If you work in a cubicle and your last on-the-job injury was a paper cut, then first aid and emergency response training may not seem relevant. However, when you spend your days suspended from a tree 70 feet off the ground with a running chain saw in your hands, or feeding brush into a 200 horsepower chipper, or any of the other potentially dangerous jobs encountered throughout the tree care industry, emergency training can literally make the difference between life and death.

“In this industry, everybody bleeds for their job,” says Mike Sestric, chief arborist and operations manager with Trees, Forests and Landscapes in St. Louis. Like many tree care professionals, Sestric is trained in first aid and CPR. He recounts one incident where he had a chain saw hit his leg: “I had to get myself down out of the tree. Fortunately I had the training and a good first aid kit, so I was able to pack the wound and stay calm and get myself to the hospital.” His co-workers were also trained, and that, combined with having the right first aid supplies, made all the difference, he emphasizes.

Sestric first took first aid class in 1996 while he was working for a tree care company in California. “It was just part of the safety and training program at that company,” he explains. More companies are adopting that philosophy, and he says a lot has changed with first aid training in the last couple decades.

“Back then it was CPR and advanced first aid, and the focus was on things like resuscitation and splinting,” Sestric recalls. That sort of in-depth training is still available today, but he says the emphasis seems to have shifted. “Over the years, research showed that sometimes more harm than good was done, because people take things into their own hands and do things like set splints or move people when they shouldn’t be moved,” he explains.

Rather than having people play doctor in the field, the focus of the trainings that Sestric has taken recently have focused more on keeping things simple. “The goal is to get things stabilized until the paramedics arrive,” he notes. To keep current, Sestric takes basic CPR and first aid training and recertifies every two years. “We’re able to apply that knowledge to aerial rescue techniques, as well,” he adds. He also points out that such training qualifies for professional CEUs, and also counts toward the requirements of the TCIA’s Certified Treecare Safety Professional program.

Sestric says that it’s not just serious cuts or falls where first aid training proves valuable. “For example, one of the things we have to know to watch for in the summer is heat exhaustion,” he explains. “Knowing what to look for as far as pallor and breathing, or if somebody stops sweating or feels chilled. They teach you that you really need to keep an eye on these things.” Sestric says he’s read of several incidents in recent years where workers in the tree care business have died due to heat exhaustion, so the danger is real, he emphasizes.

First aid training can make the difference between life and death when injuries take place on the job. Photo: American Red Cross

First aid training can make the difference between life and death when injuries take place on the job. Photo: American Red Cross

Sestric says it’s also important to put some thought into building a first aid kit that makes sense for the tree care business. Band-Aids are necessary, but it takes much more than that to address serious bleeding or trauma, he notes. “We’ll often get a basic large kit, and then stock it with additional supplies we know we’ll need: extra gauze, spray treatments that can slow bleeding, extra packages of gloves and things like that,” he explains. “We’ll wrap everything up and put certain items in zip-lock bags and tag them with dates so we know when it was stocked. If things get old, they won’t do you any good.” At his company, a kit is kept behind every truck seat and also on each trailer. Check to be sure your kit meets ANSI and OSHA regulations.

Sestric says that everyone who works at Trees, Forests and Landscapes takes part in the first aid training. “Unfortunately, you see a lot of companies that don’t send everyone to this kind of training,” he observes. “They’ll just send a few key people, but that’s pretty risky. The person who gets hurt might be the only one who knows how to administer first aid.” Trees, Forests and Landscapes contracts with a private training company to provide classes for its employees. “There’s a lot of good training companies across the country,” Sestric notes.

Perhaps the most recognizable first aid training provider is the American Red Cross, which trains more than 9 million people each year in first aid, CPR, and other health and safety programs. “When you consider training in any sort of lifesaving care, it really comes down to the fact that training gives the correct information to the learner so they can apply it correctly, whether it be minor care or lifesaving care, in the situation that they find themselves in,” explains Jonathan Epstein, senior director of instructional design and delivery at the American Red Cross.

Epstein says that for an audience such as tree care professionals, first aid training is particularly critical: “The cuts, the nicks, the scrapes, the bumps on the head, the falls, the more serious hemorrhage control when you’re talking about chain saws and other equipment — first aid can truly be lifesaving in the workplace environment.” First aid training typically covers medical emergencies such as heart attack, stroke, diabetic reactions, asthma, etc.; injuries, everything from bleeding control to sprains and strains; and environmental emergencies like heat stroke, hypothermia, tick bites and so on.

Those without first aid training may think they know what to do in an emergency, but Epstein points out that a lot of what takes place in first aid training is “myth busting.” As one simple example, in the case of a bloody nose most people have been told to tilt their head back and pinch their nose. “But from a medical, clinical perspective, and the science and evidence we have, that’s actually the wrong thing to do,” he states. “When you tilt your head back, the blood runs down your throat and can get into your stomach and cause vomiting or get down to your lungs. So we actually want people to lean forward when they have a bloody nose.”

Training provided by a professional instructor helps to correct some common misconceptions about treating injuries, and then teaches the correct way to approach the situation, says Epstein. What form do these training classes typically take? “First aid and CPR classes are often combined into one offering,” he says of the approach the Red Cross uses, noting that AED (automated external defibrillator) training is also usually incorporated. “There’s a lot of flexibility; it’s modularized,” adds Epstein. The training can be broken up into multiple days or done in one day. The Red Cross First Aid/CPR/AED in-class course takes approximately four hours and 45 minutes. There is also an option to incorporate Web-based learning, followed by an in-class skills session that takes about three to three and a half hours.

While technology is helpful in disseminating information, it can’t replace hands-on training. “If you’ve never practiced, or seen an example of how to perform a skill in a nonemergency situation, when it comes down to a true emergency, it’s very hard to get your bearings [and] really understand what you’re doing and why,” says Jonathan Epstein, senior director of instructional design and delivery at the American Red Cross.

He emphasizes that while technology is proving to be a tremendous asset in disseminating information, it can’t replace hands-on training. “If you’ve never practiced, or seen an example of how to perform a skill in a nonemergency situation, when it comes down to a true emergency, it’s very hard to get your bearings [and] really understand what you’re doing and why,” he notes. “The confidence build that we see with a student who is going through a formal training program with practice, who is able to ask questions of an instructor, their performance in the field is going to be far superior. They’re going to have the confidence because they’ve seen it before.”

That said, the Red Cross has created a free app to provide guidance on how to handle the most common first aid situations and emergencies. “If you have a minute in the truck on lunch break, you can go through some of the mini modules and get some training with videos and animation that you can learn from,” explains Epstein. “And in an emergency, you can click a button and see the most important things to do, providing reminder cues of what you’ve been trained to do.” The app is also updated whenever standards change.

The Red Cross provides regular training classes in local communities, and can arrange for employee training at companies. “The instructors will bring the equipment and come to the workplace,” he notes. There are opportunities to cover certain optional topics, such as fixing tourniquets, that may not be covered in basic first aid training, but might be relevant for certain professions, such as tree care. Spanish language trainings are also available.

The Red Cross also offers a Wilderness First Aid program that Epstein suggests would be helpful for tree care professionals and utility line clearing crews working in remote locations or “delayed-access” situations. This more advanced training covers topics that can be essential in situations where it takes time to get paramedics in. To find out about training opportunities in your area or to arrange workplace training, contact your local Red Cross chapter or look online.

Whether it’s on the job or at home, almost everyone is going to be faced with having to provide at least minor first aid at some point in their lifetime, says Epstein, noting that one in four people are involved in a situation where CPR is required. “These things happen,” says Epstein. The question is: Are you trained to handle them?

Editor’s note: This article originally appeared in the January 2014 issue and has been updated.