Safety consultant with a passion for applying common sense. Offering advice and guidance on many areas of health and safety, including: fire safety; changes in the law; facilities management, asbestos, and many other areas. Helping to keep companies out of court. We also do Food Safety.
Monday, 16 November 2009
Landlord Duties
As a landlord (or as a facilities manager) you are responsible for the premises as a whole, but have special responsibility for the common areas of the premises. These can be thought of the parts of the premises not demised to the tenants. Typically, these may include: car parking areas, external areas (roads, paths, lighting, refuge areas, etc), entrance doors, reception areas, corridors, staircases and lifts. In addition, the landlord will usually be responsible for the various plant rooms (boiler room, lift motor room, pump rooms, etc), roof areas, fixed electrical installation, water supply, etc as well as for the safe management of contractors working in these areas. There are also some special areas of safety management that need to be considered, such as: fire safety for the common areas, the fixed electrical installation, cooling towers, asbestos, etc.
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Friday, 6 November 2009
Suspension Trauma - Don’t keep them hanging about
Introduction
It is well known that the Work at Height Regulations 2005 are concerned with working safely at heights:
• avoiding work at height, where it is reasonably practicable to be do so
• preventing falls from height, where it is reasonably practicable to be do so
• mitigating the effects of falls from height, where it is reasonably practicable to be do so
Regulation 4 of the Work at Height Regulations 2005 deals with organisation and planning: Regulation 4(1) states that: every employer shall ensure that work at height is -
(a) properly planned;
(b) appropriately supervised; and
(c) carried out in a manner which is so far as is reasonably practicable safe, and that its planning includes the selection of work equipment in accordance with regulation 7
Regulation 4(2) states that: Reference in paragraph (1) to planning of work includes planning for emergencies and rescue.
All too frequently, the emergency planning element is often not considered when work at height is being planned. Largely, this is because:
• there is a general lack of awareness of suspension trauma and its consequences
• employers often fail to appreciate where and when rescue provision is required
• employers often fail to provide adequate rescue equipment or appreciate what is suitable equipment for use in rescue
One of the reasons why planning for rescue in work at height situations is important is suspension trauma (a special case of orthostatic intolerance and sometimes known as harness hang syndrome). Orthostatic intolerance is a normal and natural reaction to being upright and immobile. In such cases, a complex combination of blood pooling in the legs and cardiorespiratory restriction leads to unconsciousness. Orthostatic intolerance can occur in several sets of circumstances, such as:
• being suspended in a harness
• being trapped upright within a confined space
• being secured to a vertical stretcher or litter (such as in mountain rescue)
• many situations where people are forced to remain standing without the ability or room to move
A classic manifestation of acute orthostatic intolerance is a soldier who faints after standing rigidly at attention for an extended period of time. Suspension trauma presents an immediate threat of death to anyone immobilised in a vertical position.
Causes of suspension trauma
When people stand upright, the heart alone cannot cope with pumping the blood around the body. In particular, it can't draw blood back up, against the force of gravity, from the legs and feet. To aid the heart, our veins (the blood vessels that return blood to the heart) are very elastic and have a series of (non-return) valves at regular intervals. As people move around, the veins are squeezed by the muscles around them, a process that is important for helping to push blood back up towards the heart. If people are in an upright position for a while without working their leg muscles, then the blood doesn't get pumped back up from the lower body. Instead it collects in the veins of the lower body (venous pooling), and so reduces the amount of blood available for circulation. This reduces the quantity and the quality of blood available to the brain, which can result in loss of consciousness. This loss of consciousness is an important survival mechanism in these circumstances as when people faint, they fall over. Once they are lying down, the heart can circulate their blood quite satisfactorily, returning oxygen to the brain with no harm done.
Suspension trauma is the name given to the situation that occurs when people faint but cannot fall over, causing the body to remain upright. This is a serious problem, because if the body stays upright after losing consciousness, then the blood flow is not restored. In such circumstances, the suspended person is at serious risk as the reduced blood flow can lead to serious brain and/or kidney damage, and ultimately to death. If it is allowed to develop unchecked, it can be fatal in a very short time (a matter of minutes).
Only a short time
In averages cases, it takes somewhere between five and twenty minutes for the first signs of shock to be felt by the casually. If their legs are held perfectly still (such as if they are unconscious) then the first signs of shock may be apparent after about three minutes. If they are not rescued, a few minutes after this they the casualty will faint and shortly after this they will die. If a suspended person is to be rescued, then the rescue must be carried out quickly, preferably within ten minutes of the start of suspension.
Planning for rescue
By their nature, rescue operations are carried out under extreme pressure. Consideration should be given to all aspects of the rescue process. Elements to consider would include the type of equipment required, the demands placed upon the rescuer, the training the rescuer will require to carry out the rescue and how the effectiveness of the rescue system as a whole can be maintained
Following a fall and a person being suspended in a harness, it is clear that even if they are uninjured by the fall there is a relatively short time available during which to rescue them. Following the fall, there is only a short time before the onset of shock and suspension trauma is life threatening. It is essential, therefore, that the means of rescuing them fallen person has been planned before the event.
Even is the casualty cannot be released form suspension immediately, they can be aided by others if they can be reached safely or if they are still conscious. If possible, lift their knees into a sitting position using a rope, sling, or other items. If the casualty is hanging in a harness and is unable to escape, there are some things that they can do to prevent the onset of suspension trauma. In particular, they cam wiggle their toes and move their legs. This will move the muscles in the legs and will help to squeeze the blood back up towards the heart. This may be enough to prevent the onset suspension trauma.
First Aid
When somebody has been rescued from suspension, do not let them lie down and do not lay them down. The first action of the first aider on site when the casualty is released from suspension should be to place them in a sitting position with their body upright and their legs flat, or bent at the knees. The exact angle of the knees is not critical, the important issue is that their body is upright, and the legs are no longer dangling. This posture will reduce the pooling effect of gravity, but will keep most of the pooled blood in the legs, preventing reflow and splinting (see below). The casualty should be kept in this position for at least 45 minutes. The casualty must not be allowed to stand up, exercise, drink or eat. They should be kept calm and relaxed as this will help to reduce the effects of stress on the heart rate. The casualty should be sent to hospital, even if they are not experiencing any ill health.
The first aider must also be mindful of other injuries that have been sustained, such as spinal injuries, choking, etc.
Causes of death after an otherwise successful rescue
Casualties who have developed suspension trauma may be at risk from reflow syndrome. This is the name given to the potentially fatal situation caused when the pooled that has blood in the veins in the legs is allowed to flow back into their body. The blood that has pooled in the veins in the legs will have the nutrients and the oxygen in it used up by the leg muscles. Once this has been used up the leg muscles will respire anaerobically and the blood will accumulate the toxic breakdown products of this anaerobic metabolism
Another of the problems with treating suspension trauma casualties is overloading or splinting of the heart muscle. Lying the casualty down will cause about 60% of blood volume to return very quickly to the heart and may fill it with blood such that the pumping action is not possible. This overloading of the heart muscle can cause immediate death. During and after rescue, it is important that the casualty is not carried or laid horizontally or allowed to lie down.
Summary
Suspension trauma is a potential cause of death in all cases of vertical suspension. It may result in the death of a person who has fallen and whose fall has been arrested by their fall arrest equipment and who is otherwise unhurt. In order to prevent fatalities from suspension trauma, employers need to ensure that casualties can be rescued promptly (within ten minutes) and that the first aiders known how to deal with (suspected) suspension trauma cases.
It is well known that the Work at Height Regulations 2005 are concerned with working safely at heights:
• avoiding work at height, where it is reasonably practicable to be do so
• preventing falls from height, where it is reasonably practicable to be do so
• mitigating the effects of falls from height, where it is reasonably practicable to be do so
Regulation 4 of the Work at Height Regulations 2005 deals with organisation and planning: Regulation 4(1) states that: every employer shall ensure that work at height is -
(a) properly planned;
(b) appropriately supervised; and
(c) carried out in a manner which is so far as is reasonably practicable safe, and that its planning includes the selection of work equipment in accordance with regulation 7
Regulation 4(2) states that: Reference in paragraph (1) to planning of work includes planning for emergencies and rescue.
All too frequently, the emergency planning element is often not considered when work at height is being planned. Largely, this is because:
• there is a general lack of awareness of suspension trauma and its consequences
• employers often fail to appreciate where and when rescue provision is required
• employers often fail to provide adequate rescue equipment or appreciate what is suitable equipment for use in rescue
One of the reasons why planning for rescue in work at height situations is important is suspension trauma (a special case of orthostatic intolerance and sometimes known as harness hang syndrome). Orthostatic intolerance is a normal and natural reaction to being upright and immobile. In such cases, a complex combination of blood pooling in the legs and cardiorespiratory restriction leads to unconsciousness. Orthostatic intolerance can occur in several sets of circumstances, such as:
• being suspended in a harness
• being trapped upright within a confined space
• being secured to a vertical stretcher or litter (such as in mountain rescue)
• many situations where people are forced to remain standing without the ability or room to move
A classic manifestation of acute orthostatic intolerance is a soldier who faints after standing rigidly at attention for an extended period of time. Suspension trauma presents an immediate threat of death to anyone immobilised in a vertical position.
Causes of suspension trauma
When people stand upright, the heart alone cannot cope with pumping the blood around the body. In particular, it can't draw blood back up, against the force of gravity, from the legs and feet. To aid the heart, our veins (the blood vessels that return blood to the heart) are very elastic and have a series of (non-return) valves at regular intervals. As people move around, the veins are squeezed by the muscles around them, a process that is important for helping to push blood back up towards the heart. If people are in an upright position for a while without working their leg muscles, then the blood doesn't get pumped back up from the lower body. Instead it collects in the veins of the lower body (venous pooling), and so reduces the amount of blood available for circulation. This reduces the quantity and the quality of blood available to the brain, which can result in loss of consciousness. This loss of consciousness is an important survival mechanism in these circumstances as when people faint, they fall over. Once they are lying down, the heart can circulate their blood quite satisfactorily, returning oxygen to the brain with no harm done.
Suspension trauma is the name given to the situation that occurs when people faint but cannot fall over, causing the body to remain upright. This is a serious problem, because if the body stays upright after losing consciousness, then the blood flow is not restored. In such circumstances, the suspended person is at serious risk as the reduced blood flow can lead to serious brain and/or kidney damage, and ultimately to death. If it is allowed to develop unchecked, it can be fatal in a very short time (a matter of minutes).
Only a short time
In averages cases, it takes somewhere between five and twenty minutes for the first signs of shock to be felt by the casually. If their legs are held perfectly still (such as if they are unconscious) then the first signs of shock may be apparent after about three minutes. If they are not rescued, a few minutes after this they the casualty will faint and shortly after this they will die. If a suspended person is to be rescued, then the rescue must be carried out quickly, preferably within ten minutes of the start of suspension.
Planning for rescue
By their nature, rescue operations are carried out under extreme pressure. Consideration should be given to all aspects of the rescue process. Elements to consider would include the type of equipment required, the demands placed upon the rescuer, the training the rescuer will require to carry out the rescue and how the effectiveness of the rescue system as a whole can be maintained
Following a fall and a person being suspended in a harness, it is clear that even if they are uninjured by the fall there is a relatively short time available during which to rescue them. Following the fall, there is only a short time before the onset of shock and suspension trauma is life threatening. It is essential, therefore, that the means of rescuing them fallen person has been planned before the event.
Even is the casualty cannot be released form suspension immediately, they can be aided by others if they can be reached safely or if they are still conscious. If possible, lift their knees into a sitting position using a rope, sling, or other items. If the casualty is hanging in a harness and is unable to escape, there are some things that they can do to prevent the onset of suspension trauma. In particular, they cam wiggle their toes and move their legs. This will move the muscles in the legs and will help to squeeze the blood back up towards the heart. This may be enough to prevent the onset suspension trauma.
First Aid
When somebody has been rescued from suspension, do not let them lie down and do not lay them down. The first action of the first aider on site when the casualty is released from suspension should be to place them in a sitting position with their body upright and their legs flat, or bent at the knees. The exact angle of the knees is not critical, the important issue is that their body is upright, and the legs are no longer dangling. This posture will reduce the pooling effect of gravity, but will keep most of the pooled blood in the legs, preventing reflow and splinting (see below). The casualty should be kept in this position for at least 45 minutes. The casualty must not be allowed to stand up, exercise, drink or eat. They should be kept calm and relaxed as this will help to reduce the effects of stress on the heart rate. The casualty should be sent to hospital, even if they are not experiencing any ill health.
The first aider must also be mindful of other injuries that have been sustained, such as spinal injuries, choking, etc.
Causes of death after an otherwise successful rescue
Casualties who have developed suspension trauma may be at risk from reflow syndrome. This is the name given to the potentially fatal situation caused when the pooled that has blood in the veins in the legs is allowed to flow back into their body. The blood that has pooled in the veins in the legs will have the nutrients and the oxygen in it used up by the leg muscles. Once this has been used up the leg muscles will respire anaerobically and the blood will accumulate the toxic breakdown products of this anaerobic metabolism
Another of the problems with treating suspension trauma casualties is overloading or splinting of the heart muscle. Lying the casualty down will cause about 60% of blood volume to return very quickly to the heart and may fill it with blood such that the pumping action is not possible. This overloading of the heart muscle can cause immediate death. During and after rescue, it is important that the casualty is not carried or laid horizontally or allowed to lie down.
Summary
Suspension trauma is a potential cause of death in all cases of vertical suspension. It may result in the death of a person who has fallen and whose fall has been arrested by their fall arrest equipment and who is otherwise unhurt. In order to prevent fatalities from suspension trauma, employers need to ensure that casualties can be rescued promptly (within ten minutes) and that the first aiders known how to deal with (suspected) suspension trauma cases.
Marketing: Safety-Matter
How do you want to be found?
This is not meant in some deep, dark or sinister way but more in a Marketing sort of a way. In particular, how will your customers find you?
How do you want prospects (or potential new clients) to find you and your company. In my case, it's as a Health and Safety professional (or consultant) in Loughborough, Leicestershire or in the East Midlands. I am looking for people who (whether they know it or not) are looking for a health and safety consultant to help them with health and safety, fire safety, food safety or other risk assessments needs, etc. I am also looking for, people who are looking for ongoing health and safety advice. I have written this down to help me to clarify me thoughts on these matters rather than to provide any other reader with words of wisdom.
So, have decided what I want, the next thing is to think how to go about find these people. Who are they? Where will they look? How will they find me?
Who?Owners and managers of businesses, or directors of larger businesses.
Where will they look?
The web. Google. Search engines. In their post (real and email).
How will they find me?
Well, my intention is not to make it too difficult for them. I will be increasing by virtual and real marketplace presence
One of the purposes of this blog is to help to crystallise some of my thoughts. I need to improve my chances of been found by those who are looking for health and safety advice, guidance and consultancy.
I'm looking forward to spending more time doing health and safety work, including fire safety risk assessments for new clients in the East Midlands. If this is what happens, then it will be because of marketing focus.
Newsletters
I've always steered clear of writing Newsletters, despite the fact that I create a lot of content through various pieces of work. Recently, I have put aside my reservations and "gone for it". If you would like to look at my first foray into Newletters, please look at this. This Newsletter deals with the changes in January to the levels of fines for Health & Safety Offences and provides various cases where things have gone wrong.
My second Newsletter (produced in April) deals mainly with fire safety. While I'm quite pleased with the products, it does create the next problem - where do we go from here? Are there any areas that you would like to see covered? Please let me have your comments and feedback.
Slips, trips and falls may be worth a go - the HSE campaign is still running and it is still a major cause of injury. Importantly, it is also something that can be improved on with very little cost - although effort is required. There are some useful (and free) tools available from the HSE website.
This is not meant in some deep, dark or sinister way but more in a Marketing sort of a way. In particular, how will your customers find you?
How do you want prospects (or potential new clients) to find you and your company. In my case, it's as a Health and Safety professional (or consultant) in Loughborough, Leicestershire or in the East Midlands. I am looking for people who (whether they know it or not) are looking for a health and safety consultant to help them with health and safety, fire safety, food safety or other risk assessments needs, etc. I am also looking for, people who are looking for ongoing health and safety advice. I have written this down to help me to clarify me thoughts on these matters rather than to provide any other reader with words of wisdom.
So, have decided what I want, the next thing is to think how to go about find these people. Who are they? Where will they look? How will they find me?
Who?Owners and managers of businesses, or directors of larger businesses.
Where will they look?
The web. Google. Search engines. In their post (real and email).
How will they find me?
Well, my intention is not to make it too difficult for them. I will be increasing by virtual and real marketplace presence
One of the purposes of this blog is to help to crystallise some of my thoughts. I need to improve my chances of been found by those who are looking for health and safety advice, guidance and consultancy.
I'm looking forward to spending more time doing health and safety work, including fire safety risk assessments for new clients in the East Midlands. If this is what happens, then it will be because of marketing focus.
Newsletters
I've always steered clear of writing Newsletters, despite the fact that I create a lot of content through various pieces of work. Recently, I have put aside my reservations and "gone for it". If you would like to look at my first foray into Newletters, please look at this. This Newsletter deals with the changes in January to the levels of fines for Health & Safety Offences and provides various cases where things have gone wrong.
My second Newsletter (produced in April) deals mainly with fire safety. While I'm quite pleased with the products, it does create the next problem - where do we go from here? Are there any areas that you would like to see covered? Please let me have your comments and feedback.
Slips, trips and falls may be worth a go - the HSE campaign is still running and it is still a major cause of injury. Importantly, it is also something that can be improved on with very little cost - although effort is required. There are some useful (and free) tools available from the HSE website.
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Wednesday, 4 November 2009
Man injured by forklift truck
A worker was injured by a forklift truck and the Company was fined £7,000.
The employee was run over and dragged by a Forklift Truck without the driver noticing. During the afternoon tea break, an employee was returning to work from the car park on site when he was knocked down by a forklift truck. The driver, unaware of the collision continued driving the truck for approximately 26 metres with the employee stuck under the front until someone caught his attention. Mr Moorehead had fractures to his pelvis and legs.
The company, based in Northamptonshire, was fined £3,000 and ordered to pay £4,000 costs at Northampton Magistrates’ Court after pleading guilty to breaching Regulation 17 (1) of the Workplace (Health, Safety and Welfare) Regulations 1992 in failing to organise their Nene Valley site such that pedestrians and vehicles could move around premises safely.
This incident could have been avoided if the company had organised the workplace so that vehicles can operate safely in a set area.
The employee was run over and dragged by a Forklift Truck without the driver noticing. During the afternoon tea break, an employee was returning to work from the car park on site when he was knocked down by a forklift truck. The driver, unaware of the collision continued driving the truck for approximately 26 metres with the employee stuck under the front until someone caught his attention. Mr Moorehead had fractures to his pelvis and legs.
The company, based in Northamptonshire, was fined £3,000 and ordered to pay £4,000 costs at Northampton Magistrates’ Court after pleading guilty to breaching Regulation 17 (1) of the Workplace (Health, Safety and Welfare) Regulations 1992 in failing to organise their Nene Valley site such that pedestrians and vehicles could move around premises safely.
This incident could have been avoided if the company had organised the workplace so that vehicles can operate safely in a set area.
Food Hygiene fine
A Midhurst store has been fined £11,000 and made to pay costs of nearly £4000 following breaches of food hygiene legislation.
During a routine food hygiene inspection, Officers of Environmental Health Services found mouldy food for sale within the store. Council Officers also found that the company had failed to implement and maintain their food safety management systems, which are designed to ensure that all food sold is safe to eat. The Council wrote to the company telling them of the failings to comply with food hygiene legislation and gave them a date to rectify the problems by. In line with usual practice, lots of help and assistance was offered by the Council to the company. However, during a further visit by Officers of the Environmental Health in January 2009, the same problems were found to exist.
The Deputy Leader of the Council at Chichester District Council, says: "We are very supportive of businesses and we always go the extra mile to explain their legal responsibilities and to assist them with specialist advice. Our role is in education and improvement. However, we do take breaches of food hygiene legislation very seriously and when we see insufficient improvements being made, we will prosecute anyone who is found to be contravening that legislation. "In the vast majority of cases, the Chichester District is a source of fine food, through its many restaurants and public houses, national food retailers and more unusual local specialist food suppliers. Our Commercial Safety Team regularly inspect premises within the district to ensure that all food is safe to eat and prepared in clean and well run establishments."
During a routine food hygiene inspection, Officers of Environmental Health Services found mouldy food for sale within the store. Council Officers also found that the company had failed to implement and maintain their food safety management systems, which are designed to ensure that all food sold is safe to eat. The Council wrote to the company telling them of the failings to comply with food hygiene legislation and gave them a date to rectify the problems by. In line with usual practice, lots of help and assistance was offered by the Council to the company. However, during a further visit by Officers of the Environmental Health in January 2009, the same problems were found to exist.
The Deputy Leader of the Council at Chichester District Council, says: "We are very supportive of businesses and we always go the extra mile to explain their legal responsibilities and to assist them with specialist advice. Our role is in education and improvement. However, we do take breaches of food hygiene legislation very seriously and when we see insufficient improvements being made, we will prosecute anyone who is found to be contravening that legislation. "In the vast majority of cases, the Chichester District is a source of fine food, through its many restaurants and public houses, national food retailers and more unusual local specialist food suppliers. Our Commercial Safety Team regularly inspect premises within the district to ensure that all food is safe to eat and prepared in clean and well run establishments."
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