Injury Evaluation and Response: Best Practices for Leaders

Virginia Siegel | On-Site Health & Safety

Melanie Russell | Vimocity

Hello and welcome. Thanks so much for joining the live event today.

Today's session is on injury evaluation and response.

Be going over best practices for leaders in the field.

This topic has we've been hearing a lot about it. Leaders are trying to figure out how to respond effectively when injuries happen to ensure their employees get the right care at the right time.

But before we jump right in, just a quick note on how we're going to make the most out of today's call. So this session is being recorded, so you'll be able to go back and reference it or share it with others.

Feel free and please drop any questions or comments in the chat at any point. Any questions that we don't get to, we will follow-up via email after.

We will also be sharing a free injury management resource at the end, so stay tuned for that QR code.

All right, let's go ahead and get started. So today is helping leaders make strong decisions in the moment when someone gets hurt and giving you all a clear framework how to support those moments.

So my name is Melanie Russell. I am a communications specialist with Vimocity. For those unfamiliar with Vimocity, we work with safety and operations teams to help prevent common injuries by delivering practical, expert led content to crews across places that they work. And I'm super excited today to have Virginia Siegel joining us. She's the co-founder of On-site Health and Safety and a certified safety professional.

She has over thirty years of experience helping organizations improve how injuries are evaluated and managed in the field, especially when it comes to on-site response and first aid programs. So Virginia, I'll turn it over to you for a quick intro.

Well, hello, you did a great job. Yes, that's me, Virginia, co founder. You had to say the thirty years, I guess. But anyway, I actually was a paramedic before I became a safety person.

I know lots of safety folks come from EMS and that gives us a really unique opportunity to interact with folks when they get hurt. So On-site is a response entity. We respond to workplaces when people get hurt, of course help them with prevention first, that's why we love Vimocity, and then we respond and we help folks. So I'm Virginia from On-site, nice to meet you all.

Awesome, thank you for that intro, Virginia. And again, just super excited to have all your experience in leading this conversation today. So just starting at a high level from your experience, why do injuries that start up small end up becoming recordables?

Well, because of the treatment, right? The treatment that's provided is, you know, you could call it aggressive, you could call it a lot of money involved. And when all that money is involved and there's so many moving parts, we end up with a whole lot of treatment that perhaps we didn't need. And remember, the classification is based on the treatment.

So folks go into a clinic, there's a whole set of issues that have to be addressed. And right or wrong, we end up with prescriptions that we probably could have lived without. We end up with a lot of extra time off work for folks and most folks are working by the hour. And so taking people off work, it costs them money regardless of what the workers' comp situation is in the state.

And not only that, but sometimes it can cost them long-term challenges, especially with some of the drugs that are prescribed and some of the waiting for approvals for things that maybe we didn't actually need. We've really come to the conclusion by being in the field first that just because the insurance approves it doesn't necessarily mean it's good for the employee or the employer. And so things escalate. And, again, we've learned from the field level first, know, try trying things that, most of the things we see in the workplace do not need to become recordable.

Yeah, that's really good and helpful insight at a high level. And then how much of that really comes down to how leaders respond in the moment?

It's very important. Leaders need to respond. They need to know the difference between a life-threatening case.

A life-threatening case is a life-threatening case and folks on the site need to know when they need to call an ambulance.

But if it's not life-threatening, they also need to have the confidence not to call an ambulance, but rather to use the resources that their companies are providing that allow sort of a step in between. Something really hurts, we go to the urgent care. And there is a step in between really across the whole country that's been developing over the last thirty years. Steps in between, we call it first aid, to help address these situations in the field with a confidence that comes from training, training both workers. It's better to train workers on how to care for themselves before they're hurt than it is to wait till they're hurt and then say, oh, but listen, you know, this might be better for you.

That's probably too far down the road. So training upfront, this is what life threatening is.

These are the things that you risk when you go to an emergency room.

So folks are confident in that decision. That makes body language, that makes the whole approach confident and effective and gives the opportunity to do all the things you have the freedom to do on the site and protect folks from becoming recordables.

Yeah, absolutely. I feel like training is always super helpful in any scenario.

And obviously, this topic is very complex and a lot of layers, but if you had to simplify this, how should leaders think about injuries at a high level?

Well, there's a slide that is a really good pictogram I think of how to do that. Again, first training, recognizing what is life threatening, what's not, like you say, there's two buckets.

The vast majority of cases that we see every day are not life-threatening. And so, our on-site provides a service where the folks from the field either call or go online or now the new app where they can say, I've got a guy or a person on the job that's hurt. And so a dispatcher takes the call, a remote technician, we call it telehealth, some folks don't like that terminology, but that's fine. It's a remote technician who has the option of putting the person on telehealth, talks to the injured person as soon as possible, what's going on, what happened?

Settle down the anxiety. In the meantime, while that is happening, a field tech is dispatched. So an in-person response is a big deal. And really, wish we could get to every single job site anytime anybody gets hurt.

Most job sites in most states we can get to in person and that response is happening while the video and the conference is going on, potential telehealth. The technician arrives, provides what OSHA defines as first aid. What OSHA defines as first aid has actually become a scope of practice. And oh my goodness, there's so many things we can do with first aid, you know, massage and Steri Strips and washing out eyes and calming people down, elastic taping, all these things are available to qualified hands, trained hands.

And so that technician does that and then reports everybody who's hurt has to be offered the opportunity to seek medical care. And we differentiate between first aid and medical care. So you call for service, call is dispatched, the remote technician talks to the worker, the in person technician arrives, takes care of the worker, reports to you or your designee, the safety person or whoever's designated at the company. This person has chosen or not chosen to seek medical care after this first aid was provided.

And we found that actually ninety percent across the board, across industries will decline once they've been cared for in the field by a first aid responder.

That's super helpful. And yeah, again, we'll share that kind of process life cycle at the end in our guide for you all. But we've talked a lot about managing injuries on-site. A lot of times they don't need to be escalated, but what are the clear signs of something that is serious and needs immediate escalation?

Well, the first one, the big one is loss of consciousness. If something happens to somebody and it causes them to lose consciousness, for example, a fall or an illness of some sort, and they lose consciousness, that is life threatening. Folks need to be taken care of in a quiet place if they are no longer unconscious, but clearly unconscious is for ambulance. Severe bleeding out of say a radial artery, not your fingertip, tell all your carpenters, not your fingertip, but severe bleeding from an artery, spurting bleeding, breathing problems, airway problems, large burns, and obvious long bone fractures, obvious deformity to large bones, falls from great heights, know, person is laying on the ground and can't move.

Those things require ambulance calls. And I'll say right here, a good first aid CPR training program, which most people have, if you don't, I say get one, will train folks on how to recognize life threatening versus not life threatening. And I recommend, even though you're doing your first aid CPR, every two years, every quarter, get a refresher on what is life threatening and what is not. Cause in the moment that training helps people calm down and make a good decision.

So obvious long bone fractures, large burns, airway, breathing, circulatory problems, and loss of consciousness, those are big deal, those go EMS.

Thank you. Yeah, that's helpful I think to hear and also a good reminder that the training needs to be often just to keep it top of mind and making people feel confident in that decision-making. And you said it earlier, most injuries aren't life-threatening. So, is And so what are leaders actually seeing most of the time in the field?

Well, lacerations, abrasions, foreign bodies in the eye, twisted ankles, hurt shoulders, sore backs, sore backs that really, really hurt.

But if the person didn't fall from a height and is walking around and holding their, that's not life threatening. Now it may ultimately require intervention, but all said cases are improved, made better by an in person response from say a uniformed responder.

Folks are educated for us at On-site, person on the site, a leader on the site has a question, they know it's not life-threatening, but it's getting anxious, they call and we have a telehealth person who can help make that decision, talk down that anxiety.

And we use Vimocity videos to help people learn to really take care of their bodies. And culturally we find in organizations when folks do have the opportunity to take really good care of your people on the site, people gain confidence in that. It just improves the culture all around. So lacerations, abrasions, punctures, foreign bodies, splinters, foreign bodies in the eye, not a nail, but debris in the eye, sore muscles, sore this, twisted that, sore back, sore necks, these things happen every day and are quite easily managed effectively. The most effective management in my opinion comes when leaders in the field call for help and someone arrives and takes care of folks in their own environment.

Yeah, and I think that's super helpful just to kind of go over the breadth of everything that can be on that list.

And I think with your experience, would love to walk through an actual scenario of an injury. So just giving everyone a heads up, we're gonna show a photo. It's not bad, but if you are queasy, just maybe close your eyes.

Close your eyes for a second. Yeah.

So yeah, someone cuts their head, but they can still work.

A lot of times head injury gives immediate red flag. You walk us through what a leader should do in the moment?

Yes. And this is really a great example of one case. This is a real case. This is a real on-site response case. The leader in this case recognized that this was a potential problem, asked all the right questions.

Those questions, a lot of folks say, yeah, but it's a head injury.

Well, yeah, well, it's a scalp and it's bleeding a lot. So remember it's on the head and it's bleeding a lot. So there's a little bit of panic that comes in there. So with this case, the first question was, how did that happen? Did this person lose consciousness?

And the answer is no. He stood up and cut his head on a sheet metal, the edge of a piece of sheet metal, a piece of duct, I think. So he didn't get knocked out. He didn't get knocked down. In fact, he insisted he was wearing his hard hat. So we knew that he was awake and alert.

The bleeding is stopped. The leader in the field is coached on how to stop that bleeding.

The worker is moved into a comfortable place, the technician arrives, the technician helps clean the wound. Those white things that you see on the second picture in the slide are Steri Strips. Steri Strips are something most people are quite familiar with. They're incredibly effective when it comes to closing wounds. Noninvasive, a noninvasive approach in my experience just allows for much quicker healing.

And they're counted as first aid. So clearly no staples or stitches were needed. And the reason they weren't needed, the reason we know they weren't needed is because they weren't used and you can see the result. You have a beautifully healed, almost no scarring. We haven't seen this man in a pretty long time, but I'd be willing to bet that he has no scar.

The key is no shots, no drugs, no lost hours, no fear, no waiting at home for things. This was just a straight up in the field, taken care of, excellent care, the worker felt cared for, and this was a first aid.

Yeah, thank you. I think, yeah, super helpful just to go through a real life scenario and to your point, head injury, bleeding, sometimes that doesn't necessarily without the training feel black and white, easy decision. I think just walking through all that is super helpful and emphasizing that you're removing the fear and making everyone feel comfortable and confident on-site is key. So we've talked about how to evaluate and make the call in the moment. The next piece is what leaders actually do differently to prevent that injury from escalating. So when leaders decide not to escalate right away, what should they actually be doing to manage that injury early?

Well, obviously just addressing the person as quickly as possible. Always have, I mean, we're doing hazard analysis, we're doing preventive care, we're doing planning. So always have an affirmative plan in place. So rather than wait till someone's hurt and then think, oh, what do we do?

Always field leaders need to know what to do when someone walks in the office or the trailer on the job site, if that's the case, and they just, their back hurts and they're holding their back, what do you do? So first thing be prepared.

Don't just automatically send folks into a medical facility. It's not in their best interest. It's not in your best interest. So hold the phone.

Wait, this is not life threatening, right? So let's just wait. Let's just consider all the options. Use your resources, get help.

If on-site is your resource, we're happy to take calls twenty-four-seven. We have a worker, he's here, his back really hurts. What do we do? So at that point, even if it takes fifteen minutes to make a decision, it's a decision that is made and we can make the best decision for the worker.

During the process, sometimes leaders have a tendency to just say, forget it. I'm just going to go to take them to the clinic. And I just want to emphasize that's not in anybody's best interest. If we can settle folks down, get some ice, always have ice available if the case is musculoskeletal, especially backs, and help find the epicenter of the pain.

If you're comfortable with that, you could get coached through the telehealth while waiting for the in person tech to respond. In person tech, when they respond, they can again show videos of how to prevent, how to care for your body. They can massage. Massage is considered a first aid and at least our techs carry massage guns.

And this taping thing that we're using where we use this tape to help stabilize muscles. Again, it's elastic tape, it's first aid. It's just marvelous what can be done and then follow-up. So while the on-site team will follow-up with an injured worker, the more an employer has somebody who can follow-up, check up on the person, schedule a follow-up visit if necessary, but those visits are at work. Keep the person at work, keep the person engaged.

People get better. They get better so much more quickly, which again, I didn't know this. Like nobody told me this. It's just being in the field and listening to superintendents who can be very bossy. If you're any superintendents on here know that you're very bossy, but right, they're right. And keeping people at work and helping them get themselves better really is the best case, the best way to get people to recover and recover quickly and then know what to do next time.

Yeah, and that's so key, the confidence of knowing what to do next time. So why does taking that kind of early on-site approach actually lead to better outcomes for both the worker and the company?

Well, let's look at it side by side. A person goes in say with that head case and they go to the clinic and they get a shot for pain that hurts.

And it also is a number and numbs the body. So the body doesn't even know that it's got a problem to deal with.

And then there's an invasive method to close the wound that hurts, that causes more trauma. The person has to get pain meds.

Pain meds, I can't tell you how many people have told me that the worst part of their injury was dealing with the pain meds after the fact. In fact, just last week I was doing a training and a guy came up and told me that the worst part, he had to have surgery, so he took the pain meds. And he said the worst part of the whole thing was getting off the pain meds. We just should avoid those pain meds every time we can, it's just that important.

And then there's antibiotics that are prescribed to prevent infection and we are starting to question that. I started to question that twenty five years ago. Maybe we don't need antibiotics if we don't have an infection, just maybe.

With musculoskeletal cases, why do they escalate? And how does that affect everybody? Well, time off work. All those things that we talk about that are so bad for workers are incredibly costly.

So on the workers' comp side, I mean, anybody can take a look at the Department of Labor average cost of a workers' comp claim. I've got all that. Where the least expensive is five thousand dollars and the most expensive with Outlook, the lawsuit component is eighteen thousand dollars when upfront you could spend four eighty dollars don't get a recordable, don't have your insurance rates affected, and the worker never is subjected to all of those things. So across the board, it makes so much sense to implement some sort of aggressive or assertive, effective, call it first aid or call it frontline program, it saves the employer money.

And I tell workers too, look, when the employer loses work because they have so many recordables or so many claims, and they can't be prequalified for their number one customers anymore, that's a livelihood injury. So the very worker that we just subjected to all those things that he or she probably didn't need, well, the next job they don't get because their employer didn't get it because there's so much penalty and so much cost associated with those cases on the workers' comp side. I wish it wasn't the case, but it is. And we in the marketplace do have the ability to do something about it by just doing a great job taking care of our folks when they report non life threatening injuries.

Yeah, and have you seen that safety programs, operational leaders that adopt this system, this framework, they have stronger cultures, better level of reporting with their employees.

Yep, it absolutely makes people more comfortable reporting. Think about having to put on a paper pajama suit and sit in a medical facility. And then there's this adversarial situation that takes place that isn't even real, where you're as an employer, not allowed to ask and not allowed to say, and everybody's got to be careful. You've got all the predatory lawsuits and I'm calling them that recording or not, they're predatory.

And people are subjected to that. There's so much that goes into it where if we just get to come to the site, keep the people in their own comfortable environment, no harm, no foul, no harm to the employer, well, then folks are that much more likely to report. Again, I wouldn't have known that until we started participating with these companies and finding out people are telling us about the smallest of back pain. Their shoulder hurts a little and the employer is saying, let's get attention.

And we get to go and massage and tape and educate on how to do a better job taking care of shoulders.

The sooner and earlier people report, of course, the better opportunity we have to take care of them.

But when there's a penalty or when the only option is you have to go to a medical facility, of course folks don't report because everybody has their own threshold as to what they think needs medical care. But most folks, I can't say everyone, but most folks are comfortable with somebody coming to them and educating and caring, and you just get an opportunity to take better care of people. It influences culture, it influences reporting really in a big way.

Yeah, absolutely. When you see leaders trying to apply some of these tactics in the field, where do you see them struggle the most when trying to apply it actually in the field on a day to day basis?

Well, there's fear. There's just a lot of fear, which again, we remove with training. And then there's the actual reality of waiting at the work site for someone to get there.

It feels really long. So no matter how long it is, again, that early intervention with the person, telehealth and telemed, these things are much more acceptable than they used to be. So getting people immediately addressed, it really does help, but it's still hard. Folks are used to the old fashioned way.

Your guy gets hurt, you stick them in a car, you drive them somewhere. And we just need to get out of that mindset. We need to become a lot more self sufficient. Culturally in our country, we really have that problem.

It hurts, you go to the doctor. Well, let's just say it hurts, let's figure out why.

And more confident in what you're doing, more confidence, more training helps folks reduce the anxiety associated with waiting for someone to arrive at the job site.

Yeah, for sure. And once a leader decides not to escalate, how should they think about monitoring versus modifying work?

Call that, thank you for that, we call that appropriate assignment.

So on the other side, I call the medical side the other side, it's restricted duty. It's job restrictions. It's kind of routine. It's expected.

And then you're faced with having to deal with what do I do with those job restrictions? When on our side, on our side, we can discuss an appropriate assignment. So an appropriate assignment for someone with a sore shoulder might involve work within their scope that isn't above their head. It's down here.

So they can work all day with a sore shoulder like that because this doesn't make them sore. So appropriate assignment is within your realm as a leader to determine. If as a leader, you determine that that appropriate assignment was so far out of that person's work scope that you think it should be recorded in your three hundred log, that is your business. It is not mine or our people's business to tell you that.

All we tell you is, do you have, we ask, do you have an appropriate assignment for someone with a cut on his hand?

We can wrap it up. We can wrap it up and make him comfortable, but do you have an appropriate assignment? So in construction folks do flaggers in manufacturing. Well, you know what? He's got some training that's on his list he's supposed to be getting done.

Is that an appropriate assignment? Is that a modified duty? Is that restricted duty as far as the three hundred log? That's up to whoever signs your three hundred log to decide. But there is almost always an appropriate assignment at work for your injured worker that you can assign him to or her to so that they get to stay at work and get better and you decide if that appropriate assignment was beyond their scope or not.

Yeah, that's super helpful.

And as we're approaching getting close on time, I just would love for you to maybe one to two takeaways of actions leaders can take tomorrow, put into practice based on your expertise.

Well, think about training. Look, there's lots of folks that do good training.

Think about training and think about research, be a discerning consumer. I mean, of course I want everybody to come to On-site, but On-site can't take care of everybody in the entire country. There's more than just On-site. I think we're the best. I think we set the bar and certainly call, ask questions. If you're in a city that we don't respond to, I can help you and we will help you. This is our mission.

So think about training, think about reaching out. You're gonna get some resources from the Vimosity team. Use those resources. There's no harm in calling and asking.

There's no cost to calling and asking. Start doing your research and start considering, maybe even talking to some other companies in your industry that have implemented such a program and ask them what their experience is and see about implementing something. But I would say nowadays a company that has no program is the less common. Companies are figuring it out and putting interim programs in place and we'd love to help.

Well, Virginia, so appreciate you taking the time today and sharing all your valuable experience. It was so incredibly practical and insightful for this audience. So thank you again.

And yeah, for everyone on the call, like we mentioned, we have an injury decision guide, so you'll see a QR code there on the screen. It's a free resource and it captures a lot of what we talked about today with all the wonderful insights from Virginia.

Feel free to scan that.

If you had any questions in the chat that we didn't get a chance to get to live, we will definitely follow-up with you after and connect you with Virginia.

Thank you again, and if you're interested in joining future live events, definitely scan this QR code, which will send you reminders of all of our upcoming events. Thanks again for joining. Really appreciate the time and we'll see you next time.