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First Aid Risk Assessment Template Charts Included

This document is a template for conducting a first aid risk assessment at a work site. It collects information about the work site such as the maximum number of employees, identified hazards and their severity/likelihood, distance to medical facilities, and any barriers to treatment. Based on the assessment, a rating of low, moderate or high risk is determined. The appropriate type, size and number of first aid kits is identified according to standards. The level of first aid attendants required is also noted. The completed assessment is reviewed by an occupational health and safety committee.

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Sharif Fayiz Abushaikha
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686 views2 pages

First Aid Risk Assessment Template Charts Included

This document is a template for conducting a first aid risk assessment at a work site. It collects information about the work site such as the maximum number of employees, identified hazards and their severity/likelihood, distance to medical facilities, and any barriers to treatment. Based on the assessment, a rating of low, moderate or high risk is determined. The appropriate type, size and number of first aid kits is identified according to standards. The level of first aid attendants required is also noted. The completed assessment is reviewed by an occupational health and safety committee.

Uploaded by

Sharif Fayiz Abushaikha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

FIRST AID RISK ASSESSMENT

TEMPLATE
Work site: ________________ Location: _______________________

What is the maximum number of employees at the work site during any shift?

 2-25  26-50  51-100  100+


Identify hazards at the work site that could cause an injury/illness
Severity of Likelihood of Score
Jobs Task Hazard
Harm Harm
Low/Moderate /High Very unlikely – Very
likely

Distance to local medical facility?  The work site is 15 minutes or less.


 The work site is 15-30 minutes.
 The work site is greater than 30 minutes.
Barriers to reaching medical treatment (ie: transportation, train tracks, road construction, etc):

Overall workplace hazard rating:


 Low
 Moderate
 High
Are work sites spread over more than one location? How many work sites?
 No
 Yes
Do additional standards or guidelines for first aid kits exist at the workplace?
 No
 Yes (Add below)

(ie)) OHS Regulation First Aid Register, section 5-8
- Every first aid station is provided with a first aid register
- Each first aid treatment given, and each case referred for medical treatment must be recorded
- First aid register is readily available for inspection by the committee/representative
Do any of the locations require extra supplies to provide adequate first aid? (refer to table A.1 for examples) Please
note that some equipment requires specialized training.
 No
 Yes (Add below)
Type of First Aid kits required to address potential injuries (refer to CSA Z1220-17):
 Type 1 (personal): # of kits:
 Type 2 (basic): # of kits:
 Type 3 (intermediate): # of kits:

First Aid kit size based on the maximum number of workers at a work site (refer to CSA Z1220-17):
 Small
 Medium
 Large
Number and level of First Aid attendants (refer to OHS Regs Table 9): ________________________

Date completed: Completed by (Name): _

Reviewed by OHS Committee on: Signature:

*Note: Where multiple work sites exist, a risk assessment will need to be completed for each work site.
*Note: Review of assessment should be done within one year of completing the initial first aid risk assessment or whenever
there are significant changes in operations.

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