American National Standard for

Minimum Requirements for Workplace First Aid Kits and Supplies

Secretariat

International Safety Equipment Association

Approved April 15, 2022 American National Standards Institute, Inc.

American National Standard

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ISEA Z308.1-2021

Foreword

(This Foreword is not part of American National Standard ANSI/ISEA Z308.1-2021).

ANSI/ISEA Z308.1-2021 is the sixth revision of a voluntary industry consensus standard that was first published in 1978 and builds upon the initial objective to standardize first aid kits to ensure that items needed to treat the most common types of injuries and sudden illnesses encountered in the workplace are readily accessible and available.

This edition retains the kit classification (Class A or Class B) established in 2015 and includes several notable updates: A foil blanket has been added as a mandatory item for both kit classes. This was considered based on an assessment of similar international standards and in recognition of the multiple purposes that the item can serve during treatment of a workplace injury or illness. More specificity has been included for tourniquets to distinguish them from those types of bands used to draw blood, which are not as effective in preventing blood loss, as is intended. Similarly, the appendix includes greater guidance on a separately-packaged bleeding control kit. In addition, the standard includes more robust discussion to assist the employer in assessing risks, identifying potential hazards and selecting additional first aid supplies relevant to a particular application or work environment.

This revision was prepared by a task group of industry stakeholders who are recognized leaders in the research and development of first aid treatment items and training. The following companies were members of the group at the time of the approval of the standard:

Acme United                                                         Honeywell Safety and Productivity Solutions

Aero Healthcare                                   Medique

American Red Cross                                            National Safety Council

Certified Safety Manufacturing                        Safeguard Medical/Water-Jel

Cintas Corporation

Suggestions for improvement of this standard are welcome. They should be submitted to standards@safetyequipment.org.

This standard was processed and approved using consensus procedures prescribed by the American National Standards Institute. The following organizations were contacted prior to the approval of this standard. Inclusion in this list does not necessarily imply that the organization concurred with the submittal of the proposed standard to ANSI.

 

Clark Construction Group

Concurrent Technologies Corporation

Laborers’ Health & Safety Fund of North America

Liberty Electric Power

Marathon Petroleum

North Texas Municipal Water District

Sales Solutions, Inc.

Stony Brook University

Think Safe, Inc.

Contents

SECTION PAGE

  1. Scope and Purpose …………………………………………………………………. 1
  2. Compliance and Effective Date ………………………………………………………………. 1
  3. Definitions ……………………………………………………………………………………………. 1
  4. Normative Reference…………………………………………………………… 2
  5. Designation of First Aid Kits …………………………………………………………………………… 2

5.1 Classes of First Aid Kits ……………………………………………………………………………….                        2

5.2 Types of First Aid Kit Containers ……………………………………………………………………                        2

  1. Requirements First Aid Supplies …………………………………………………………………….. 4

6.1 General ………………………………………………………………………………………………………                       4

6.2 Adhesive Bandage ………………………………………………………………………………………                         4

6.3 Adhesive Tape ……………………………………………………………………………………………                         4

6.4 Antibiotic Application ……………………………………………………………………………………                      4

6.5 Antiseptic ……………………………………………………………………………………………………                       5

6.6 Burn Dressing (gel soaked) …………………………………………………………………………..                       5

6.7 Burn Treatment ……………………………………………………………………………………………                      5

6.8 Cold Pack …………………………………………………………………………………………………..                         5

6.9 CPR Breathing Barrier ………………………………………………………………………………….                        5

6.10 Eye Covering …………………………………………………………………………………………….                        5

6.11 Eye/Skin Wash ………………………………………………………………………………………….                        6

6.12 First Aid Guide …………………………………………………………………………………………..                       6

6.13 Foil Blanket ……………………………………………………………………………………………….                       6

6.14 Hand Sanitizer …………………………………………………………………………………………..                        5

6.15 Medical Exam Gloves …………………………………………………………………………………                        6

6.16 Roller Bandage ………………………………………………………………………………………….                        6

6.17 Scissors ……………………………………………………………………………………………………                         6

6.18 Splint ………………………………………………………………………………………………………..                       6

6.19 Sterile Pad ………………………………………………………………………………………………..                        6

6.20 Tourniquet …………………………………………………………………………………………………                      6

6.21 Trauma Pad ……………………………………………………………………………………………….                       6

6.22 Triangular Bandage……………………………………………………………………………………..                       6

  1. First Aid Kit Marking and Labeling ………………………………………………………… 7

Tables

Table 1. Classes of First Aid Kits and Required Supplies …………………………………………………. 3

Table 2. Characteristics of Types of First Aid Kits ……………………………………………………………. 3

Table 3. Drop Test Samples ……………………………………………………………………………… 4

Figures

Figure 1A ANSI/ISEA Z308.1-2021, Class A Kit Label ……………………………………………………….. 8

Figure 1B ANSI/ISEA Z308.1-2021, Class B Kit Label ……………………………………………………….. 8

Appendices

Appendix A First Aid Guide (normative) ……………………………………………………………………………. 9

Appendix B Guidance on Bleeding Control Kits and, Other First Aid Supplies, Ongoing Maintenance and

Unitized Kits (informative) ………………………………………………………………………………………………. 10

Appendix C Guidance on Selection of Contents for First Aid Kits (informative) ………………………. 12

American National Standard

Minimum Requirements for Workplace First Aid Kits and Supplies

  1. Scope and Purpose
  • This standard establishes minimum performance requirements for first aid kits and their supplies that are intended for use in various work environments. Classification of first aid kits, designating the assortment of items and quantity of each item is based the complexity of the work environment and level of hazards. First aid kit containers are classified by portability, ability to be mounted, resistance to water and corrosion and impact resistance.
  • In this standard, imperial units of measurement are followed by an approximate SI equivalent in

parenthesis. In keeping with prevalent measurement and packaging norms for first aid products in the United States, only the imperial value shall be regarded as the requirement.

  • Unless otherwise stated, all values for measurement are to be considered nominal.
  1. Compliance and Effective Date
  • First aid kits in compliance with this standard shall be classified either Class A or Class B, in accordance with Section 5.1 and shall contain the assortment of supplies in the quantities specified in Table
  • First aid supplies included in a first aid kit shall meet the applicable performance requirements as specified

in Sections 6.1 through 6.21.

  • Containers used to house first aid supplies shall be designated Type I, Type II, Type III or Type IV in accordance with Section 5.2 and summarized in Table 2. Type IV containers shall meet the performance requirements of Section 5.2.5.
  • First aid kits in compliance with this standard shall be labeled in accordance with Section 7.
  • The effective date of this standard shall be six months from the date of ANSI approval
  1. Definitions

Abrasion. The most common type of open wound, characterized by skin that has been rubbed or scraped away.

Antiseptic. A substance that inhibits the growth of microorganisms on human skin.

Bandage. Material used to wrap or cover a part of the body; commonly used to hold a dressing or splint in place.

Burn. An injury to the skin or other body tissues caused by excessive heat, chemicals, electricity or radiation.

CPR Breathing Barrier. A personal safety device that prevents any contact between the mouth of the responder and victim’s mouth and/or nose that requires rescue breaths.

Dressing. Sterile pad used to cover an open wound, generally secured by a bandage.

First Aid. Immediate care given to a person with an injury or sudden illness until more advanced care can be obtained.

First Aid Kit. A container including a variety of medical supplies consistent with treating injuries and/or sudden illness.

Foil Blanket: A metalized plastic sheet which can retain body heat in emergency first aid situations, help prevent or treat hypothermia, act as a windbreaker, and can be worn as an emergency waterproof wrap.

Roller Bandage. A bandage made of gauze or gauze-like material that is wrapped around a body part, over a dressing, using overlapping turns until the dressing is covered.

Splint. A device used to immobilize body parts.

Swab. A single-use crushable, hermetically sealed ampoule with an applicator tip used to clean and/or apply a solution.

Tourniquet (arterial). A tight, wide strap designed to be effective in preventing blood loss in a severely injured limb (arms, legs) by compressing the tissue around the arteries and providing effective occlusion within 90 seconds or less

Towelette. A single-use, sealed, impregnated material used to clean and/or apply a solution.

Wound. An injury to the soft tissues.

  1. Normative References

The following standards contain provisions that, through reference in this text, constitute provisions of this American National Standard:

ASTM B117 Standard Practice for Operating Salt Spray (fog) Apparatus, 2019

ASTM E96/E96M Standard Test Methods for Water Vapor Transmission of Materials, 2016

Title 21, Code of Federal Regulations (CFR) Part 800.20, Patient examination gloves and surgeons’ gloves; sample plans and test method for leakage defects; adulteration

Title 21, Code of Federal Regulations (CFR) Part 349, Ophthalmic Drug Products for Over-the Counter Human Use

United States Pharmacopeia – National Formulary (USP/NF), current edition

  1. Designation of First Aid Kits

5.1 Classes of First Aid Kits

5.1.1 Class A Kits

Class A first aid kits are intended to provide a basic range of products to deal with most common types of injuries encountered in the workplace including: major wounds, minor wounds (cuts and abrasions), minor burns and eye injuries. First aid kits designated as Class A shall contain the assortment of compliant supplies in the quantities specified in Table 1. See Appendix C for workplace hazard assessment information.

5.1.2 Class B Kits

Class B kits are intended to provide broader range and quantity of supplies to deal with injuries encountered in more populated, complex and/or high-risk workplace environments. First aid kits designated as Class B shall contain the assortment of compliant supplies in the quantities specified in Table 1. See Appendix C for workplace hazard assessment information.

5.2 Types of First Aid Kit Containers

5.2.1 Type I

Type I first aid kits are intended for use in stationary, indoor settings where the potential for damage of kit supplies due to environmental factors and rough handling is minimal. Type I first aid kits shall have a means for mounting in a fixed position and are generally not intended to be portable.

NOTE: Typical applications for Type I first aid kits may include, but are not limited to, the following: general indoor use, an office setting or a manufacturing facility. First aid cabinets would generally fall into the Type I classification.

5.2.2 Type II

Type II first aid kits are intended for portable use in indoor settings where the potential for damage of kit supplies due to environmental factors and rough handling is minimal.

NOTE: Typical applications for Type II first aid kits may include, but are not limited to, the following: general indoor use, an office setting or a manufacturing facility.

5.2.3 Type III

Type III first aid kits are intended for portable use in mobile, indoor and/or outdoor settings where the potential for damage of kit supplies due to environmental factors is not probable. Type III kits shall have a means to be mounted in a fixed position and shall have a water resistant seal.

NOTE: Typical applications for Type III first aid kits may include general indoor use and sheltered outdoor use.

Table 1. Classes of First Aid Kits and Required Supplies
First Aid Supply Minimum Quantity Minimum Size or Volume K Safety Part# Class A K Safety Part# Class B
Class A Kits Class B Kits (US) (metric)
Adhesive Bandage 16 50 1 x 3 in. 2.5 x 7.5 cm 737 737
Adhesive Tape 1 2 2.5 yd (total) 2.3 m 305 305
Antibiotic Application 10 25 1/57 oz 0.5 g 1004 1004
Antiseptic 10 50 1/57 oz 0.5 g 681 681
Breathing Barrier 1 1 N/A N/A 4924 4924
Burn Dressing (gel soaked) 1 2 4 x 4 in. 10 x 10 cm 2653 2653
Burn Treatment 10 25 1/32 oz 0.9 g 2651 2652
Cold Pack 1 2 4 x 5 in. 10 x 12.5 cm 300 300
Eye Covering, with means of attachment 2 2 2.9 sq. in. 19 sq. cm 2700 2700
Eye/Skin Wash 1 0 1 fl oz total 29.6 ml 2717B  
0 1 4 fl. oz total 118.3 ml   2716
Foil Blanket 1 1 52 x 84 in. 132 x 213 cm 1011 1011
First Aid Guide 1 1 N/A N/A 2491 2491
Hand Sanitizer 10 20 1/32 oz 0.9 g 3042 3041
Roller Bandage 1 2 2 in. x 4 yd 5 cm x 3.66 m 802 802
1 4 in. x 4 yd 10 cm x 3.66 m   945
Scissors 1 1 N/A N/A 1006 1006
Splint 0 1 4.0 x 24 in. 10.2 x 61 cm   1001
Sterile pad 2 4 3 x 3 in. 7.5 x 7.5 cm 832 832
Tourniquet (C.A.T Style) 0 1 1.5 in. (width) 3.8 cm (width)   56525
Trauma pad 2 4 5 x 9 in. 12.7 x 22.9 cm 925 925
Triangular Bandage 1 2 40 x 40 x 56 in. 101x 101 x 142 cm 918 918
Table 2. Characteristics of Types of First Aid Kits
Type Use Portable Mountable Water Resistant Waterproof Performance
I Indoor        
II Indoor        
III Indoor/ Outdoor    
IV Indoor/ Outdoor   Section 5.2.5

5.2.4 Type IV

Type IV first aid kits are intended for portable use in the mobile industries and/or outdoor settings where the potential for damage to kit supplies due to environmental factors and rough handling is significant. Type IV kits shall have a means to be mounted in a fixed position and shall meet the performance requirements of Section 5.2.5.

NOTE: Typical applications for Type IV first aid kits may include, but are not limited to, the following: the transportation industry, the utility industry, the construction industry, and the armed forces.

5.2.5 Performance Requirements for Type IV Kits

5.2.5.1 Corrosion and Moisture Resistance

Three kits shall be tested for corrosion and moisture resistance in accordance with ASTM B117 for a duration of 480 hours (20 days). The exterior surface of each sample shall be carefully blotted dry and the container shall be opened. Each sample shall be evaluated for ease of operation. The interior of the kit container shall be examined for evidence of moisture. Difficult operation or any evidence of moisture is sufficient cause for failure.

5.2.5.2 Impact Resistance

Test sample shall consist of a first aid container loaded with the appropriate weight as noted in Table 3.

Table 3. Drop Test Samples

Load (Lb)

Container Dimensions (see note)

in.

cm.

1

8.0 x 5.0 x 2.5

20.3 x 12.7 x 6.4

1.5

9.5 x 6.5 x 2.5

24.1 x 16.5 x 6.4

2

8.0 x 8.0 x 3.0

20.3 x 20.3 x 7.6

2.5

14.0 x 9.5 x 2.5

35.6 x 24.1 x 6.4

Note: The container dimensions are intended to be representative of
containers commonly identified as a numeric “unit container” and
are approximate.

Three samples shall be conditioned hot at 120F (49C) for a minimum of 2 hours, and three samples shall be conditioned cold at 0F (-18C) for a minimum of 2 hours.

Continued next pg

 

ISEA Z308.1-2021                                           Continuation

 

Each conditioned sample shall be subjected to the following drop test within 1.0 minute of removal from the conditioning environment. Each sample shall be dropped freely from a vertical height of 4 ft (1.20 m), as measured from the bottom of the kit sample, onto a hard, flat rigid surface such as concrete or a surface of equivalent hardness. Each sample shall be dropped once, each on a different corner of the case. For first aid kits that do not have corners, each sample shall be dropped on a different location. The kits shall be examined after impact to determine if the kit is opened or is capable of being opened. If any of the three test samples cannot be opened easily after impact or opens as a result of impact, the kit fails the test. END

 

  1. Requirements for First Aid Supplies

6.1 General

First aid supplies shall meet the individual performance requirements specified in Sections 6.2 through 6.21 and shall not be manufactured using natural latex rubber. Supplies shall comply with all applicable FDA regulations. The quantities, dimensions, or volume listed for each supply shall be considered the minimum for compliance with this standard. Larger-sized supplies that meet or exceed the performance requirements of Sections 6.2 thorough 6.21 shall be considered equivalent.

6.2 Adhesive Bandage

Each adhesive bandage shall consist of a non-adherent absorbent pad attached to the central area of a strip of adhesive material 3.0 in. ± 1/16 in. (76 mm ± 1.6 mm) by 1.0 in. ± 1/32 in. (25.4 mm ± 0.8 cm). The absorbent pad shall have an area between 0.65 and 1.0 sq. in. (420 – 645 sq. mm). The adhesive material shall have a moisture vapor transmission rate of at least 500 gm/m2 per 24 hours over its entire area in accordance with ASTM E96. Protective material shall cover the adhesive material and pad in such a manner as to prevent contamination of the pad, not impair the adhesiveness of the adhesive material and shall be easily removed. Each bandage shall be individually packaged, sealed and sterile.

NOTE: Inclusion of a variety of adhesive bandage shapes and styles to properly cover wounds is strongly recommended. This includes, but is not limited to, strips in various sizes, fingertip bandages, knuckle bandages, large patch bandages, hydrocolloid bandages, and others.

6.3 Adhesive Tape

Adhesive tape shall be at least 3/8 in. (9.5 mm) wide and a minimum of 2.5 yd (2.3 m) long and meet the applicable requirements for adhesive tape as defined in the current edition of the USP/NF.

NOTE: Multiple rolls may be used to meet the minimum requirement of 2.5 yd (2.3 m) of tape.

6.4 Antibiotic Application

Each antibiotic application shall meet the applicable requirements as defined in the current edition of the USP/NF. Each application shall be packaged in individual-use, non-reusable applications containing at least 1/57 oz (0.5 g).

6.5 Antiseptic

Each antiseptic shall meet all applicable FDA requirements and shall be contained in an individual-use, non-reusable application containing at least 1/57 oz (0.5 g) of antiseptic.

NOTE: Commonly used applicators are swabs and towelettes. Spray containers containing the minimum number of 1/57 oz. (0.5 g) applications required for Class A or Class B kits are acceptable to meet this requirement.

6.6 Burn Dressing (gel soaked)

Burn dressings shall be a sterile gel-soaked pad made of a material that prevents fibers from becoming imbedded in the burn wound. Gel material shall be water-soluble. Each dressing size shall be at least 16 sq. in. (103.23 sq. cm) and shall be single use.

6.7 Burn Treatment

Each burn treatment shall be a water-soluble compound packaged in individual-use applications containing at least 1/32 oz (0.9 g).

NOTE: Spray containers containing the minimum number of 1/32 oz (0.9 g) applications required for Class A or Class B kits are acceptable to meet this requirement. Burn treatment, as required here, is intended to address the treatment of minor burns.

6.8 Cold Pack

Each cold pack shall be at least 4 x 5 in. (10 x 12.5 cm) in size and shall reach a temperature between 20 – 40F (-6 – 4C) within 10 seconds of activation and shall maintain this temperature for a period of at least 10 minutes. Cold packs shall activate under normal hand pressure and shall not leak under normal conditions of use.

6.9 CPR Breathing Barrier

The CPR breathing barrier shall be a single use disposable medical device listed with the U.S. Food and Drug Administration (FDA) and have a current valid 510 (k) with the purpose of delivering ventilations by a responder to a non-breathing victim (e.g., rescue breaths and CPR ventilations). The device shall provide protection from direct contact with bodily fluids by means of its construction as approved by the FDA. Each barrier shall be packaged in an easily opened container, clearly labeled with the name of the device, together with comprehensive instructions and/or illustrations for use.

 

NOTE: When evaluating the workplace to determine the need for other items, consideration should be given to state or local governing authority related to breathing barriers and training on these devices.

6.10 Eye Covering

Eye covering(s) shall have the ability to cover both eyes, an area of at least 2.9 sq. in. (19 sq. cm) per eye, and conform to each eye cavity. The covering shall have a thickness of at least 1/4 in. (0.64 cm) when not compressed. Each eye covering shall have at least the absorbency of absorbent gauze as defined by the current edition of the USP/NF. The eye covering shall be free of loose threads and raveled edges. Each eye covering shall be individually packaged, sealed, and sterile.

NOTE: The minimum requirement for eye covering shall be two eye pads or a single covering for both eyes.

6.11 Eye/Skin Wash

A sterile, isotonic, buffered solution as specified in FDA regulation 21 CFR 349 shall be contained in at least 0.5 fl. oz. (15 ml) individual-use applications.

NOTE: Where the work environment dictates the possible exposure to corrosive materials or chemicals and the need for emergency flushing facilities, users should refer to ANSI/ISEA Z358.1 American National Standard for Emergency Eyewash and Shower Equipment

6.12 First Aid Guide

Guidance for immediate care given to a victim of injury or sudden illness until arrival of more advance care, if needed, shall be included in the kits. At a minimum, the guide shall include the areas outlined in Appendix A.

6.13 Foil Blanket

The foil blanket shall be a metalized plastic sheet, having a minimum size of 52 x84 in (132 x 213 cm) and shall be single use.

6.14 Hand Sanitizer

Hand sanitizers shall be water-soluble, alcohol-based and meet applicable FDA regulations.

NOTE: Spray containers containing the minimum number of 1/32 oz. (0.9 g) applications required for Class A or Class B kits are acceptable to meet this requirement.

6.15 Medical Exam Gloves

Gloves shall meet the requirements of FDA regulation 21 CFR 800.20 for medical grade gloves.

6.16 Roller Bandage

Each bandage shall be constructed from a material at least the equivalent strength of Type I USP 28-NF23 (44/36) gauze as defined by the current edition of USP/NF. Each bandage shall be individually packaged and sealed.

NOTE: A conforming bandage that can stretch to at least 4 yd (3.65 m) may be used in place of roller bandage.

6.17 Scissors

Scissors shall be autoclavable, at least 3.5 in. long (8.9 cm), capable of cutting through clothing, feature a blunt end to protect a person from accidental injury and of medical professional quality 

6.18 Splint

Each splint shall be padded, made of malleable material and shall be at least 4.0 in. x 24 in. (10.2 cm x 61.0 cm).

6.19 Sterile pad

Each sterile pad shall be at least 3 x 3 in. (7.5 x 7.5 cm) in size and shall have at least the absorbency of absorbent gauze as defined by the current edition of the USP/NF. Each sterile pad shall be individually packaged, sealed and sterile.

6.20 Tourniquet (arterial)

Each tourniquet shall be at least 1.5 in. (3.8 cm) wide and shall be effective on limb sizes ranging from 7 to 33 in (17.8 to 83.8 cm). Each tourniquet shall be individually packaged as a single-use device, with instructions.

NOTE: A tourniquet used for blood drawing is insufficient to meet the criteria set forth. Common arterial tourniquets that meet this standard utilize a method such as a ratchet or a windlass to reach full occlusion. Application scenarios include trapped and open limb application as well as the ability to self-apply and apply to a victim.

6.21 Trauma Pad

Each trauma pad shall be at least 45 sq. in. (290.33 sq cm) with no side smaller than 5 in. (12.7 sq cm) and shall have at least the absorbency of absorbent gauze as defined by the current edition of the USP/NF. Each trauma pad shall be individually packaged, sealed and sterile.

6.22 Triangular Bandage

Each bandage shall be made from muslin at least 60/48 weave or a material of equivalent mechanical strength. When unfolded, the outer dimensions of the bandage shall be at least 40 x 40 x 56 in. (101 x 101 x 142 cm).

  1. First Aid Kit Marking and Labeling

7.1 All labeling and markings shall be legible and permanent. Where adhesive labels are used, they shall not be easily removed.

7.2 Each kit and/or location shall be visibly marked as a place where first aid supplies are located.

7.3 Each complete first aid kit shall contain the information shown in Figure 1A or Figure 1B, written in at least 6 point font

ANSI/ISEA Z308.1-2021, Class A, Type I, II, III or IV First Aid Kit This kit meets the ANSI/ISEA Z308.1-2021 standard as sold. It contains first aid products which meet performance specifications detailed in the standard at the below required minimum fill. It will continue to be compliant only when maintained with products that meet the standard at specified quantities.
Required Minimum Fill 16 Ea.  Adhesive Bandage 1 x 3 in. (2.5 x 7.5 cm) 1 Ea. Adhesive Tape 2.5 yd (2.3 m), total 10 Ea. Antibiotic Application 1/57 oz (0.5 g) 10  Ea. Antiseptic 1/57 oz (0.5 g) 1  Ea. Burn Dressing (gel soaked) 4 x 4 in.(10 x 10 cm) 10  Ea. Burn Treatment 1/32 oz (0.9 g) 1  Ea. Cold Pack 4 x 5 in. (10 x 12.5 cm) 1  Ea. CPR Breathing Barrier 2  Ea. Eye Covering w/ means of attachment 2.9 sq. in. (19 sq cm) 1 Ea. Eye/Skin Wash 1 fl oz (29.6 ml) total 1 Ea. First Aid Guide 1 Ea. Foil Blanket 52 x 84 in. (132 x 213 cm) 10 Ea. Hand Sanitizer 1/32 oz (0.9 g) 2 pr Medical Exam Gloves 1 Ea. Roller Bandage 2 in. x 4 yd (5 cm x 3.66 m) 1 Ea. Scissors 2 Ea. Sterile pad 3 x 3 in. (7.5 x 7.5 cm) 2 Ea. Trauma pad 5 x 9 in. (12.7 x 22.9 cm) 1 Ea. Triangular Bandage 40 x 40 x 56 in. (101 x 101 x 142 cm)
The described kit should be considered adequate for a workplace only when a hazard assessment of the work environment has been competed by competent personnel. For a variety of operations, employers may find that additional first aid supplies and kits are needed. Kits should be inspected frequently to ensure the completeness and usability of all first aid supplies. Any supply beyond its marked expiration date should be discarded and replaced.

Appendix A (normative)
First Aid Guide

The inclusion of a first aid guide in a first aid kit is required per Section 6 of this standard. At a minimum, the information below shall be included in the guide. The manner in which such information is conveyed is left to the discretion of the manufacturer.

First Aid Guide Areas

 

Emergency steps of assessing the scene and person, calling 9-1-1 or location emergency number

 

Establishing responsiveness

 

Establishing and maintaining an open and clear airway

 

Performing rescue breathing

 

Treating airway obstruction in a conscious victim

 

Performing CPR

 

Using an AED

 

Recognizing the signs and symptoms of shock and providing first aid for shock from illness or injury

 

Assessing and treating a victim who has an unexplained change in level of consciousness or
sudden illness

 

Methods of controlling bleeding, including direct pressure and tourniquet

 

Poisoning

 

Responding to Medical Emergencies
Chest pain
Stroke
Breathing problems
Anaphylactic shock and allergic reaction
Hypoglycemia in diabetics taking insulin
Seizures
Reduced level of consciousness
Impaled object

 

Wounds
Assessment of and first aid wounds including abrasions, cuts, lacerations, punctures, avulsions, amputations and crush injuries
Principles of wound care including infections precautions
Principles of body substance isolation, universal precautions and use of PPE

 

 

 

 

 

Burns
Assessment of the severity of a burn, including extent (size) and depth
Recognizing whether a burn is thermal, electrical or chemical, or caused by sun exposure and the appropriate first aid

 

 

 
 

Temperature extremes
Exposure to cold, including frostbite and hypothermia
Exposure to heat, including heat cramps, heat exhaustion and heat stroke

 

 

 

Musculoskeletal injuries
Fractures
Sprains, strains, contusions and cramps
Head, neck, back and spinal injuries

 

 

 

 

Eye injuries

 

Mouth and teeth injuries
Oral injuries, lip and tongue injuries, broken and missing teeth

 

 

Bites and stings
Human and animal bites
Bites and stings from insects; instruction in first aid treatment for anaphylaxis

 

 

 

Appendix B (informative)

Guidance on Bleeding Control Kits and Other First Aid Supplies, Ongoing Maintenance, and Unitized Kits

B.1 Bleeding Control Kits

Careful consideration should be given to providing uniquely packaged and designated bleed control kits. These kits contain more advanced first aid supplies to immediately treat victims with life-threatening external bleeding and such unique packaging will enable a first aid provider to readily access supplies.

Essential bleed control items include:

  • Chest seal
  • Compression bandage
  • Hemostatic bandages
  • Thermal blanket
  • Tourniquet

Related kit contents include:

  • Gloves
  • Permanent marker
  • Shears

B.2 Supplemental First Aid Supplies for Consideration – Applicable Environments

Each work environment is unique. Accordingly, it is expected that a first aid kit containing the minimum required first aid supplies will be augmented with additional items or additional quantities of required supplies based upon the specific hazards existing in a workplace environment. The selection of such items should be based on the recommendation and consultation of a person or persons competent in first aid and cognizant of the hazards found in the workplace. Federal, state and local requirements should be consulted, where appropriate. Augment kits with the following first aid supplies, as applicable:

 

FIRST AID SUPPLY

PURPOSE

Adhesive bandages, assorted sizes and styles

Effective cover wounds of varying sizes located
 on various parts of the body (knuckle, fingertip)

Analgesics (oral and/or topical)/anti-inflammatory

Pain management; swelling control

Antihistamine (non-drowsy)

Allergic reactions

Aspirin, low-dose

Used to treat suspected heart attack

Electrolyte replacement

Heat-stress related injuries

Glucose replacement

Diabetic or hypoglycemic episodes

Face mask, 3-ply, Level 1

Used for pandemic precaution

Hemostatic agent/dressing

For individuals with compromised clotting or
uncontrollable bleeding

Hydrocortisone

Itchiness and skin-related reactions including rashes

Splinter remover

Removing splinters

Surface disinfecting wipes (EPA approved)

Helps to disinfect surfaces that may contain
harmful viruses such as the common cold, flu, or coronavirus

Thermometer, disposable

Able to determine the risk of transferring infectious
diseases from worker-to-worker

 

B.3 Ongoing Maintenance of First Aid Kits

  1. First aid kits should be inspected at least monthly or following a first aid incident when product is used. Frequent inspection is recommended to ensure the completeness and usable condition of supplies to maintain compliance with this standard. Any supply beyond its marked expiration date should be replaced.
  2. Cabinet surfaces should be disinfected regularly, during restocking or following any first aid incident when product is used. Dependent on workplace environment, cabinet surfaces may need to be cleaned and disinfected more frequently.
  3. It is recommended that product is easily identified and well organized.

B.4 Unitized Kits

Unitized first aid kits contain first aid supplies arranged in uniform-sized boxes to help simplify the organization and restocking of the kit. It is recommended that products are grouped together in like-categories and color-coded. First aid supplies can be categorized as such:

  • Antiseptics
  • Bandages
  • Burn Treatment
  • Eye Care
  • Personal Protective Equipment (PPE)
  • Miscellaneous

Appendix C (informative)

Guidance on Selection of Contents for First Aid Kits

C.1 Workplace Hazard Assessment

Conduct a workplace hazard assessment to first decide if a Class A or Class B minimum fill best fits the type of hazards at your facility. There are many ways to conduct a workplace hazard assessment, but here are three guiding questions that will help complete this task to determine which supplies to augment your first aid kits with:

  1. What are the hazards that exist?
  2. What kinds of injuries have occurred or could occur in relation to these hazards?
  3. What types of first aid supplies are needed to treat these injuries?

All workplaces are unique, and therefore making additions to the Class A or Class B minimum requirements should take place to reflect the unique hazards and injuries that could occur in the workplace.

Field (mobile) workers shall also have access to first aid supplies whether they are on a remote worksite or in a work vehicle.

C.2 Quantity and Location of First Aid Kits

When assessing risk, proximity of first aid supplies in relation to each worker is imperative. It is inadequate to base first aid kits and cabinets solely on the number of people in a work environment (i.e. 10-Person, 25-Person, 50 Person or 100-Person First Aid Kits).

First aid kits contain a variety of supplies to respond to many kinds of injuries, including minor injuries or more serious bleeding incidents. There are a variety of recommendations pertaining to response times for a first aid incident in the workplace that can provide guidance in a workplace’s decision on placement of first aid kits and ensuring they can be accessed quickly in an emergency. For example, an OSHA Letter of Interpretation from January 16th, 2007 addresses the definition of near proximity to first aid as 3-4 minutes from the hazards and employees that could be impacted by those hazards. Additionally, the Hartford Consensus, published by the American College of Surgeons in 2016, states that victims with life-threatening external bleeding must be treated immediately at the point of wounding. These recommendations, and others, are applicable when considering the distance between an employee and the first aid kit they can access to first aid supplies.

C.3 Selecting Additional Products for the Work Environment

  1. Oral Over-the-Counter (OTC) medications

Over-the-counter medications are non-prescription medications that can be provided by the employer to address common symptoms such as pain/inflammation, headaches, upset stomach, and cold and sinus symptoms, and others. According to the FDA definition of over-the counter medications, these are safe and effective when the directions on the label are followed.

Having OTC medications appropriate for workplace use as part of a first aid program may provide benefits such as decreased worker loss time, increased employee productivity and overall workplace safety.

Guidelines for providing OTC medications in workplace first aid kits:

  1. The products should be individually packaged in the proper doses, tamper evident, with drug facts printed on each packet so employees can make an informed decision about the product they are selecting. This type of packaging may also help reduce the spread of germs and disease that can happen with consumer-designed products in bottles.
  2. OTCs that contain any active ingredients that cause drowsiness are not recommended.
  3. Seasonal Items

Conducting a workplace hazard assessment may reveal that workers are exposed to the elements (throughout the year, or during certain months), resulting in common injuries and ailments such as allergic reactions, insect stings and bites, poison ivy skin rashes, heat stress and more. In this case, employers should add products that address these first aid concerns to workplace first aid kits. For example: OTCs containing antihistamines should be considered to treat seasonal allergies and insect stings.