First Aid Kits
One of the most important tools for an emergency responder is the first aid kitâ€”a portable collection of supplies used in the care of ill or injured patients. First aid kits come in various sizes, and their contents depend on the training of the responder, the purpose of the kit, and the regulations and policies that govern what first aid measures can be administered by the public, private attendants, or public safety personal.
Types of First Aid Kits
First aid kits can be classified by:
- Size and contents
- Type of emergency
- Expertise/training of responder using it
Size and contents
First aid kits can be small (pocket, travel, or fanny-pack sizes). These kits are usually limited in materials to assorted adhesive bandages (i.e., plasters), antiseptic wipes, and medications such as antibiotic ointment, hydrocortisone, and acetaminophen. They may also contain nonlatex medical gloves and gauze dressings/bandages.
Medium-sized first aid kits may fit in backpacks, glove compartments, brief cases, or carry-on luggage. In addition to the items found in smaller kits, these kits may contain tape, scissors, tweezers, instant cold packs, glucose doses, larger gauze bandages, triangular bandages, and space blankets.
Larger kits may contain greater qualities of materials and supplies in a bag, a box, or a backpack. Still larger kits may be mounted to the wall of a first aid room or station.
Type of emergency
Although most first aid kits are general purpose, some first aid kits have a specific purpose (e.g., trauma kits, obstetrics packs, etc.) Even a lifeguard’s fanny pack is designed to provide those items (i.e., resuscitation mask, gloves, and gauze pads) required for initial care of an unresponsive patient until a larger first aid kit can be brought to the scene.
Expertise of the responder
As a general rule, first aid kits should only contain the supplies that you have been trained to use and are allowed to use by regulation or local policy. For example, if local policy prohibits you from dispensing medications, then all medications should be removed from the first aid kit you use.
EMTs and paramedics may use first aid kits with such advanced devices as:
- Advanced airways
- Manual or mechanical suctioning equipment
- Oxygen equipment
- Injectable and intravenous drug therapies
- Blood-pressure equipment (i.e., aneroid sphygmomanometer, stethoscope, etc.)
- Tourniquets and hemostatic agents
In the United States, Occupational Safety and Health Administration (OSHA) requirements for workplace first aid kits are found in 29 CFR 1910-151. Part of this regulation states “…in the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available.” Additionally, an appendix in this regulation recommends the American National Standards Institute (ANSI) requirement Z308.1-1998 as a guideline for the minimum content of an industrial first aid kit.
Recommended minimum fill content
This requirement specifies the following content for Type I (indoor mounted), II (indoor portable), and III (outdoor portable) first aid kits:
- 1 absorbent compress, 4″ x 8″ minimum
- 16 adhesive bandages (plasters), 1″ x 3″ each
- 1 adhesive tape, 5 yards
- 10 antiseptic applications, 0.5g each
- 6 burn treatments, 0.5g each
- 2 pair medical examination gloves
- 4 sterile pads, 3″ x 3″ each
- 1 triangular bandage, 40″ x 40″ x 56″
In addition to these minimum fill requirements, employers should add additional items deemed necessary during the number of employees at a work site and the type of duties performed. The selection of additional supplies should be made by consulting with a health care professional or a person competent in first aid who is knowledgeable of the hazards found in that specific workplace. The optional items shall meet specifications stated in Section 5.3 of ANSI Z308.1-1998.
As part of additional items to include in a first aid kit, the regulation ties back into the Blood-borne Pathogens standard by stating: “If it is reasonably anticipated that employees will be exposed to blood or other potentially infectious materials while using first aid supplies, employers are required to provide appropriate personal protective equipment (PPE) in compliance with the provisions of the Occupational Exposure to Blood-borne Pathogens standard, Â§ 1910.1030(d)(3) (56 FR 64175). This standard lists appropriate PPE for this type of exposure, such as gloves, gowns, face shields, masks, and eye protection.”
Labeling and markings
First aid kits in compliance ANSI Z308.1-1998 must have the following label affixed to the back or outside of the kit with no writing smaller than a 6-point font:
Additional labeling/marking requirements exist for unitized first aid kits. A unitized first aid kit contains first aid applications and materials packaged in uniform boxes containing one or more applications. This packaging must meet certain requirements as detailed in the ANSI specification and must be color coded as follows:
- Blue: antiseptics
- Yellow: bandages
- Red: burn treatments
- Orange: personal protective equipment
- Green: Miscellaneous
Other Standard Markings
The International Organization of Standardization (ISO) has designated a white cross on a green background to indicate first aid. This has been widely accepted throughout Europe. In the United States, you may see the ISO designation or sometimes either a Red Cross on a white field or a white cross on a red field.
Note: The International Committee of the Red Cross (ICRC) and, by extension, the American National Red Cross shares a trademark of the Red Cross symbol with the pharmaceutical and therapeutic company Johnson & Johnson, the inventor of commercial first aid kits, BAND-AIDÂ® brand adhesive strips, maternity kits, and mass-produced dental floss, among other innovations. Click this link for more Johnson & Johnson history.
A final symbol that may appear on a first aid kit is the Emergency Medical Services (EMS) Star of Life. This symbol identifies first aid kits, vehicles, and other equipment used by emergency medical responders (EMRs), emergency medical technicians (EMTs), paramedics, and other advanced medical personnel.
The points on the Star of Life stand for early detection, early reporting, early response, on-scene care, care in transit, and transfer to definitive care. The image in the center is the Rod of Asclepius, an ancient Greek symbol for healing.
Lifeguard First Aid Kit System
It has become popular for lifeguards to carry a fanny pack with minimal first aid supplies, such as a pair of gloves, a resuscitation mask, sterile pads, and an absorbent compress (roller gauze). Lifeguards use the contents of the fanny pack to begin first aid care until other lifeguards bring a larger first aid kit and other equipment to the scene.
Because the fanny pack contains a resuscitation mask, it is often brought into the water with the the rescuing lifeguard. If the fanny pack contains sterile items (e.g., adhesive bandages, gauze pads, roller gauze, etc.), these items must be sealed in waterproof protection or, better still, they should not be taken into the water at all. Gloves, gauze, adhesive bandages, etc. are useless in the water and they may become contaminated or lost in the water when the lifeguard brings the fanny pack into the water for the rescue.
A better system
A better first aid equipment solution for lifeguards follows:
- Lifeguards should have a rescue tube/rescue board and a fanny pack (perhaps red) containing adult and pediatric resuscitation masks. This fanny pack can go into the water with the lifeguard during a rescue to give initial ventilations, if necessary.
- A second fanny pack (perhaps green) should be mounted at every lifeguard station. This fanny pack should not get wet because it contains the following items:
- Nonlatex examination gloves, 2 pair (1 pair large and 1 pair medium/one-size-fits-most)
- Hand sanitizer, small bottle
- Adhesive bandages, assorted, sterile, and waterproof
- Absorbent pads, 2 sterile 3″ x 3″ items
- Absorbent compress, 2 sterile 4″ x 8″ or more
- Foil blanket
- The person in charge (PIC) or another lifeguard should take over first aid care after the victim is removed from the water. This means the rescuing lifeguard is relieved. After all, that lifeguard is wet and has just completed an exhausting swimming rescue. Additionally, the victim should be kept dry and warm (i.e., normal body temperature).
- A break lifeguard or other team member should bring out an ANSI Z308.1-1998 Type III first aid kit as soon as possible.
Contents of a Type III facility first aid kit
The Type III First Aid can be used for employees and guests. It should contain all mandatory items listed above as well as additional items as follows:
- Resuscitation masks for adults, children, and infants
- Bag-valve-masks for adult and pediatric patients
- Adhesive bandages; assorted, sterile, and waterproof; including 1″ x 3″s, knuckle, fingertip, large patch, dots, butterfly, etc.
- Elastic bandages
- Roller gauze bandages, sterile, 4-inch and 6-inch
- Tape, surgical, hypoallergenic
- Triangular bandages, muslin, 40″ x40″ x 56″
- Absorbent gauze pads, sterile, 4″ x 4″
- Eye patches, sterile
- Occlusive dressings, sterile, 4″ x 4″
- Trauma dressings, sterile, 10″ x 30″
- Obstetrics pack
- Bulb syringe, sterile
- Clamps or ties
- Scissors, sterile
- Splints, rigid
- Cotton swabs
- Emergency foil blanket
- Saline and irrigation syringe
- Alcohol prep pads
- Antiseptic applications
- Burn treatments
- Cold packs
- Glucose doses
- Heat packs
- Personal protective equipment
- Apron or smock
- Exam gloves, nonlatex, various sizes
- Face shields or goggles and surgeon’s masks