October 2, 2012

Lessons from Ernest Shackleton's Medical Kit

"Men wanted for hazardous journey. Low wages, bitter cold, long hours of complete darkness. Safe return doubtful. Honour and recognition in event of success."

That is the ad that was allegedly posted to attract crew to Sir Ernest Shackelton's Arctic Expedition on the Nimrod in 1907-09. There's been a lot written about this adventure to one of the then-most remote corners of the earth. It is still among the most remote wilderness locations today - contemporary workers who agree to stint at Antarctic bases have to prepare for a long haul since some locations only afford a two to three month window when bases are reachable.

A few years ago, when Gavin Francis accepted the position as a medical doctor 'wintering' at Halley Base, a profoundly isolated research station on the Caird Coast of Antarctica, he had to plan accordingly since the base is unreachable for ten months of the year. He's written a pretty fascinating article in Granta magazine comparing the preparations he took in terms of supplying a medical kit with the list of supplies in Shackleton's Medical Kit.

"In the well-stocked polar section of the little base library I unearthed the packing list for Shackleton's medical kit - the drugs and dressings he took on the sledge trips of his Nimrod Expedition of 1907, the one that turned back only ninety-seven miles from the South Pole. It added up to a weight of about three kilos, less than a sixth of the modern kit, and to my technomedical mind read more like a witch's grimoire than the best medical advice of just a century ago."

It's a pretty fascinating read, one that we think might tickle the fancy of occupational physicians. We enjoyed the author's observations about how the practice of medicine has changed, particularly in regards to the challenges of caring for a workforce in a remote location.

Chances are, no matter how remote your workplace, planning for employee health and safety program doesn't have quite the same extremes in parameters. But one thing remains true: advance planning can still mean the difference between life and death; knowing how to respond quickly can be the difference between a relatively minor event and a life-changing tragedy.

What's the status of your workplace first aid kit?
In Fundamentals of a Workplace First-Aid Program (PDF), OSHA suggests:

"Employers should make an effort to obtain estimates of EMS response times for all permanent and temporary locations and for all times of the day and night at which they have workers on duty, and they should use that information when planning their first-aid program. When developing a workplace first-aid program, consultation with the local fire and rescue service or emergency medical professionals may be helpful for response time information and other program issues."
The booklet outlines OSHA Requirements, recommended First-Aid Supplies, including Automated External Defibrillators, guidance on First-Aid Courses and Elements of a First-Aid Training Program. In addition to evaluating their own organization's risk factors, employers should be aware of any state laws governing workplace first aid.


ANSI/ISEA Z308.1-2009 is the current minimum performance requirements for first aid kits and their supplies that are intended for use in various work environments. You can purchase these through the American National Standards Institute (ANSI) or the International Safety Equipment Association (ISEA). If you want to save a few dollars, you may be able to find a free copy, such as the one we found minimum contents list from the Minnesota Department of Labor and Industry.

Automated external defibrillators (AEDs) programs are an increasingly common component in a workplace health and safety program to address sudden cardiac arrest. These programs require some medical guidance and training to put in place.

Arguably, one of the most parts of your emergency planning should be to prepare your employees and your supervisors about what to do in the case of a medical emergency. Put your policies and protocols writing and communicate them to your employees frequently. Don't forget to include solitary and remote workers in your emergency planning.

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About this Entry

This page contains a single entry by Julie Ferguson published on October 2, 2012 1:11 PM.

Annals of Compensability: Heart Attacks at Work was the previous entry in this blog.

News roundup: Risk, Dispensing Docs, Costs for Employees, Litigation & more is the next entry in this blog.

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