13 Medical FirstAid

Yanbu National Petrochemical Company Site Safety Procedures Manual
Yanbu Petrochemical Complex U & O Project July 2005

Fluor Arabia Limited Contract A2IT Page 1 of 13
13. MEDICAL FACILITY AND FIRST AID SUPPLIES

The medical facility of the Owner will function as the main medical facility on the
project.
A GENERAL
The Project recognizes the fact that the health and welfare of the employees and that their basic
health needs must be met at the highest level in order for them to perform and execute their
assigned tasks safely and efficiently. The Project also recognizes that immediate treatment of
injuries and illnesses directly benefit the employee and the project.
The objectives of having a medical facility on the project are as follows:
• To provide and meet the basic health care needs of project employees.
• To attend to all First Aid Cases, injuries requiring medical treatment and other medical
emergencies and notify the Project Safety Manager and Owner Safety Manager
immediately.
• To maintain an acceptable level of health and hygiene within the site, laydown areas
and man camp.
• To administer scheduled vaccinations.
• To conduct health education programs where necessary.
• To make the necessary hospital referral/consultation to the local medical facilities
outside the project if necessary after initial consultation at the job site.
• To conduct and participate actively in health care promotion and coordinate with the
Project Safety Manager for the implementation of the No Accidents Program.
• To conduct hospital visits to admitted patients and make daily progress notes and report
them to the Project Safety Manager.
• To conduct liaison work with the local Health Ministry regarding health care.
• To conduct basic CPR/First Aid Training as directed by the Project Safety Manager.
The project shall have an onsite medical facility for the treatment of injuries and illnesses when
the total number of employees reaches 250. All employees shall be notified where the medical
facility is located.
Prior to mobilizing the onsite medical facility the project is responsible for locating a medical
facility/hospital in the area to provide medical services for the project until the project has 250
employees.
The Safety Representative is responsible for visiting the medical facility/hospital and
establishing protocols for treatment, return to work policies, medical surveillance programs etc.
with the selected physician. Contact the Owner Safety Department for a list of approved
medical providers for the area.
An emergency eye wash station shall be provided in the immediate vicinity of any area where
the eyes or body of any person may be exposed to injurious, corrosive materials. Eye wash
stations shall be easily accessible and inspected on a weekly basis.
H:\000_General\Share\501 - Construction\SITE SAFETY PROCEDURES\13-Medical-FirstAid.doc GENERAL SITE CONDITIONS AND SAFETY PROCEDURES
B MEDICAL CLINIC/FACILITY
The Medical Facility shall manned by a competent and skilled Physician certified by the Saudi
government and assisted by a Nurse certified by the Saudi government. It shall be equipped
with the basic equipment, medicinal supplies with ambulance transport services manned by an
experienced ambulance driver. The facility shall be designed to attend to minor medical and
surgical procedures and have adequate supplies for emergency treatment and stabilization
before transporting a patient to a major medical facility outside the project.
All other cases which after examination and evaluation by the onsite Physician determines
further consultation is necessary by a specialist shall be referred to a medical facility/clinic
outside the project for further evaluation and treatment.
1) MEDICAL STAFF/PERSONNEL
1.1 PHYSICIAN
A practicing Physician who is currently holding a medical license to practice

his profession and Saudi government certification shall head the Medical
Facility. He must be western trained and able to speak and write English. A
membership to the Royal College of Medical Practitioners or related affiliations
shall be an added advantage but will not be necessary.
1.2 NURSE
A male nurse is required on this Project. He must be a holder of a Diploma in

Nursing with current nursing registration licensed to practice his profession and
Saudi government certification. He must have 2 years hospital based
experience as an emergency room nurse. He must be able to speak and write
English.
1.3 AMBULANCE DRIVER
He must be a holder of a current Saudi Driving License with the specific

restriction code. He must be trained in first aid and able to understand and
speak the English language. He must be able to pass the practical driving test
conducted by the Project Safety Manager or his representative. The Ambulance
driver must familiarize himself of the road access at the work site and
fabrication yards.
2) DUTIES AND RESPONSIBILITIES
2.1 PHYSICIAN
As head of the Medical Facility he must perform his duties in the highest
degree of competence and professionalism. He must be able to deal efficiently
and diligently to the employees of varied nationalities, culture and background.
Listed are his duties and responsibilities. It is understood that the physician may
be asked to perform other duties and responsibilities as determined by the

Project Director or the Safety Manager.
• Conducts medical and physical examination to employees and write the

necessary recommendation.
• Attends to outpatients and performs the necessary examinations and
prescribes the corresponding treatment.
• Dispenses medications to patients.
• Attends to First Aid Cases and or Surgical/Emergencies and evaluates and
prescribes the necessary treatment or medications.
• Makes the necessary hospital referral for cases that to his judgment cannot
be treated at the clinic. Before any hospital referral shall be made, the
Physician shall coordinate with the Project Safety Manager or his
designated representative. The Physician shall fill-out a Hospital Referral
Form of which a copy shall be provided to the Project Safety Manager.
• He shall maintain a patient’s logbook indicating the patients seen during the
day. A Daily Illness Record Log shall be provided. The Physician must
maintain an individual patient’s file for record purposes and which shall
serve as an aid for further follow-up treatment. Relevant history shall be
written in the patient files, i.e., history of allergies to food and medications
and present medications he is taking, etc.
• He shall conduct periodic inspections of the job-site and its premises
regarding the health and hygiene standards of the site.
• He shall conduct periodic health inspections at the camp mess facilities.
• He shall conduct periodic health education programs and attend a medical
safety meeting in coordination with the Project Safety Manager if the need
arise when there is an increase in the number of specific injury cases or
illnesses.
• He shall keep and maintain a statistical record of the number of cases
attended to or treated in a certain month.
• He shall conduct a periodic emergency medical evacuation drill to evaluate
the preparedness of contractor medical staff and foreman/supervisors in
dealing with an injured employee.
• He shall conduct a blood pressure and diabetic screening program.
• He shall perform liaison work to the Health Ministry for health/medical
related matters.
• He shall prepare a monthly accomplishment and status report to be
submitted to the Project Safety Manager.
• He shall make the necessary or relevant recommendations required for the
safe performance of work tasks on Site.
• The Physician shall have the authority to issue a 24-hour bed rest/no work
status when necessary. The patient must report back to the clinic the
following day for further evaluation.
• The Physician shall administer the necessary vaccination program to all
employees as required.
• He shall ensure the operation of the Medical Facility is managed in
adherence to local Health Ministry and Local Laws.
2.2 NURSE
The Nurse is an active participant in the promotion and implementation of the

health care and injury treatment program on the Project. He shall competently
perform the following duties and responsibilities and must be willing to
perform other duties and responsibilities asked for by the Project Safety
Manager.
• He shall assist the physician in medical examinations and administer

prescribed treatment to patient and or the injured.
• He shall assist the physician in the performance of clinic related activities.
• He shall maintain a record of all cases attended to.
• He shall maintain a file of all patients attended to and keep them in a locked
filing cabinet.
• He shall keep an inventory of medicines dispensed and all equipment and
supplies of the Medical Facility.
• He shall ensure that instruments are autoclaved/sterilized in a proper
manner. Instruments shall be disinfected or soaked in a prescribed soaking
solution prior to use.
• He shall see to it that needles/blades shall be one time used and shall be
disposed of accordingly in a designated sharps only receptacle.
• Nurse shall see to it that sterile gloves shall be used in all invasive or open
cases when blood or body fluids shall come into contact with any part of
the body.
• All patients kept at the observation room shall be closely monitored.
• The Nurse shall accompany all patients (that do not need the assistance of
the Doctor) referred to the Hospital. He shall inform the Physician the
condition of the patient while at the Hospital.
• The Nurse shall not be allowed to insert or start intravenous medications
without instruction by the physician. The Nurse shall not administer
medications and shall not dispense any mediations without instruction by
the physician.
• The Nurse shall not apply stitches or sutures to a wound.
• In the absence of the Doctor, the Nurse shall attend to cases limited only to
the dispensing of analgesics/antipyretics, anti-diarrhea medications. All
other cases shall then be referred to the hospital for further treatment and
management in the absence of the physician.
• The Nurse shall keep the medical facility in a hygienically sound condition
and at the cleanest level at all times. Paper bed covers shall be changed for
each patient seen.
• He must conduct a daily inventory of the ambulance to ensure if supplies
are complete and that O2 delivery system is in order. He must coordinate
with the Ambulance Driver in order to keep and maintain the ambulance
ready in the event of an emergency.
• The Nurse must be able to perform CPR and must have undergone CPR/
BLS Training Course.
• Prior to patient’s release from the medical facility, the Nurse must conduct
pre-discharge health teachings.
2.3 AMBULANCE DRIVER
The ambulance driver is a member of the health care team. He must see to it
that the ambulance is properly maintained and in good running condition. He
must have training is basic first aid and be willing to work in extended
time/hours as the need arise. In addition to his duties as an Ambulance Driver,
during the course of his work, he shall be trained about proper lifting of the
injured.
C BASIC MEDICAL FACILITY (CLINIC) INSTRUMENTS/EQUIPMENT
In order to properly manage and treat injuries and illnesses on the project in a timely manner to
prevent the injury or illness to become more serious and to deal with emergencies the medical
facility must be equipped with the following:
1) INSTRUMENTS / EQUIPMENT
- Sphygmomanometer, Mercury Type (Baumanometer)

-3M Stethoscope
- IVAC Electronic Thermometer with Disposable plastic probes
- Ophthalmoscope
- ENT examination set
- Ear irrigation set
- Examination light
- Examination torch
- Knee hammer
- Examination bed
- Blankets
- Bed sheets
- Disposable tongue depressors
- Disposable surgical gloves
- Injection trays
-Instrument trays
- Glass jars/stainless jars for supplies
- Disposable eye sheets
- Needle holder
- Blade holder
- Mosquito forceps, curve
- Mosquito forceps, straight
- Bandage scissors
- Mayo curve scissors
- Thumb forceps
- Tissue forceps
- Sponge forceps/pick-up forceps
- Disposable surgical blades
- Disposable sutures (Prolene 3-0, Prolene 4-0, Plain Catgut-0, Plain Catgut 4-0)
- Folding stretcher (canvas type)
- Fracture board complete with Velcro Straps
- Basket stretcher
- Fracture splints (various sizes)
- Tubigrip (for the fingers)
- Tubigrip insertor
- Finger splint
- Air splint
- Thomas splint
- Skin Traction set (adult)
- Cicagraf skin closure system
- Elastic Bandage( 2”,3”,4”,5”)
- Disposable Sterile Gauze 2”x2”, 3”x3”, 4”x4”
- Sterile Eye pad
- Hypoallergenic plaster
- Sanitary Napkin
- Cotton Buds
- Sterile cotton
- Sterile syringes (3 ml, 5 ml, 10 ml)
- Insulin syringe
- Asepto syringe
- Dressing tray
- Kidney basin
- IV Cannula Abbocath G-22,G-23
- IV Set (Macrodrip)
- Haemaccel 500ml
- Lactated Ringer’s 500ml
- D5LR 500 ml
- D5W 500ml
- 0.9%NSS 500ml.
- Dextrose 10% 250 ml
- Portable Medical O2 cylinder w/gauge,tubing, face mask or nasal cannula
- Ambu Bag
- Shaving kit
- Portable EKG Machine
- Portable Hewlett-Packard DC defibrillator with cardiac monitors
- Sterilizer/Auto clave machine
- Gluco meter
- Glucose stick
- Urine stick
- Cervical collar
- Triangular bandage
- Arm sling
- Tourniquet
- Hot water bag
- Ice cap
- Spirit swab
- Spirit of ammonia
- Ipecac syrup
- Milk of magnesia
- Ice maker
- Scoop stretcher
- Pat-slide board
- Nebulizer kit
2) MEDICINES
- Solu-Cortef inj
- Solu-Medrol inj
- Ventolin sol. for inhalation
- Adrenaline inj.
- Anti-Tetanus Serum
- Chlorphenilamine maleate 10 mg inj.
- Benadryl inj.
- Buscopan inj.
- Voltaren inj.
- Xylocaine inj. plain w/out adrenaline
- Xylocaine spray 2%
- Povidone Iodine
- Savlon antiseptic
- Cidex sol.
3) NSAIDs/ANALGESICS
- Brufen 200/400 mg tabs

- Voltaren tabs
- Paracetamol 500mg
- Feldene tabs
4) COUGH/COLD MEDICATION
- Actifed syrup
- Bisolvon syrup
- Coricidin-D
- Benylin syrup
- Eskornade spansule
5) ANTIDIARRHEALS
- Imodium caps
- Lomotil tabs
-Oral Rehydration Salts
6) ANTIBIOTICS
- Augmentin caps
- Amoxycillin 500 mg
- Bactrim Forte
- Cephalosphorin 500 mg
7) ANTACIDS
- Maalox tabs
- Gelusil susp.
8) ANTIPRURITIC/ANTIHISTAMINE CR.
- Locacorten vioform cream

- Kenacort cream
- Betnovate cream
9) EYE/EAR MEDICATIONS
- Visine eye drops

- Otosporin eye drops
- Tetracycline oint.
- Chloramphenicol eye drops
- Maxitrol eye drops
- Lidocain eye drops
10 OINTMENTS/CREAMS
- Bactroban oint.
- Fucidin oint
- Silver sulphadiazine cream
- Sufratulle
- Fucidin Intertulle
- Ichthamol oint.
- Voltaren gel
- Deep heat cream
- BenGay cream
D LABORATORY SERVICES
In the event laboratory services are required the local offsite Medical Facilities / Hospitals will
be used.
E PHARMACY SERVICES
The Project Medical Facility shall be well stocked with the essential medicines and supplies to
treat the most commonly encountered illnesses. Over the counter medications are available and
intravenous fluids for injection.
F ON SITE CONSULTATION PROCEDURES
In order to shorten the duration of waiting time the following consultation procedures must be
adhered to and must be disseminated to all Contractors and their employees. This Medical
Consultation Report shall come in duplicated copies. One form shall be retained by the medical
facility and the other form shall be returned back to the patient’s immediate supervisor/foreman
with the Doctor’s Medical Report To The Employer attached to it.
1) No patient shall be seen by the Physician unless referred to by his company and/or
immediate Supervisor or Foreman. An Employee Injury / Illness Report shall be
accomplished indicating the time the patient was sent out by the supervisor for medical
consultation. As soon as the patient arrives at the medical facility he must check in with
the nurse. He must hand in the referral form to the Nurse where his time of arrival at the
medical facility shall be logged in so an orderly sequence is followed according to the
time of arrival of the patient shall be followed on a first come first served basis. The
form shall be filled out by the physician with the diagnosis or impression, and the
treatment prescribed. Recommendations and further comments by the Physician shall
also be written on this form and if there is a need for a time off for 24 hours. The Nurse
at the Reception shall then log in the time he was discharged from the medical facility.
A copy of the completed Employee Injury / Illness Report and Doctor’s Medical Report
To The Employer shall be given to the patient for submission to his immediate
supervisor/foreman and the other shall be retained by the medical facility for future
reference.
2) In the event of an emergency situation the above medical consultation procedures shall
be bypassed. The injured employee must be brought immediately to the clinic for urgent
treatment. Walk-in patients must wait until the injured patient has been treated.
However, the immediate supervisor of the injured patient must sign the Employee
Illness/Illness Report and submit it to the nurse regarding the case.
3) Emergency Cases evaluated and examined by the physician which are referred to an
offsite medical facility/hospital for further care and management shall be immediately
transported and evacuated via ambulance and accompanied by the nurse or physician.
G HOSPITAL REFERRAL
No Hospital Referral shall be made unless accompanied by the Consultation Referral Form.
When cases are complicated as in severe injuries/medical emergencies the patient must to be
transported to the hospital immediately. The following procedures must therefore be followed
prior to any hospital referral.
1) The patient brings along with him the Employees Report of Occupational Injuries /
Illness filled out and duly signed by his immediate supervisor. If the patient is unable to
do this, his supervisor will bring the form.
2) The project Physician examines the patient. After examination and evaluation and
arriving at an initial diagnosis, he decides if the patient needs to be referred to a
Hospital for further consultation or treatment.
3) The patient is referred a Hospital with the Official Referral Form signed by the
Physician. This form shall then be carried by the patient if he is ambulatory otherwise
he shall be transported by the ambulance if he not ambulatory or needs assistance.
4) The patient is seen at the hospital. The project physician at the hospital must fill in the
accompanying referral form indicating the nature of illness of the patient, diagnosis and
treatment and recommendations. A copy of the completed form shall be forwarded to
the project medical facility and to his immediate supervisor for proper disposition.
5) In the event that the patient is admitted to the Hospital, the project Physician must be
informed immediately and shall inform the Project Safety Manager immediately.
H FIRST AID CLINICS
All Contractors working on the Project shall set up fully equipped satellite First Aid Clinics
only with the approval of the Owner. Approved first aid clinics shall be inspected by the project
Physician prior to its operation. A Licensed Male Nurse must staff the First Aid Clinic with 2
years hospital based experience working as an emergency room nurse.
These clinics shall have the following basic equipment, supplies and medicines:
- Sphygmomanometer (blood pressure cuff)

- 3M Stethospcope
- Sets of splints
- Triangular bandage
- Thermometers(Oral)
- Cervical Collar
- Folding Stretcher (canvass)
- Fracture Board/Spinal Board
- Examination Bed
- Torch/Penlight
- Tongue Depressors
- Elastic Bandage of diff. sizes.
- Cicagraf skin closure system
- Sterile gauze (2” x 2”, 3” x 3”, 4” x 4”)
- Sterile eye pad
- Hypoallergenic plaster
- Sanitary Napkin
- Spirit of Ammonia
- Dressing Tray
- Bandage scissors
- 10 ml syringe for irrigation
- Refrigerator
- Sterilizer
- Visine eye gtts.

- Bactroban oint
- Fucidin oint
- Sufratulle dressing
- Fucidin Intertulle dressing
- Tweezers
- Sterile needle (G-21)
- Xylocaine spray
- Deep Heat cream
- Voltaren Gel
- Antidiarrheals
- Analgesic/antipyretic
- Cough cold medications
- Shaking kit
- Povidone Iodine
- Savlon antiseptic
- Cidex sol.
- Spirit swab
- Medicine bag
1) First Aid Clinics shall keep a Daily Illness Record of patients seen. Each patient seen
must be logged with the complaint of the patient and written treatment given. The
Daily First Aid / Illness Record is to classify the cases seen whether they are work-
related illnesses or non-industrial related cases and for an overview of the number of
specific cases seen or attended to for the week and month. A Weekly/Monthly
Summary form shall be used for this purpose.
2) Satellite Clinics shall keep a record of medicines given or administered. At no event

shall the Nurse dispense antibiotics or apply sutures to any wound. He may apply
butterfly dressing if the wound is superficial or is not compromised.
3) Satellite Clinics shall maintain a direct communication link between them and the
medical facility. This is to facilitate the immediate relay of information in case of an
emergency.
4) Nurse shall ensure that contaminated waste materials shall be disposed of in a separate
container/receptacle.
5) First Aid Clinics must be provided with ample potable water supply.
I HEALTH PROGRAMS
The Medical Facility shall support the following programs in the interest of the employees
safety and good health.
Diabetic Screening Program.

BP Screening Program
Vaccination Program
J BLOODBORNE PATHOGENS PREVENTIVE EXPOSURE PLAN
The purpose of Bloodborne Pathogens Standard is to reduce occupational exposure to Hepatitis

B Virus (HBV), Human Immuno-deficiency Virus (HIV) and other bloodborne pathogens that
employees may encounter in their workplace. The Medical Facility is an advocate to this
program Standard.
K FIRST AID SUPPLIES
1. In the event the total number of employees are less than 250 and where work areas are
far away from the onsite medical facility, the project shall designate an area in offices
and/or work areas where a 36-package kit first aid supplies can be stored and
maintained. A sign stating First Aid shall be posted at the entrance door into the
designated area.
2. All vehicles shall also be equipped at minimum with a 16-package first aid kit.
Unobstructed access to the First Aid Kit is to be provided and maintained.
4. The contents of the first aid kit shall consist of appropriate items and stored in a
weatherproof container with individual sealed packages of each type per ANSI
Standard Z308.1-1998. The first-aid kits are maintained at the ten, sixteen, twenty-four
or thirty-six package level and shall contain at least the following:
16 Package kit:
1 Pkg. Absorbent gauze, 24" x 72" (1 per pkg.)
1 Pkg. Adhesive bandages, 1 " (16 per pkg.)
2 Pkg. Bandage compresses, 4" (1 per pkg.)
1 Pkg. Eye dressing (1 per pkg.)
1 Pkg. Scissors* and tweezers (1 each per pkg.)
2 Pkgs. Triangular bandages, 40" (1 per pkg.)
1 Pkg. Antiseptic soap or pads (3 per pkg.)
7 Pkgs. of consulting physicians choice
36 package Kit:
4 Pkgs. Absorbent gauze, 24" x 72" (1 per pkg.)

2 Pkgs. Adhesive bandages, 1" (16 per pkg.)
5 Pkgs. Bandages compresses, 4" (1 per pkg.)
2 Pkgs. Eye dressing (1 per pkg.)
1 Pkg. Scissors* and tweezers (1 per pkg.)
8 Pkgs. Triangular bandages, 40" (1 per pkg.)
1 Pkg. Antiseptic soap or pads (3 per pkg.)
13 Pkgs. of consulting physician's choice
a). Scissors shall be capable of cutting 2 layers of 1 oz. cotton cloth or its
equivalent.
b.) The contents of the first aid kit is to be checked initially and weekly thereafter
to ensure that expended items are replaced.
c.) At least one employee will be adequately trained to administer first aid.
Training shall include at a minimum Basic First Aid, CPR and Bloodborne
Pathogens.
ATTACHMENTS :
ATTACHMENT A: EMPLOYEES REPORT OF OCCUPATIONAL INJURIES / ILLNESS

ATTACHMENT B: DOCTOR’S MEDICAL REPORT TO THE EMPLOYER
ATTACHMENT C: MEDICAL CONSULTATION REPORT
ATTACHMENT D: DAILY FIRST AID / ILLNESS RECORD
ATTACHMENT E: WEEKLY SUMMARY REPORT

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Yanbu National Petrochemical Company Site Safety Procedures Manual

Yanbu Petrochemical Complex U & O Project July 2005

13. MEDICAL FACILITY AND FIRST AID SUPPLIES

The objectives of having a medical facility on the project are as follows:

A practicing Physician who is currently holding a medical license to practice

A male nurse is required on this Project. He must be a holder of a Diploma in

1.3 AMBULANCE DRIVER

He must be a holder of a current Saudi Driving License with the specific

2) DUTIES AND RESPONSIBILITIES

be asked to perform other duties and responsibilities as determined by the

• Conducts medical and physical examination to employees and write the

The Nurse is an active participant in the promotion and implementation of the

• He shall assist the physician in medical examinations and administer

2.3 AMBULANCE DRIVER

C BASIC MEDICAL FACILITY (CLINIC) INSTRUMENTS/EQUIPMENT

- Sphygmomanometer, Mercury Type (Baumanometer)

- Brufen 200/400 mg tabs

- Locacorten vioform cream

- Visine eye drops

F ON SITE CONSULTATION PROCEDURES

H FIRST AID CLINICS

- Sphygmomanometer (blood pressure cuff)

- Visine eye gtts.

2) Satellite Clinics shall keep a record of medicines given or administered. At no event

Diabetic Screening Program.

J BLOODBORNE PATHOGENS PREVENTIVE EXPOSURE PLAN

The purpose of Bloodborne Pathogens Standard is to reduce occupational exposure to Hepatitis

K FIRST AID SUPPLIES

1 Pkg. Adhesive bandages, 1 " (16 per pkg.)

2 Pkg. Bandage compresses, 4" (1 per pkg.)

1 Pkg. Eye dressing (1 per pkg.)

1 Pkg. Scissors* and tweezers (1 each per pkg.)

2 Pkgs. Triangular bandages, 40" (1 per pkg.)

1 Pkg. Antiseptic soap or pads (3 per pkg.)

7 Pkgs. of consulting physicians choice

4 Pkgs. Absorbent gauze, 24" x 72" (1 per pkg.)

2 Pkgs. Adhesive bandages, 1" (16 per pkg.)

5 Pkgs. Bandages compresses, 4" (1 per pkg.)

2 Pkgs. Eye dressing (1 per pkg.)

1 Pkg. Scissors* and tweezers (1 per pkg.)

8 Pkgs. Triangular bandages, 40" (1 per pkg.)

1 Pkg. Antiseptic soap or pads (3 per pkg.)

13 Pkgs. of consulting physician's choice

ATTACHMENT A: EMPLOYEES REPORT OF OCCUPATIONAL INJURIES / ILLNESS

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