30 CFR § 50.20-3 Criteria--Differences between medical treatment and first aid.
(a) Medical treatment includes, but is not limited to, the suturing
of any wound, treatment of fractures, application of a cast or other
professional means of immobilizing an injured part of the body, treatment of
infection arising out of an injury, treatment of bruise by the drainage of
blood, surgical removal of dead or damaged skin (debridement), amputation or
permanent loss of use of any part of the body, treatment of second and third
degree burns. Procedures which are diagnostic in nature are not considered by
themselves to constitute medical treatments. Visits to a physician, physical
examinations, X-ray examinations, and hospitalization for observations, where
no evidence of injury or illness is found and no medical treatment given, do
not in themselves constitute medical treatment. Procedures which are
preventive in nature also are not considered by themselves to constitute
medical treatment. Tetanus and flu shots are considered preventative in
nature. First aid includes any one-time treatment, and follow-up visit for
the purpose of observation, of minor injuries such as, cuts, scratches, first
degree burns and splinters. Ointments, salves, antiseptics, and dressings to
minor injuries are considered to be first aid.
(1)Abrasion. (i) First aid treatment is limited
to cleaning a wound, soaking, applying antiseptic and nonprescription
medication and bandages on the first visit and follow-up visits limited to
observation including changing dressing and bandages. Additional cleaning and
application of antiseptic constitutes first aid where it is required by work
duties that soil the bandage.
(ii) Medical treatment includes examination for removal of
imbedded foreign material, multiple soakings, whirlpool treatment, treatment
of infection, or other professional treatments and any treatment involving
more than a minor spot-type injury. Treatment of abrasions occurring to
greater than full skin depth is considered medical treatment.
(2)Bruises. (i) First aid treatment is limited
to a single soaking or application of cold compresses, and follow-up visits
if they are limited only to observation.
(ii) Medical treatment includes multiple soakings,
draining of collected blood, or other treatment beyond observation.
(3)Burns, Thermal and Chemical (resulting in
destruction of tissue by direct contact). (i) First aid treatment is
limited to cleaning or flushing the surface, soaking, applying cold
compresses, antiseptics or nonprescription medications, and bandaging on the
first visit, and follow-up visits restricted to observation, changing
bandages, or additional cleaning. Most first degree burns are amenable to
first aid treatment.
(ii) Medical treatment includes a series of treatments
including soaks, whirlpool, skin grafts, and surgical debridement (cutting
away dead skin). Most second and third degree burns require medical
treatment.
(4)Cuts and Lacerations. (i) First aid
treatment is the same as for abrasions except the application of butterfly
closures for cosmetic purposes only can be considered first aid.
(ii) Medical treatment includes the application of
butterfly closures for non-cosmetic purposes, sutures, (stitches), surgical
debridement, treatment of infection, or other professional treatment.
(5)Eye Injuries. (i) First aid treatment is
limited to irrigation, removal of foreign material not imbedded in eye, and
application of nonprescription medications. A precautionary visit (special
examination) to a physician is considered as first aid if treatment is
limited to above items, and follow-up visits if they are limited to
observation only.
(ii) Medical treatment cases involve removal of imbedded
foreign objects, use of prescription medications, or other professional
treatment.
(6)Inhalation of Toxic or Corrosive Gases. (i)
First aid treatment is limited to removal of the miner to fresh air or the
one-time administration of oxygen for several minutes.
(ii) Medical treatment consists of any professional
treatment beyond that mentioned under first aid and all cases involving loss
of consciousness.
(7)Foreign Objects. (i) First aid treatment is
limited to cleaning the wound, removal of any foreign object by tweezers or
other simple techniques, application of antiseptics and nonprescription
medications, and bandaging on the first visit. Follow-up visits are limited
to observation including changing of bandages. Additional cleaning and
applications of antiseptic constitute first aid where it is required by work
duties that soil the bandage.
(ii) Medical treatment consists of removal of any foreign
object by physician due to depth of imbedment, size or shape of object, or
location of wound. Treatment for infection, treatment of a reaction to
tetanus booster, or other professional treatment, is considered medical
treatment.
(8)Sprains and Strains. (i) First aid treatment
is limited to soaking, application of cold compresses, and use of elastic
bandages on the first visit. Follow-up visits for observation, including
reapplying bandage, are first aid.
(ii) Medical treatment includes a series of hot and cold
soaks, use of whirlpools, diathermy treatment, or other professional
treatment.
