Will your staff help if customer falls ill?

Asthmatic teen’s pleas for help fall on deaf ears at Tim Hortons; employers should have emergency preparedness and response policy: Experts
By Amanda Silliker
|Canadian HR Reporter|Last Updated: 04/08/2013

Tim Hortons employees will be receiving a refresher on the company’s emergency protocols after a teenage boy suffered an asthma attack at a franchise in London, Ont., according to media reports.

The 17-year-old boy was gasping for breath and managed to say “help” and “phone” to employees but they told him the phone wasn’t for customer use and directed him to a payphone across the street, according to Kali Sproat, a customer who witnessed the incident.

“The teen boy was going between the two tills, there were five or six employees… he was visibly in distress,” Sproat told the London Free Press. “They didn’t ask if he needed help. The whole time, not one of them came out from behind the counter to see if he was OK.”

Sproat called 911 and stayed with the boy until paramedics arrived. But when the paramedics showed up, they found themselves at an exit-only door and employees did not open the door to let them in. They managed to pry the door open and take the boy to the hospital, said Sproat.

Michelle Robichaud, a spokesperson for Tim Hortons, told the London Free Press: “My understanding is that the young man asked to use a phone and the team member didn’t recognize he was in medical distress,” she said. “The safety and well-being of our guests is of utmost concern to us.”

Robichaud also said the company will review with the staff at this location what they should do in an emergency situation.

When developing emergency protocols, employers should consult provincial health and safety legislation as well as specific first aid or emergency response regulations, typically outlined under workers’ compensation legislation, said Norm Keith, a partner at Gowlings law firm in Toronto.

“Employers have a general duty to make sure everyone, not just workers, are safe in their workplace,” he said. “Assuming the worst — a pandemic, health concerns, someone fainting at work because of a health episode — you have to have a plan that deals with that.”

The specific requirements around first-aid kits and other materials or devices — such as a dressing table or automated external defibrillators (AEDs) — will vary based on the jurisdiction, type of workplace, number of employees and distance from EMS, said Lorna Pawluk, legal counsel at Bernard & Partners law firm in Vancouver.

“(Consider) what kind of risk your industry poses for your people. If you are four blocks from St. Paul’s hospital in downtown Vancouver, it’s a different risk than if you’re in Vanderhoof 40 miles away from the nearest hospital in the bush and you have to helicopter out somebody,” she said.

Employers should be conducting regular reviews of their first-aid facilities and supplies because if their first aid is found to be inadequate, they may be subject to enforcement actions in their jurisdiction. This can include a range of sanctions, from compliance orders through to fines and — in the most egregious cases — prosecution in the courts, said Pawluk. For example, in British Columbia, WorkSafeBC can write a compliance order and levy a maximum fine of $600,000, she said.

The required number of employees with first-aid training will also vary. But, as a best practice, at least everyone on the joint health and safety committee should be trained, said Keith.

If there are only a few employees requiring training, they can simply attend a regularly scheduled course from a training provider. But if a lot of employees need to be trained, some providers, such as St. John Ambulance, can go to the workplace and train certain employees who will then act as instructors for the others, said Hugh Bouchard, national director of training research and program development at St. John Ambulance in Ottawa.

“This allows us to customize the program to the needs of the employer,” he said. “As an example, if we deal with RCMP, we may want to add technical first aid. If we deal with airlines, we may want to include altitude first aid — altitude-related sickness and injuries. It allows us to customize the program to the needs of the workplace and the employees.”

Training can range from eight to 16 hours and up, said Bouchard. The basic training includes CPR, deadly bleeding, medical conditions such as asthma, anaphylactic reaction, eye injuries and fractures, he said. But legislation will determine the level and type of training employees need.

Once employers know the legislative requirements, they should conduct a risk assessment. They should use a checklist or guide to know what to look for, and then look through the workplace very carefully and thoughtfully to identify potential risks, said Keith.

They should also conduct an emergency preparedness survey so staff can be engaged, provide input and identify potential hazards. It’s also helpful for future risk and liability, he said.

“If you’ve surveyed everybody and no one says, ‘I’m anaphylactic’ or (that they’re) allergic to something, and you give them a chance to participate in a survey and they don’t tell you, then you don’t know,” he said. “You want to be both, from a positive HR point of view, engaging people but also protecting yourself legally at the same time.”

Then employers can put together a policy that deals with emergency preparedness and response that considers all the hazards and worries people have at work, said Keith.

The policy should outline the proper reporting procedures if an incident does occur, said Pawluk. Depending on the jurisdiction and type of injury, there will be various reporting requirements for the Ministry of Labour in the event of an accident investigation or for workers’ compensation claims.

All employees should read the policy and there should be some verification mechanism around this, such as requiring employees to provide feedback or complete a test, said Keith.

Setting the rules

In early March, an 87-year-old women at a Bakersfield, Calif., retirement home died after a nurse refused to give her CPR, saying it was against company policy to provide medical help.

The executive director of the facility defended the nurse’s actions, saying she did indeed follow procedure.

“In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” said Jeffrey Toomer in an Associated Press article. “That is the protocol we followed.”

An employer always has the option of setting the rules around emergency protocols and procedures, said Bouchard. But it needs to be aware it is liable if anything happens on the company’s premises.

“There’s some pretty broad and serious legal liability if you don’t manage not only the risk of workers but the risk of anybody in the workplace carefully,” said Keith.

An employer may be open to a lawsuit if an incident occurs with a visitor, as opposed to a worker. But most jurisdictions across Canada have the equivalent of Ontario’s Good Samaritan Act that protects people from being sued if they do their best, within reason, to try to help or save a life and something goes wrong, said Keith.

Whether the medical or first-aid incident occurs with a worker or customer, the employees’ response should be the same, he said.

Employers should be sure to periodically remind employees about the company’s emergency protocols and procedures.

“Some employers will have a prevention approach, a safety-oriented culture within their company, and they’re going to keep reminding employees of the safest procedures and what to do if something goes wrong,” said Bouchard.

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