First aid kit for employees - equipment, accounting

Is an employer required to have a first aid kit?

Labor legislation also regulates issues of labor protection for workers.
This does not depend either on the size of the enterprise where citizens work, or on its organizational and legal form. Not only firms, but also individual entrepreneurs with employees are subject to labor laws. Read about the 2021 innovations in labor protection in the article “Labor safety in 2021: new rules and changes .

Compliance with all labor safety principles is the responsibility of the employer. These include the provision of sanitary services and medical care for workers. This obligation is established by Art. 223 Labor Code of the Russian Federation. What is included in these concepts:

This is not a complete list of measures that an employer must take to ensure occupational safety. As you can see, the presence of a first aid kit for employees is established by the requirements of the labor legislation of the Russian Federation.

You will find a link to a sample order for approving the contents of a first aid kit at the beginning of the article.

Let's consider what requirements apply to emergency first aid kits.

From March 1, 2022, changes regarding labor protection at enterprises will come into force. Sign up for a free trial access to ConsultantPlus and find out what needs to be changed in the organization of labor protection.

What's in a first aid kit?

According to the recommendations of the Ministry of Health, the first aid kit does not contain medicines. This is explained by several reasons:

By law, only organizations or individual entrepreneurs licensed to carry out medical or pharmaceutical activities can store medicines;
the use of medications requires accurate diagnosis; without a doctor’s prescription and supervision, taking them can pose a health hazard, for example, cause an allergic reaction;
It is not always possible for an enterprise to create optimal conditions for storing medicines.

Composition of a first aid kit, approved by Order No. 1331n

product name	Quantity (not less than specified)
Medical mask, non-sterile, disposable	10 pieces
Non-sterile medical gloves, size no less than M	Two pairs
Device for artificial respiration “Mouth-Device-Mouth”	1 piece
Hemostatic tourniquet to stop arterial bleeding	1 piece
Medical gauze bandage measuring at least 5 m x 10 cm	4 pieces
Medical gauze bandage measuring at least 7 m x 14 cm	4 pieces
Sterile medical gauze wipes, size no less than 16 x 14 cm, 10 pcs. packaged	2 packs
Rolled fixing adhesive plaster measuring at least 2 x 500 cm	1 piece
Antibacterial adhesive plaster measuring at least 1.9 x 7.2 cm	10 pieces
Bactericidal adhesive plaster measuring at least 4 x 10 cm	2 pieces
Isothermal rescue blanket measuring at least 160 x 210 cm	1 piece
Scissors for cutting bandages	1 piece
First aid instructions using a first aid kit	1 piece
Case (bag)	1 piece

The order prohibits the use of sterile medical products from a first aid kit if their packaging is damaged, as well as the repeated use of products and instruments contaminated with blood or biological fluids.

Changes in requirements for first aid kits

Since September 2021, new requirements for a first aid kit at an enterprise have appeared; to be more precise, the new requirements relate to the contents of the first aid kit. The fact is that a new order came into force, which canceled the old order.

Previously, the first aid kit for employees was equipped according to order 169n dated 03/05/2011. From September 1, this order lost force due to the entry into force of the order of the Ministry of Health and Social Development dated September 18, 2020 No. 995n.

Starting from September 1, 2021, the first aid kit will be equipped according to another order.

The first aid kit is formed in accordance with the order of the Ministry of Health and Social Development dated December 15, 2020 No. 1331n.

The formation of a first aid kit according to order 1331n must be done from September 1, 2021. If the enterprise has a first aid kit for employees under an order that has expired, then it can be left until the end of the expiration date, but no later than August 31, 2025.

Did you buy a first aid kit using your personal injury contribution and don’t know if VAT can be deducted? The answer is in our review “Purchase of personal protective equipment at the expense of the Social Insurance Fund: what about VAT deduction” .

Packaging of emergency medicines for the most common pathological conditions in outpatient dentistry

To provide effective emergency care for somatic pathology at a dental appointment, you should have syndromic sets of medications placed in a portable bag (suitcase), where, in addition to medications, there is also the necessary equipment and algorithms for providing assistance.

Legal basis:

The composition of the first aid kit for providing emergency assistance in organizations that do not provide emergency medical care has not been approved at the federal level. The management of a medical organization has the right to independently approve the composition of such a first aid kit by analogy with the composition of the medical kit of a mobile emergency medical team (see standards below). It is worth considering:

Features of storage of narcotic drugs if the organization has a drug license.
Order 169n dated 03/05/2011 regulating a first aid kit (should be available even in a cafe).
The requirements of clause 8.3 of SP 3.1.5.2826-10 “Prevention of HIV infection” and Appendix 12 to SanPiN 2.1.3.2630-10 The composition of the “anti-AIDS first aid kit” is also not approved at the federal level.
Appendix to the order of the Ministry of Health and Social Development of the Russian Federation

dated December 7, 2011 No. 1496n

Have in a dental outpatient facility at least:

1 One (1) per office: a set of devices, instruments, medicines, teaching materials and documents for providing emergency medical care for life-threatening conditions (a first aid kit for providing emergency care for general somatic complications in dental offices)

2 One (1) per clinic (clinic) – Tracheotomy instrument set

This list of medications for the formation of syndromic patterns was prepared on the basis of clinical recommendations (protocols) for the treatment of emergency and life-threatening conditions adopted by professional medical associations of the Russian Federation

Along with the syndromic instructions, there should also be documents regulating how, where, what and in what dose to administer. It is most correct to draw up documents such as SOPs.

SOPs for the treatment of threatening and emergency conditions, compiled on the basis of current clinical recommendations, can be downloaded at https://algohelp.ru

Ampoules, tablets and inhalers must be in syndromic storage in full accordance with the appendix to order No. 1496n

Bottles with saline solution, as well as medical supplies (air duct, microtracheotomy set, etc.) can be placed in a single bag for the institution.

Some medicines are duplicated and can only be found in one stack. At the same time, in the remaining layouts it should be noted which drug to take from.

Some of the drugs (bottles with solutions) are stored in a single common storage area on the institution (floor), in the same place as medical supplies. appointments

Acute coronary syndrome

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Nitroglycerin spray	Bottle with dispenser	1	1 dose	sublingually	Pain reduction Feeling better
Nitroglycerin granules. (if there is no spray)	0.5 mg granules	10	0.5 mg	sublingually	Reducing pain Improved well-being
Analgin (Metamizole sodium)	Ampoules 2 ml 50%	2	2 ml	IV, IM	Reducing pain Improved well-being
Aspirin (Acetylsalicylic acid)	Table uncoated - 500 mg	1 package	2 tables	Per os, Chew	Pain reduction Feeling better
Syringes*	5ml	1

2. Hypertensive crisis:

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Capoten (captopril)	Table 0.025 each	package	½ tablet	sublingually	Decrease in A/D
Baralgin (Metamizole sodium + pitofenone + fenpiverinium bromia)	Ampoules 10 ml	2 ampoules	1 ml	V/muscular	Pain reduction
Nitroglycerin spray	Bottle with dispenser	bottle	sublingually	Decreased blood pressure
Nitroglycerin granules (if spray is not available)	0.5 mg granules	package	0.5 mg	sublingually	Decreased blood pressure
Corvalol	Bottle	1	Adult 40 drops Child 2 drops per year of life Read also: Study of the effectiveness of local anesthetics in dental practice.	Per os	Calming effect
Syringes*	5 ml	1

3. Fainting-collaptoid state

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Ammonia	Bottle – 10 ml 10%	1 bottle	couples	With air inhaled through the nose	Restoring consciousness
Gutron in drops**	Bottle 10 ml 1%	1 bottle	Adults and children over 12 years old: 7 drops; Children under 12 years old: 1 drop for 2 years of life	Per os, on a lump of sugar or with 2-3 ml of water	Restoring consciousness
Prednisolone (can be taken from the Anaphylactic Shock pack)	Ampoules 30 mg/ml	2	adults and children under 14 years of age: 90–120 mg (3-4 ampoules); children (up to 14 years old), 1-2 mg/k	i/m	Stabilization of blood pressure, restoration of consciousness
Syringes*	5 ml	1

4 Anaphylactic shock:

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Epinephrine solution adrenaline hydrochloride 0.1% (Store in a cool place) or adrenaline hydrotartrate 0.18% (can be stored at a temperature not exceeding 25 degrees C) Regardless of where adrenaline is stored, a 5 ml syringe should be stored next to the adrenaline ampoules	Ampoules 1.0	2	Adults 0.5 Children 0.1 ml/year) no more than 0.3,	V/m, IV drip in saline solution	Improvement
Prednisolone	Ampoules 30 mg	4	Children 5 – 10 mg/kg Adults 150 mg	IV, IM	Improvement
Dexamethasone (if prednisolone is not available)	Ampoules 4 mg	2	Adults 4 mg Children 0.02 mg/kg	IV, IM	Improvement
Salbutomol	Inhaler with spacer	1	1 dose	With inhaled air	Improvement
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV	Improvement
Suprastin (Chloropyramine solution)	Ampoules 2% - 2.0	1 ampoule	Children 0.1 -0.15 ml/year Adults 2 ml	IV, IM	Improvement
Syringes*	5 ml 10 ml	2 1

5. Cramps:

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Diazepam (only if the clinic has the right to stock this drug)	Ampoules 0.5% - 2.0	2	Children 0.1 – 0.2 mg/kg not more than 4 ml Adults 2 – 4 ml	IV, IM	Stopping seizures
Syringes*	5 ml	1

6. Hypoglycemia in diabetes mellitus:

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
glucose solution	Ampoules 40% — 10,0	4	Children 0.2 ml/kg Adults 40 ml	Per os, IV	Improvement
Glucose solution	Bottle 5% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV	Improvement
Syringes*	20 ml	1

7 Sudden cardiac arrest in an adult, child (only for clinics licensed to provide anesthesia)

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Epinephrine solution adrenaline hydrochloride 0.1% (Store in a cool place) or adrenaline hydrotartrate 0.18% (can be stored at a temperature not exceeding 25 degrees C)	Ampoules 0.1%-1.0	2	Children 0.1 ml/year (0.01-0.02 mg/kg), Adults 1.0 Read also: What is retrograde filling and features of its implementation	IV, IV	Heart rate restoration
Amiodarone (cordarone)	Ampoules 150 mg	2	300 mg	IV, IV	Heart rate restoration
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV
Sodium chloride solution	Ampoules 0.9% -10 ml	5	IV
Syringes*	10 ml	2

8. Bleeding:

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Dicynone	Ampoules 1 ml	2	Children 8 mg/kg Adults 1 ml	IV, IM	Stop bleeding
Hemostatic collagen sponge	Platinum in blister 5x5	1	Locally	Stop bleeding
Calcium gluconate	Ampoules 10% — 10,0	1	Children 1.0 per year of life, Adults 10 ml	IV	Stop bleeding
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV	Improvement
Syringes*	5 ml 10 ml	1 1

9 Stroke

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Kapoten	Table 0.025	wafer	½ table	Under the tongue	Decrease in blood pressure
Glycine	1000 mg	wafer	1000 mg	Under the tongue	Improving the metabolism of the ischemic zone
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV	Improvement

10 Hives

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Prednisolone (can be taken from the Anaphylactic shock pack)	Ampoules 30 mg	4	Children 2 – 5 mg/kg Adults 190-120 mg	IV, IM	Improvement
Suprastin (Chloropyramine solution) (can be taken from the Anaphylactic shock pack)	Ampoules 2% - 2.0	1 ampoule	Children 0.1 -0.15 ml/year Adults 2 ml	IV, IM	Improvement
Syringes*	5 ml	2

11. Quincke's edema

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Prednisolone (can be taken from the Anaphylactic shock pack)	Ampoules 30 mg	4	Children 2 – 5 mg/kg Adults 190-120 mg	IV, IM	Improvement
Suprastin (Chloropyramine solution) (can be taken from the Anaphylactic shock pack)	Ampoules 2% - 2.0	1 ampoule	Children 0.1 -0.15 ml/year Adults 2 ml	IV, IM	Improvement
Galazolin (Xylometazoline)	Bottle	1	1-2 injections	Intranasally	Improvement
Syringes*	5 ml	2

12. Eclampsia

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Diazepam (if the clinic has the right to store and use)	Ampoules 0.5% - 2.0	2	Children 0.1 – 0.2 mg/kg not more than 4 ml Adults 2 – 4 ml	i.v., i.m.	Stopping seizures
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle Stored in general storage	10 – 20 ml/kg	IV	Improvement
Magnesium sulfate solution.	Ampoules 25% - 10.0	2 ampoules	10 ml ml diluted per 200 ml saline. solution	IV	Improvement
Anaprilin (Propronalol)	Table 0.04	Blister	0.01 (1/4 tablet)	Chew	Improvement
Papaverine hydrochloride	Ampoules 2% 2ml	2 ampoules	2 ml	i/m	Improvement
Syringes*	5 ml 20 ml	2 1

13. Attack of bronchial asthma

Name of the drug	Release form	Quantity per pack	Dose	Route of administration	Efficiency mark
Salbutomol	Inhaler with spacer	1	1 dose	With a breath	Improvement
Prednisolone (can be taken from the Anaphylactic Shock pack)	Ampoules 30 mg	4	Children 2 – 5 mg/kg Adults 190-120 mg	IV, IM	Improvement
Sodium chloride solution	Bottle 0,9% — 200,0	1 bottle. Stored in general storage	10 – 20 ml/kg	IV	Improvement
Epinephrine solution adrenaline hydrochloride 0.1% (Store in a cool place) or adrenaline hydrotartrate 0.18% (can be stored at a temperature not exceeding 25 degrees C) take from the pack Anaphylactic shock	Ampoules 0.1%-1.0	2	Children 0.1 ml/year) no more than 0.3, Adults 0.5	PC	Improvement
Syringes*	5 ml	2

General installation - one per establishment or one per floor

Equipment:

Name	Quantity
Device for measuring pulse rate and saturation (oxyhemoglobin) - household pulse oximeter	1
Blood pressure measuring device (tonometer)	1
cotton wool	1 small package
Bandage	2 packs
Disposable alcohol wipes for disinfection of injection sites	10
Air duct for adult	1
Air duct for a child	1
Venous/arterial tourniquet	1
Venous catheters on a needle, diameter 1.4 mm	3
Venous catheters on a needle, diameter 1 mm	4
Venous catheters on a needle, diameter 0.6 mm	2
Household oxygen inhaler	1
Band-Aid	1
Manual respirator (self-inflating bag) “Ambu”	1
System for transfusion of infusion solutions	2
Debridement catheter (may be included with tracheotomy kit)	1
Set for tracheotomy (conicotomy)	1
Laryngeal mask for tracheal intubation for adults (size 4, single use) or Combitube	1
Laryngeal mask for tracheal intubation for a child (size 3, single use) or Combitube	1
Phonendoscope	1
Syringes 5 ml*	5 - if stored in general storage, if stored in syndromic storage, the quantity corresponds to the number of medications
Syringes 10 ml*	2 if stored in general storage, if stored in syndromic storage, the quantity corresponds to the number of medications
Syringes 20 ml*	2 if stored in general storage, if stored in syndromic storage, the quantity corresponds to the number of medications
Stand for mounting infusion solutions	1
Sodium chloride solution 0.9% - 200 ml for intravenous administration from the list of drugs for syndromic laying with o	2 bottles
Glucose solution 5% - 200 ml for intravenous administration from the list of drugs for syndromic laying with o	1 bottle

* Syringes can be stored both in general storage and in syndromic medicinal storage, 1 syringe per individual name of the drug

The volume of the syringe corresponds to the dose of the administered drug, taking into account possible dilution

For drugs with a recommended maximum dose of up to 2-3 ml, 5 ml syringe

For drugs with a recommended maximum dose of 3 to 10 ml - 10 ml syringe

For drugs with a recommended maximum dose of 5 to 10 ml or more with mandatory dilution - a 20 ml syringe

** Possible substitutes for Gutron

There are no direct analogues of midodrine (Gutron) yet...

The closest in direction of action:

Fethanol

Mesocarb

Ekdisten

— Increased blood pressure due to the vasoconstrictive effect on peripheral vessels

— Improving the activity of consciousness during asthenia

— Psychostimulation for hypotension and asthenia

The closest action in terms of urgency is Fethanol.

Composition of the first aid kit according to the new order

Now let’s look at what composition a first aid kit should have for providing first aid under the new order and how it differs from the first aid kit at an enterprise under the old order.

Order No. 1331n is valid until 08/31/2027, that is, for 6 years.

So, what should be in the first aid kit:

Some points may not be staffed with the same units. For example, to close the item “Non-sterile disposable medical mask”, you can use:

The quantitative combination of different masks can be anything, the main thing is to close the total number in the first aid kit - 10 pieces.

Similarly, you can use different things for a first aid kit:

You will find a complete detailed list of first aid kits given in the order in our news “New requirements for first aid kits from September 1” .

All products in the first aid kit must be manufactured and registered in accordance with the law. They must have a current expiration date. Reuse of first aid kit items is prohibited.

Compared to previous requirements, the composition of the first aid kit has been reduced. Now you don’t need to store it:

notebook,
fountain pen,
safety pins.

But at the same time, the number of necessary masks, gauze bandages and blankets has increased.

IMPORTANT! For the absence of a first aid kit, the employer is subject to a fine under Part 1 of Art. 5.27.1 Code of Administrative Offenses of the Russian Federation: from 2,000 to 5,000 rubles for individual entrepreneurs and from 50,000 to 80,000 rubles for legal entities.

First aid kit placement

The medications included in the first aid kit may be kept in a case or bag at a special sanitary station. As a rule, this is an open cabinet or a cabinet with doors that cannot be locked with a key. First aid kits can be made portable, which is especially important for organizations that involve traveling. Near the location of the stationary first aid kit there must be a corresponding sign (white cross on a green background) or an inscription, in addition, it is indicated on the evacuation plan.

Every organization, business or office should have at least one first aid kit. Their number can be increased depending on the number of employees, the presence of several premises, workshops, offices for professional activities, remote from each other. The first aid kit must be available to all employees of the enterprise throughout the day.

Results

A first aid kit should be available at any enterprise. From September 1, 2021, the mandatory contents of a first aid kit have changed. Old first aid kits can be used before the expiration date, but no later than August 31, 2025. The current composition of first aid kits will be relevant for 6 years, until August 31, 2027.

Sources:

Order of the Ministry of Health and Social Development dated December 15, 2020 No. 1331n
Labor Code of the Russian Federation

You can find more complete information on the topic in ConsultantPlus. Free trial access to the system for 2 days.

Responsibility for the presence/absence of a first aid kit

The employee responsible for storing and using the first aid kit is appointed by the organization's management. He must take a first aid course. The duties of the responsible employee also include:

checking the expiration date of products included in the first aid kit;
disposal of products that have expired;
drawing up an application for the purchase of the necessary components of a first aid kit;
timely replenishment of the contents of the first aid kit.

Not mandatory, but recommended by Rostrud letter No. PG/8351-3-5

dated November 7, 2012, maintaining a log of product use. After each use of a first aid kit or a completed inspection, a corresponding entry is made in the log.

The presence of a first aid kit at an enterprise can be checked by the State Labor Inspectorate or Rospotrebnadzor. Failure to do so will result in a fine being imposed on the employer.

Disposal of expired products

The order of the Ministry of Health states that after expiration dates, medical products and other items from the first aid kit are subject to write-off and destruction (disposal) in accordance with the legislation of the Russian Federation. The disposal of medical products is regulated by Federal Law No. 89 of June 24, 1998 “On production and consumption waste.” Since, according to current rules, there are no medicines in first aid kits, bandages, napkins, and expired adhesive plaster can be disposed of as normal household waste.

Additional equipment for the first aid kit

For a number of areas of activity, auxiliary composition requirements have been approved. They are prescribed in sanitary regulations: SanPiN, SP. They may also be contained in industry documents. For example, an enterprise specializing in working with metal should have validol, analgin, and Zelenin drops in its first aid kit. The corresponding list is contained in Appendix 8 of the joint venture for mechanical shops No. 5160-89 dated December 7, 1989, approved by the Chief Sanitary Doctor.

Printing industries also need to purchase additional funds.

Printing industries also need to purchase additional funds. In particular, the first aid suitcase should contain tires, iodine, baking soda, hydrogen peroxide, and ammonia.

Only those drugs that can be used without a doctor’s prescription are purchased.

Plate shops need neutralizing solutions. They are useful for acid and alkali burns. The person responsible for additional equipment is the head of the workshop or section.

Pulp, paper and wood chemical entities must have in their first aid kit all medications that may be required to provide assistance. The list of additional drugs is approved either by representatives of the medical unit or by the health center. The corresponding rule is given in paragraph 1.333 of the Labor Safety Rules for pulp, paper and wood chemical enterprises dated June 6, 1997.

IMPORTANT! Replenishment should be carried out if there are valid grounds for this. The corresponding decision is fixed in the collective agreement.

What happens if there is no first aid kit?

The absence of a first aid kit is a violation of labor protection. This is an administrative violation. Responsibility is imposed on the employer on the basis of Part 1 of Article 5.27 of the Code of Administrative Offenses of the Russian Federation. The penalty is a fine:

1,000-5,000 rub. – for officials and individual entrepreneurs.
30,000-50,000 rub. – for YUL.

If a violation is discovered during an inspection by Rospotrebnadzor, liability is imposed on the basis of Article 6.3 of the Code of Administrative Offenses of the Russian Federation:

500-1,000 rub. – for officials and individual entrepreneurs.
10,000-20,000 rub. – for YUL.

In case of a serious violation (for example, many people work at the enterprise, but there is no first aid kit), the company’s activities may be suspended for 3 months.

Basic rules for providing first aid

The responsible employee must know the rules of first aid. It will be provided using funds from the first aid kit:

You need to wear special gloves to provide assistance. If the problem is an infectious disease, you need to wear a mask.
If blood pressure begins, you need to apply a tourniquet. A note about the timing of application should be in the first aid kit.
If you need to perform artificial ventilation, you should use a medical mask.
If an employee has a wound, sterile napkins are applied to it. Then a bandage and bandage are used.
If microtraumas are detected, a bactericidal adhesive plaster is used.
If biological fluid (blood, saliva, etc.) comes into contact with the skin of the person providing assistance, it is removed using an antiseptic wipe.
An isothermal blanket is needed to prevent hypothermia.

The manager must ensure that the enterprise has detailed instructions on providing first aid.