When a workplace accident occurs, the immediate response can make the difference between a minor incident and a serious injury. Everyone in your workplace should know what to do when someone is hurt or becomes ill.
Has someone been injured or become ill at work?
Let's determine the appropriate immediate response.
Immediate response to workplace accidents
When an accident happens, quick, calm action is essential. The initial response follows a clear sequence.
The DR ABC approach
First aiders are trained in the DR ABC approach, but everyone should understand the basics:
D - Danger
- Check for danger to yourself, the casualty, and others
- Don't rush in if there's ongoing danger (machinery, electricity, chemicals, fire)
- Make the area safe if possible without putting yourself at risk
- Keep others away from the scene
R - Response
- Check if the casualty is conscious and responsive
- Speak clearly: "Can you hear me? Open your eyes."
- Gently shake their shoulders if no response
- Shout for help if needed
A - Airway
- Check the airway is clear
- Remove any obvious obstructions (if safe and trained to do so)
- Open the airway by tilting the head back slightly
B - Breathing
- Look, listen, and feel for breathing
- Watch for chest movement
- Listen for breath sounds
- Feel for breath on your cheek
- If not breathing normally, call 999 and start CPR if trained
C - Circulation
- Check for severe bleeding
- Control bleeding with direct pressure
- Look for signs of shock (pale, cold, clammy skin)
If you're not a trained first aider, your main role is to ensure help is summoned. Call 999 for emergencies, summon a workplace first aider, and stay with the casualty providing reassurance until help arrives.
Life-threatening emergencies
Some situations require immediate action before anything else.
When to call 999
Call 999 immediately if someone:
- Is unconscious or unresponsive
- Is not breathing or not breathing normally
- Has severe bleeding that won't stop
- Has a suspected heart attack (chest pain, breathlessness, nausea)
- Has a suspected stroke (facial drooping, arm weakness, speech difficulty)
- Has a severe allergic reaction (anaphylaxis)
- Has been seriously burned
- Has a suspected spinal injury
- Has been electrocuted
- Has been exposed to hazardous chemicals
- Has a suspected fracture to major bones
- Has severe head trauma
- Is having a seizure for the first time, or a prolonged seizure
What to tell 999
When calling emergency services, speak clearly and provide:
- Your location - Full address, postcode, building name, specific location within building
- What has happened - Nature of the accident or illness
- Condition of the casualty - Conscious? Breathing? Bleeding?
- Number of casualties - One person or multiple injuries?
- Any hazards - Ongoing dangers (chemical spill, unstable structure, etc.)
- Access information - How ambulance can reach you, any access issues
Stay on the line and follow any instructions given. Don't hang up until told to do so.
When calling 999, they may ask you to perform first aid. Follow their instructions exactly. The call handler can guide you through CPR, stopping bleeding, or other emergency measures while waiting for the ambulance.
While waiting for the ambulance
Do:
- Stay with the casualty
- Keep them warm (but not overheated)
- Provide reassurance
- Continue any first aid (CPR, bleeding control)
- Monitor breathing and consciousness
- Note any changes in condition
- Send someone to meet the ambulance and guide them in
- Clear a path for the ambulance crew
- Gather any relevant information (medication, medical conditions, what happened)
Don't:
- Move the casualty unless absolutely necessary (danger present)
- Give them anything to eat or drink
- Remove embedded objects from wounds
- Leave them alone
- Allow crowds to gather
- Post about the incident on social media
- Attempt first aid beyond your training level
Serious injuries
Not every injury requires an ambulance, but all serious injuries need proper first aid and assessment.
Summoning a workplace first aider
Make sure all employees know:
- Who the first aiders are
- How to summon them (phone extension, radio, tannoy, emergency button)
- Where first aid equipment is located
- What to do while waiting for the first aider
Effective communication: When summoning a first aider:
- State clearly: "First aid emergency in [location]"
- Briefly describe: "Someone has fallen from a ladder" or "Colleague has chest pain"
- Specify location precisely
- Don't assume someone else has called for help
First aider assessment
When a first aider arrives, they will:
- Assess the casualty using DR ABC
- Provide appropriate first aid treatment
- Decide whether emergency services are needed
- Arrange transport to hospital if necessary (but not immediately life-threatening)
- Record the incident
- Inform management
- Recommend whether the person can return to work or should go home
Injuries requiring hospital assessment
Even if not immediately life-threatening, some injuries should be assessed at hospital:
- Head injuries with loss of consciousness, confusion, or repeated vomiting
- Eye injuries involving chemicals, penetration, or sudden loss of vision
- Suspected fractures beyond fingers and toes
- Deep cuts requiring stitches
- Severe burns covering more than a small area
- Suspected internal injuries after trauma
- Chest pain that might be cardiac-related
- Difficulty breathing not quickly resolved
- Severe abdominal pain
- Chemical exposures requiring medical evaluation
Quick first aid response prevented minor injury becoming serious
A warehouse worker slipped and struck his head on a pallet. He was dazed but conscious. A colleague immediately summoned a first aider rather than assuming he was fine.
- ✗Initial injury seemed minor - just a bump on the head
- ✗Worker initially said he was fine and wanted to continue working
- ✗No obvious external bleeding or loss of consciousness
The first aider assessed the casualty and noted developing confusion and unsteadiness. She arranged immediate transport to hospital. CT scan revealed a small brain bleed that required monitoring. Doctor confirmed that early medical assessment was crucial. The worker recovered fully after 2 weeks off work.
Never assume a head injury is minor. Symptoms can develop over time. Trained first aiders can spot concerning signs. When in doubt, seek medical advice. The colleague who immediately called for help potentially saved serious complications.
Minor injuries
Most workplace accidents are minor and can be managed without emergency services.
Basic first aid for common minor injuries
Cuts and grazes:
- Wash your hands and put on disposable gloves
- Clean the wound under running water
- Pat dry with sterile gauze
- Apply sterile dressing
- Record in accident book
- Advise to seek medical help if signs of infection develop (redness, swelling, pus)
Bruises and bumps:
- Apply a cold compress or ice pack (wrapped in cloth, not directly on skin)
- Elevate the injured area if possible
- Rest the injured area
- Record in accident book
- Monitor for unusual swelling or severe pain
Minor burns and scalds:
- Cool the burn under cold running water for at least 10 minutes
- Remove jewelry or tight clothing before swelling occurs (unless stuck to burn)
- Cover with cling film or sterile non-fluffy dressing
- Don't apply creams, ointments, or ice
- Record in accident book
- Burns larger than the casualty's palm, or to face/hands/joints, should be assessed at hospital
Sprains and strains:
- Follow RICE: Rest, Ice, Compression, Elevation
- Apply cold compress for 15-20 minutes
- Support with bandage if first aider available
- Avoid using injured area
- Seek medical help if severe pain, unable to bear weight, or significant swelling
Even minor injuries must be recorded in the accident book. Seemingly trivial injuries can develop complications, and you need a record for insurance, legal, or health and safety analysis purposes.
When minor injuries aren't minor
Seek medical advice if:
- Pain doesn't improve after a few hours
- Swelling worsens
- Signs of infection appear (heat, redness, pus, fever)
- Normal function isn't restored within expected timeframe
- The person has concerns about the injury
Recording workplace accidents
Every workplace accident must be recorded, regardless of severity.
The accident book
Legal requirement: All employers must keep a record of accidents. This is usually done in an accident book.
What to record:
- Date, time, and location of accident
- Name and job of injured person
- Details of the injury
- What happened and how (brief description)
- Treatment given
- Name of first aider or person dealing with incident
- Signature of injured person (if possible)
Data protection considerations: Modern accident books have tear-out pages or separate sheets to protect personal data. You can't keep a traditional bound book where everyone can read all entries.
Retention: Accident records must be kept for at least 3 years from the date of the incident.
Digital accident recording systems are increasingly popular. They offer better data protection, easier trend analysis, and automatic reminders for RIDDOR reporting deadlines. However, a paper accident book is still perfectly acceptable if properly managed.
Why recording matters
Recording all accidents helps you:
- Identify trends - Multiple minor accidents in one area might indicate a hazard
- Meet legal obligations - Required under health and safety law
- Insurance claims - Essential evidence if someone later makes a claim
- RIDDOR compliance - Helps identify reportable incidents
- Learn lessons - Analysis reveals areas for improvement
- Defend claims - Contemporary records support your version of events
Accident investigation
Serious accidents should be investigated to prevent recurrence.
When to investigate
Always investigate:
- Fatalities
- Specified injuries (major fractures, amputations, etc.)
- Injuries resulting in over 7 days off work
- Dangerous occurrences (near misses with serious potential)
- Accidents indicating a systemic problem
Consider investigating:
- Injuries requiring hospital treatment
- Near misses that could have been serious
- Repeated similar incidents
- Accidents involving multiple people
- Incidents suggesting equipment failure
Basic investigation steps
1. Secure the scene
- Preserve evidence where safe to do so
- Take photographs (wide shots and close-ups)
- Don't disturb anything unless necessary for safety
- Prevent unauthorized access
2. Gather information
- Interview the injured person (when able)
- Interview witnesses separately
- Collect written statements
- Review CCTV footage if available
- Check maintenance records, training records, risk assessments
- Examine equipment involved
3. Identify causes
- Immediate causes (what directly caused the injury)
- Root causes (underlying failures in systems or management)
- Contributing factors (conditions that made the accident more likely)
4. Determine corrective actions
- What needs to change to prevent recurrence?
- Are controls adequate?
- Is training sufficient?
- Do procedures need updating?
- Is equipment suitable and maintained?
5. Document findings
- Write investigation report
- Record findings in accident records
- Share lessons learned with staff
- Update risk assessments
- Implement corrective actions
- Set timescales and responsibilities
Accident Investigation Timeline
Take photos, secure equipment, prevent disturbance
Speak to injured person and witnesses while memories fresh
Gather evidence, identify immediate causes
Analyze underlying failures and systemic issues
Make changes to prevent recurrence
Document findings and share lessons learned
Common investigation mistakes
1. Blaming the individual Don't just conclude "employee error." Ask why the error occurred. Were they trained? Supervised? Rushed? Tired? Working with faulty equipment?
2. Accepting "accident" as explanation "Accidents happen" isn't an investigation conclusion. There are always causes and contributing factors.
3. Incomplete evidence gathering Interview all witnesses, not just those immediately involved. Review documentation, not just physical evidence.
4. Failing to identify root causes Don't stop at immediate causes. Dig deeper to find underlying management or system failures.
5. Not implementing recommendations Investigation reports that sit in a file do nothing. Act on findings promptly.
RIDDOR reporting requirements
Some workplace accidents must be reported to the Health and Safety Executive (HSE) under RIDDOR.
What must be reported
Report immediately:
- Deaths arising from work-related accidents
- Specified injuries: fractures (except fingers, thumbs, toes), amputations, crush injuries leading to internal organ damage, serious burns, loss of sight, injuries requiring hospital admission for more than 24 hours
Report within 15 days:
- Injuries causing more than 7 consecutive days off work (not counting the day of the accident)
Also reportable:
- Certain occupational diseases diagnosed by a doctor
- Dangerous occurrences (specified near-miss events)
How to report to HSE
Online reporting: Use the HSE's online RIDDOR reporting form at www.hse.gov.uk/riddor/report.htm
Telephone reporting: For deaths and specified injuries, you can phone 0345 300 9923 (Monday-Friday, 8:30am-5pm)
Who reports: The employer of the injured person, or the person in control of the premises where the accident occurred.
Failure to report under RIDDOR is a criminal offence. Penalties include unlimited fines and up to 2 years imprisonment for serious cases. Always report when in doubt - HSE would rather receive an unnecessary report than miss a serious incident.
RIDDOR deadlines
Immediate (deaths and specified injuries): Report without delay by the quickest means practicable. In practice, report the same day or next working day.
Within 15 days (over-7-day injuries): Report within 15 days of the accident if the injured person is still off work after 7 consecutive days.
As diagnosed (occupational diseases): Report as soon as a doctor diagnoses a reportable work-related disease.
For more detailed guidance on RIDDOR reporting: Understanding RIDDOR reporting requirements →
Emergency preparedness and planning
The best accident response starts before any accident happens.
Essential preparations
1. Trained first aiders
- Ensure adequate numbers for your workplace
- Display names and locations prominently
- Maintain training and requalification
2. First aid equipment
- Well-stocked first aid kits in accessible locations
- Regular checks and restocking
- Specialized equipment for specific risks (eye wash, burns dressings)
3. Communication systems
- Clear procedures for summoning first aiders
- Emergency contact numbers displayed
- Method to communicate with all areas of workplace
- System to alert emergency services and guide them in
4. Information and training
- All staff know what to do in an emergency
- New starters receive emergency procedure induction
- Regular reminders and refreshers
- Clear signage showing first aider locations and emergency exits
5. Emergency procedures
- Written procedures for different emergency scenarios
- Evacuation plans if needed
- Assembly points identified
- Procedures tested regularly
6. Access for emergency services
- Clear external signage
- Access routes kept clear
- Designated person to meet and guide ambulance crew
- Site maps available for emergency services
Good vs Poor Accident Preparedness
Poor Preparedness
- •No trained first aiders or out of date training
- •First aid kit empty or contents expired
- •No clear procedure for summoning help
- •Staff don't know who first aiders are
- •Emergency numbers not displayed
- •No accident investigation process
Good Preparedness
Recommended- •Multiple trained first aiders with current qualifications
- •Well-stocked, regularly checked first aid kits
- •Clear procedures for all emergency scenarios
- •First aider names and photos displayed prominently
- •Emergency contacts visible throughout workplace
- •Structured accident investigation and learning process
Bottom line: Good preparedness doesn't prevent all accidents, but it significantly reduces their severity and consequences. Invest time in preparation to ensure effective response when accidents occur.
Supporting injured workers
An accident doesn't end when the immediate response is complete.
Immediate support
During recovery:
- Keep in contact with injured employee
- Understand their prognosis and likely return-to-work date
- Ask about their wellbeing, not just when they'll return
- Ensure they're not worried about job security
- Provide sick pay as per their contract
- Consider sending get-well wishes
Returning to work:
- Discuss return-to-work plans
- Consider phased return or light duties
- Obtain medical clearance if needed
- Discuss any ongoing restrictions
- Update risk assessments if needed
- Provide reassurance and support
Psychological support
Don't overlook psychological impacts:
- Accidents can be traumatic for casualties and witnesses
- Some people develop anxiety about returning to work
- Offer access to counseling or employee assistance programs
- Be understanding about concerns and fears
- Gradually rebuild confidence
For witnesses and colleagues:
- Check on witnesses' wellbeing
- Allow them to talk about what they saw
- Don't force them to work in same area immediately if distressed
- Consider wider team briefing to prevent rumors
Legal and insurance matters
Workers' compensation: If eligible, help the injured person claim any benefits.
Insurance claims: Report accidents to your insurance company as per your policy (often required within specific timeframes).
Legal claims: If the injured person makes a legal claim:
- Inform your insurer immediately
- Preserve all evidence and records
- Don't admit liability
- Seek legal advice
Being supportive to an injured employee doesn't mean admitting liability. You can show care and concern while still protecting your legal position. Good support often prevents claims from being made in the first place.
Preventing future accidents
Every accident provides learning opportunities.
Learning from incidents
Share lessons:
- Communicate findings from investigations
- Explain what changes have been made
- Remind staff of safe procedures
- Use real examples in training (anonymized if appropriate)
Update documentation:
- Revise risk assessments based on findings
- Update safe working procedures
- Modify training materials
- Adjust supervision levels if needed
Monitor effectiveness:
- Check that changes are working
- Ensure new controls are being used
- Track whether similar incidents recur
- Adjust approach if needed
Building a safety culture
Encourage reporting:
- Thank people for reporting accidents and near misses
- Never punish reasonable mistakes
- Investigate to fix systems, not blame people
- Act on reports to show they're taken seriously
Proactive approach:
- Regular workplace inspections
- Safety briefings and toolbox talks
- Involve workers in identifying hazards
- Celebrate safety successes
Management commitment:
- Lead by example
- Provide adequate resources
- Prioritize safety over production
- Listen to safety concerns
Frequently asked questions
No. Call 999 for life-threatening emergencies (unconscious, not breathing, severe bleeding, suspected heart attack/stroke). For other injuries, a trained first aider should assess and decide if hospital treatment is needed. They can advise whether to call an ambulance, take the person to A&E, or arrange a GP appointment.
Call 999 if it's an emergency. For less serious injuries, call for the appointed person (every workplace should have one) who can summon emergency services, provide basic comfort, and look after first aid equipment. If working alone or remotely, have clear emergency procedures including how to summon help.
Only move someone if there's immediate danger (fire, explosion risk, continuing hazard). Otherwise, keep them still until professional help arrives, especially if there's any possibility of spinal injury. Let paramedics or first aiders make decisions about moving casualties.
No. Only specific serious incidents must be reported under RIDDOR: deaths, specified injuries (major fractures, amputations, etc.), injuries causing over 7 days off work, certain occupational diseases, and dangerous occurrences. However, you must record ALL accidents in your accident book.
You cannot force someone to accept first aid or hospital treatment (unless they're unconscious or unable to consent). Strongly advise them to seek treatment for serious injuries. Document that treatment was offered and declined. If refusing treatment could endanger them or others, seek advice immediately.
No, not for serious injuries or if they're in pain, shocked, or have taken medication. Arrange for someone else to drive them, call an ambulance, or provide a taxi. Never let someone drive if they might be impaired, in shock, or have injuries that could worsen during driving.
The employer should investigate all serious accidents. HSE may investigate deaths, specified injuries, or incidents revealing serious management failures. Your investigation should happen regardless of whether HSE gets involved. For complex accidents, consider bringing in external health and safety consultants.
At least 3 years from the date of the incident. However, consider keeping them longer - claims can be made years after an accident, particularly for conditions that develop slowly. For RIDDOR reports, keep copies indefinitely alongside HSE's confirmation.
Next steps
Ensure your workplace is prepared:
-
Check your first aid provision - Do you have adequate trained first aiders and equipment?
-
Train your first aiders - Ensure qualifications are current
-
Understand your RIDDOR obligations - Know what must be reported to HSE
-
Review your procedures - Ensure everyone knows what to do in an emergency
Need help developing emergency response procedures, investigating a serious accident, or improving workplace safety management? A health and safety consultant can provide expert guidance tailored to your workplace.
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