work accidents. TYPES OF ACCIDENTS Accidents in work performance. Accidents Path: those that occur in the course of residence for work and when we returned from work to our residence. Professional disease: is produced or triggered by exercise work. (Ex: silicosis, lung disease common in coal miners). Disease Labour: that is acquired or launched in function special conditions under which the work is done and it relates directly. (Ex: te nosynovitis). CAUSES OF ACCIDENTS Workplace accidents arise basically from three primary causes: unsafe acts These acts are performed in a manner contrary to the Safety Standards (eg, cli mbing chair to change a light bulb). 7 UNSAFE CONDITIONS There are deficiencies, defects, irregularities technical work environment tha t can cause an accident (eg, stairs without handrails, slippery floors).
PERSONAL FACTORS OF INSECURITY
Are the physical or mental characteristics of an individual that can interfere with work being performed (eg, emotional instability, lack of coordination). SAFETY INSPECTION It's the survey that is done in workplaces, in order to uncover risks of acciden ts: ROUTINE INSPECTIONS inspections are normally performed by members of CIPA and aim, above all, observe and avoid the creation of known risks, such as cupboards dangerous defects in paragraphs 8 vital equipment, carpets hipsters, use of extensions, benjamins (Ts), dangerous attitudes of officials, etc.. PERIODIC INSPECTIONS There are inspections that are done at regular intervals, mainly to discover r isks already provided, which can be characterized by exhaustion, aggressiveness and other efforts that are subject furniture, machinery, etc.. SPECIAL INSPECTIONS Inspections are usually performed by specialists in Work place Safety, using special equipment to monitor physical agents and / or chemic al (eg, decibel meter, thermometer, dosimeter, etc.).. INVESTIGATION OF ACCIDENTS Investigate an accident is to do your analysis after its occurrence, in order to discover the causes and take corrective action to prevent a recurrence of simil ar cases. To carry out an investigation of the accident, you should consider five (5) fact ors: AGENT OF INJURY Is the local environment, the act, well, what could be the cause of the injury. 9 A SOURCE OF INJURY It is the object that, acting on the body caused the inju ry. FACTOR FOR PERSONAL INSECURITY If there. NATURE OF INJURY Establish as was the contact between the injured person and the object or movement that ca used it (burn, cut, fracture, etc.).. THE LOCATION OF INJURY Allows often id entify the source of the injury and also indicate certain frequencies in relatio n to some factors of insecurity-rity. E.P.I. PROTECTIVE EQUIPMENT It is considered Personal Protective Equipment - PPE, any device for individual use, manufacturing domestic or foreign, to protect the health and physical integ rity of the worker. CABE THE EMPLOYER Provide employees free of charge Protective Equipment approved by the Ministry o f Labour - MTb appropriate to risk and in perfect condition and operation, where the measures of a general offer no complete protection against the risks of acc idents and injury to health employees. 10 CABE TO EMPLOYEE • Use it only for its intended purpose;• To take responsibility for their care, conservation and sanitation; • Communicate to the employer any change that rend ers it unfit for use, • the employee's wrongful act constitutes the unjustified refusal of the use of PPE NOTE All E.P.I. will present, in indelible and clearly visible, the trade name of man ufacturer or importer, and the number of CA (*) (*) - CA - Certificate of Approv al, issued by the Ministry of Labor and Employment - MTE. E.P.I. 's MOST USED TYPE OF PROTECTION FOR FACE PROTECTION PURPOSE against the risk of particle impact, splashes from chemicals, the action of light or heat radiation (infrared, ultraviolet and heat). against the risk o f falling objects beats, beats for electric shock, hair pulled, etc.. - EQUIPMENT STATED safety glasses (for flame cutters, grinders, grinders, welders, machinists). - Masks and shields (for welding). - Safety helmet PROTECTION FOR THE SKULL against noise hearing protection that exceed the limits of tolerance. RESPIRATOR Y PROTECTION - against gases or other substances harmful to the body that have the vehicle protective insert (or not moldable) guards outside (shell type) respirators with mechanical filters, chemical or combination of both types, 11 PROTECTION BODY PROTECTION OF UPPER LIMBS respiratory infection. against all kinds of aggressive agents. against cutting m aterials, abrasives, escoriantes, penetrating, thermal, electrical, chemical, bi ological and radiant that may damage or cause disease in their hands through the m. against impacts, electricity, molten metals, moisture, chemicals, sharp tools , biological agents, etc.. etc.. aprons of leather or PVC, PVC, canvas and plastic, depending on the type o f agent. steel mesh gloves, rubber, neoprene and vinyl, leather, scrapes, canvas and cotton, Kevlar, etc.. - PROTECTION OF LOWER LIMBS - safety shoes leggings leggings boots (with steel toe caps, insulators, etc.. mad e of leather, canvas, rubber, etc.. C.I.P.A. INTERNAL COMMISSION OF PREVENTION OF ACCIDENTS CIPA was founded in 1944, the government of Getulio Vargas. Its primary objective "to prevent accidents and occupational diseases." 12 The current legislation that regulates the Ordinance is No. 8, edited by the Min istry of Labor and Employment - MTE 2/23/1999. CIPA is composed of representatives of employers and employees, and substitutes, according to the proportions set out in Tables minimum of NR-5 POWERS OF CIPEIROS Members of CIPA have the following responsibilities: Identify the risks of the work process, and develop the risk map, with the participation of more workers, with the advice of SESMT (Specialized in Safety Engineering and Occupational Medicine), where it exists. Develop work plan that allows for preventive action in solving problems of safety and health at work. participate in the implementation and quality control of the necessar y preventive measures as well as assessment of priorities for action in the work place. Conduct periodically checks the environments and working conditions for the identification of situations that may pose risks to safety and health of wo rkers. 13 Make every meeting (monthly), assessment of compliance with targets fixed in its work plan and discuss the situations of risk was identified. Diss eminate information to employees on safety and health at work. participate, th e SESMT, where there is, of discussions facilitated by the employer to assess th e impacts of changes in the environment and work process related to safety and h ealth of workers. request the SESMT, if any, or the employer, the stoppage of a machine or secto r where it considers there are serious and imminent risk to safety and health of workers. Collaborating in the development and implementation of PCMSO (NR-7) and PPRA ( NR-9) and other programs related to safety and health at work. Disseminate and promote compliance with the Regulatory Standards and clauses i n contracts and collective bargaining work, concerning safety and health at work . participate, together with SESMT, where there is, or with the employer's ana lysis of the causes of diseases and accidents at work and propose measures to so lve the problems identified. Ordering the employer and analyze information on issues that have interfered with the safety and health of workers. To request copies of the CAT company issued. 14 Promote annually in conjunction with the SESMT, where there is the Internal We ek for Prevention of Work Accidents - SIPAT. participate annually in conjunction with the company, Campaigns Prevention of AIDS (and anti-smoking). FIRE PREVENTION AND COMBAT The instructions below are intended to give some theoretical notions regarding t he use of portable fire fighting. FIRE It is the result of a chemical reaction resulting from the combination of three elements, consisted the so-called "Triangle of Fire": FUEL is the element that serves food to the fire and can be: Solid: fabric, wood , paper, etc.. Liquid: gasoline, alcohol, ether, oil, diesel, etc.. Gas: gas coo king, gas, street, etc.. OXYGEN Also called oxidant, is another element of fire and is present in nature, it is he who gives life to the flames. 15 HEAT is the last element, leaving him the task of initiating combustion. Note the absence of any of these elements allows the emergence of fire. LEGAL ASPECT According to the Regulatory Standard No. 23 - Fire Protection, all companies mus t have: protection against fire. Sufficient exits for quick evacuation of the bu ilding. Adequate equipment to fight the fire in its early stages. People trained in correct use of equipment (extinguishers, hydrants, etc.).. PREVENTION The main goal of prevention is to prevent the emergence of a principle of fire, is hampering its development, or providing their extinction. HIERARCHY OF SHARES In case of fire must adopt the following procedures: Trigger the Fire Departme nt; Start the abandonment of the establishment; Fighting fire. 16 CLASSIFICATION OF FIRES CLASS MATERIAL CATEGORY A - (I) common fuel material: paper, wood, fabric, etc.. than to burn out, leave residues B - (II) Flammable liquids: gasoline, oils, pa ints, grease, etc.. that the burn does not leave residues C - (III) D energized electrical equipment - (IV) METHOD OF EXTINCTION TYPE OF EXTINGUISHER Cooling: w ater or fire extinguisher containing water. Choking: extinguishers smother or isolate flammable liquid air: dry chemical, fo am, CO-2 Extinguisher non-conductive of electrical current, ie not containing wa ter: CO-2 and dry chemical. Pyrophoric metal magnesium, tungsten, Sand, special chemicals, titanium, zirconium graphite, iron filings or rock salt. (CHARACTERISTICS OF EXTINGUISHERS) EXTINGUISHER DRY CHEMICAL POWDER FOAM (*) COMPARATIVE TABLE CATEGORY OF FIRE CO2 WATER A - (I) WOOD, CLOTH, PAPER, ETC. B - (II) OIL, GASOLINE, PAINT, GREASE, ETC. C - (III) EQUIPA.ELÉTRICO No, but early fire control Yes Yes Yes No, but small foci controls Yes Yes Yes Yes No No No 17 EMPOWERED D - (IV) pyrophoric metal E - (V) NUCLEAR FIRE (*) Foam Mechanics Extinguishing Media: Sand, special chemical compounds, graphite, iron filings or rock salt Specific Extinction FIRST AID Below we provide some basic, simple and important to attend to first aid. Rememb er, the life of the victim depends on the mode and the speed with which such cal ls are given. Hemorrhage Every time the blood out of the veins or arteries cau ses bleeding. Features: • When you notice that the blood spurts or sneeze into j et know that there was damage to the artery and the blood is bright red; • When the blood flows continuously without jets, the lesion was of the veins and dark red color is blue; • When blood is seen leaving the injury, saying that it was e xternal hemorrhage, otherwise the bleeding is internal call. Treatment of minor bleeding in intensity in arms and legs: • amounts to the injured limb, causing compression with gauze or clean cloth. in excessive bleeding: 18 • The procedure must be fast and safe by starting to cut or rip the clothes quic kly so that the wound is thoroughly exposed; • Then with gauze or a towel to do compression on the wound; • bleeding from the legs, arms and fingers can be cont rolled by tourniquet (tie, scarf or cloth strip). the nosebleeds (epistaxis): • Unscrew and remove the clothing ties; • placing the victim in a position recli ning with his head high; • pinch with the index finger of the wing nose against the nasal septum during 50-10 minutes. hemorrhages in the neck: • Compress the area with gauze and never use garrote. Burns Burns are injuries produced by e xcessive heat, electricity or chemicals (acids, bases).Rating: Can be 1st, 2n d and 3rd degrees and are much more serious as more extensive areas of the body affected. Treatment: cover the burned site with gauze; with extensive burns, seek to involve them with cloths, clean sheets or plastic; if the burn is pro duced by soaking clothing with acids or bases, withdraw it immediately, and wash with running water reached the surface; never use the site burned any "home r emedy"; not pierce bubbles; forward for medical evaluation. 19 Insolation and Intermação Features: Heatstroke is caused by the direct actio n of sunlight; The intermação is due to proximity to sources of heat such as o vens used by smelters, engineers, firemen, etc.. Treatment: • remove the clothes of the patient; • put it in shade or cool and airy • promote hydration, if nece ssary. Fainting Features: are caused by various reasons such as: - weakness - starvation - an upright position property. Treatment: • loosen the victim's cl othing and place it in an airy place; • talk to the victim in order to breathe d eeply, lowering his head forcefully forward, placing it between the legs on the lower level of the knees , • can also keep the victim lying on her back, trying to leave the head at lower level than the rest of the body. Eye Injury 20 Features: are caused by foreign bodies such as swarf, dust, insects, emery, ac idic materials, corrosives, etc.. Treatment: • Do not try to remove the foreign body, • where materials acids, or caustic, rinse immediately hit the eye with ta p water; • make packing and transporting the victim to medical care. lesions i n the bones and joints Injuries column: Keep the victim wrapped up and motionl ess. do not mess and do not let anyone touch the victim. never turn a person wit h a suspected broken spine; note vital signs, transport has to be done on a stre tcher or litter, avoiding to the maximum bend the body of the victim - during tr ansport in vehicles, avoid sudden braking and balances not to aggravate the inju ry - when the lesion is in the neck, wrap around the same, without pressing a sh irt, towel or other cloth to immobilize it. Fractures: In case of fractures, f irst aid is only to prevent the displacement of the broken pieces to avoid furth er damage. Features: - closed fractures: when the bone is broken but the skin wa s not perforated - fractures: when the bone is broken and the skin broken. 21 Arrangements: in closed fractures: • keep the injured limb in the position it was found, trying not to correct deviations; • Place the affected member support ing battens, so they are long enough to overcome the joints above and below the fracture; • any rigid material can be used as a splint (board, cardboard, metal rod, magazine or folded newspaper) • Use a cloth or soft material to pad the spl ints, to prevent damage to skin, • tie the splints with bandages or strips cloth , not too tight at the end of the joint below the fracture ends and at the joint above the fracture. open fractures: • place a gauze, a handkerchief or cloth over the wound; • firmly secure the dressing in place, using for this, a necktie , strip of cloth, etc.., • in the case of bleeding serious follow the instructio ns seen before; • keep the victim lying; • apply splints, as described for close d fractures, without trying to puch the member or to make it back to its natural position; • transport the victim to a doctor or hospital, as previous instructi ons, after the fracture has been immobilized. Dislocations and Displacements: • Whenever the bones of a joint board or do they leave their place as in the cas e of closed fractures. • Place the arm in a sling when there is dislocation of t he shoulder, elbow or wrist; • forward for medical care. 22 Sprains: • Treat as if there were a closed fracture, • applying ice and cold c ompresses; • refer for medical attention. Poisoning: Types: • by ingestion, inhalation •, • by skin contamination. Measures: • observ e evidence on the spot (bottle of poison pills, etc.). • assess vital signs and level of consciousness, • remove victim to fresh air, when there is contaminatio n of the environment, • remove clothing and wash with water current, when there is contamination of the skin, • do not induce vomiting if victim ingested gasoli ne, kerosene, acids,caustic soda or if you are unconscious or having seizures; • liquid and does not offer home or antidotes, • refer the victim to medical car e. 23 Cardio Pulmonary Resuscitation - CPR CPR is a set of measures that should be followed in the event of a cardiac arres t and / or respiratory until they transport the victim to the appropriate place for medical care. Parade Respiratory occurs when the total absence of breath ing, the person will die if breathing is not immediately reestablished. Signs of respiratory arrest: • absence of chest expansion, • lack of air out through the nostril or mouth. Arrangements: • approaching the ear of the victim's face to try to hear if there's air passage , or • placing a mirror or a glass object in front of the mouth and nostrils of the victim and if this is found not to be blurry to respiratory arrest; • apply immediately 04 (four) inflated with air and for this: • place the victim in the correct position (lying on your back supporting your neck with one hand and with the other press the forehead down, • keep your head in this position, plug the nostrils and blow forcefully into the mouth of the victim (placing the lips so t hat covers the entire mouth of the victim so that no air leaks) • in children, c overing his mouth with the lips and nostril, • between each inflated air, remove mouth not to impede the return air (expiration); • after the 04 (four) first continuous inflated, keep breathing at a rate of twe lve (12) to sixteen (16) by minutes, 24 • when respiratory arrest is caused by poisonous gases, chemical fumes or lack o f oxygen, remove victim to fresh air before you start breathing • when respirato ry arrest is caused by drowning, remove, if possible, the victim of water or rem ove it for a boat or a more reason to start breathing; • when respiratory arrest is caused by suffocation by plastic bag, tear the plastic and immediately start breathing • when respiratory arrest is caused by electric shock, break or separ ate the victim from the power before you start breathing. Cardiac Arrest: Signs of Cardiac Arrest: • no heartbeat; • no pulse (carotid, femoral or radial) • marked pallor. Arrangements: • place the victim lying on her back on hard surface, • put both hands and overl apping fingers interlaced in the lower half of the sternum of the victim; • pres sure to do next with enough force to the sternum download more or less 05 ( five ) inches and compress the heart against the vertebral column (then unzip) • repe at the maneuver as often as necessary (approximately 60 (sixty) compressions per minute). • put pressure on babies with only 02 (two) fingers to avoid fracturin g the ribs. cardiopulmonary arrest: If while cardiopulmonary arrest, you should perform ca rdiac massage associated with mouth to mouth, as follows: 25 to fifteen (15) and chest compressions without interruption, apply two (02) br eaths, repeating this cycle many often as necessary (if you're alone providing relief); making 05 (five) chest compressions while the second a rescuer applies mouth to mouth resuscitation (if in two rescuers); if necess ary, these procedures continue while the victim is being transported to the hosp ital. 26