A Remote Medical International medic in the field recently reported a worker with lower back pain to our Senior Medical Director Richard Misiaszek.
“We needed to take a step back because it could have been an injury that happened at work,” said Misiaszek.
If the injury happened at work, it could turn into a recordable injury. The medic ended up prescribing 400 mg of ibuprofen instead of 600 mg. According to Misiaszek, the dosage would still help with the back pain and the injury would be a first aid case instead of a medical treatment case.
After further investigation, the worker’s lower back pain was caused by kidney stones and was not a work related case.
A recordable injury is a work-related injury or illness that requires medical treatment beyond first aid, according to OSHA. Using caution is one way that Misiaszek says helps mitigate recordables in the field. Other ways include hiring the right medical providers, reviewing chart documentation, developing trust with workers on-site, and handling case management.
Remote Medical International frequently deals with recordable injuries and understands the steps that are needed to either prevent them or handle them correctly. We put together the steps below to share what we’ve found. For more details, read our eBook “Five Best Practices to Mitigate OSHA Recordables on Industrial Projects.”
Hire the Right Providers
Having the right medical providers on-site means you have someone who can look after your workers in remote and challenging environments, even without access to a typical hospital.
“On an industrial site, we work towards ensuring the overall health and safety of the workers is the number one priority,” said Misiaszek.
The hiring process is important. Misiaszek looks for medical providers who have advanced life support skills, work passionately, and are certified in the field that they practice in. If hired, medical providers are put under the direct supervision of Misiaszek and have to call in every injury. Misiaszek is then able to make sure each case is addressed correctly for both the patient and the company.
If a provider is fresh out of a training program, they don’t have enough experience to be in the field, according to Misiaszek. Since remote environments require a different set of skills in medicine, having someone who does not have at least three years of experience in a remote setting should not be considered.
“A lot of folks have credentials, but what we really look for are providers who can operate in this environment, are confident in their skill set, and know when to ask for help earlier than later,” said Misiaszek.
Review Chart Documentation Frequently
Misiaszek reviews every chart throughout all projects at Remote Medical International, ensuring that every injury is documented correctly and that there are no need for follow-up questions.
“I can tell very quickly that someone can accurately gather history and explain that to me,” said Misiaszek.
Along with hiring the right medical provider, they also need to be able to document each injury accurately. Having this documentation allows Misiaszek to monitor how providers handle injuries and prevent recordables. While Misiaszek is not on-site, the documentation gives insight to the incident and provides guidance to how an injury should be handled.
Develop Trust with Workers On-site
The provider needs to carry themselves and have the right knowledge to develop trust on a project site, according to Misiaszek. If a worker comes to a medical provider with a health issue, and the provider addresses their health with confidence and knowledge, the worker will start to trust the provider.
“The way a provider carries themselves, demonstrates quality, and knowledge and personality, helps to develop trust,” said Misiaszek.
It is easy to gain or lose trust with every interaction. By maintaining trust on-site, workers are more willing to engage with a provider and seek the help they need.
Handle Case Management
Case management is the management of a worker’s injury from start to finish, according to Misiaszek. Case management covers the initial remote evaluation of an injury, the treatment instructions for the injury, and daily follow-up until the injury has been healed.
Avoiding the emergency room is key when dealing with an injury on a project site, since the injury will almost always become a recordable if treated at an ER.
“The outcome for the patient will be no better in most cases if taken to the ER,” said Misiaszek.
If the above patient with the back injury had gone to an emergency room, the ER providers could have prescribed 600 mg of Motrin, causing a recordable. Treating every injury on the work-site with care and gathering the necessary information can help prevent recordables and keep workers safe.