Confined Space Rules – Reducing the Dangers for Workers

The State of California reported seven fatalities and two injuries among workers operating in a confined space in 2011. One of the fatalities occurred during an attempted rescue. Two workers in Houston, Texas were injured recently as a result of an explosion at a hydraulic fracturing tank site. OSHA, after inspecting the site earlier this year, cited serious health and safety violations on the company. The organization also found that the workers were made to enter a ruptured tank (confined space) for cleaning, without first testing it for atmospheric hazards, and training the employees on the hazards of confined spaces.

Each year, nearly 100 workers are killed in confined spaces in the US. Of this number, about 60% are comprised of rescue –personnel or co-workers who attempted saving the workers inside a confined space. According to OSHA, “Confined and enclosed space operations have a greater likelihood of causing fatalities, severe injuries, and illnesses than any other type of shipyard work.” This is because workers employed in confined spaces are operating under unusual circumstances with restricted movement.

It is clear from the statistics that, owing to the critical nature of the work, confined spaces pose a high risk to the lives and health of the workers operating in them. Moreover, a significant number of fatalities occur due to lack of sufficient training. In reality, most of these fatalities are preventable.

Identifying the risk of working in an enclosed space and understanding the causes of confined space casualties are the primary steps toward preventing accidents.

Causes & Risks of Confined Space Accidents

A lack of training, as we have witnessed in the above cases, is one of the major reasons for confined space accidents. Untrained personnel working in and around confined spaces can put their own lives at risk and impinge on performing rescue operations. Other reasons why accidents in confined spaces occur or can occur include errors in judgment of the obstacles and hazards presented by a confined space; if existing hazards are not controlled or eliminated before a worker steps in a confined space; the absence of an attendant; rescue personnel not reaching on time; inexperienced rescue personnel attempting rescue; and a lack of sufficient warnings posted around confined spaces to identify confined spaces and signal untrained personnel to keep away from them.

Some of the risks or hazards involved in working in confined spaces can be broadly classified as atmospheric, engulfment, entrapment, mechanical and electrical categories. Atmospheric hazards include little or too much oxygen, flammable gas, or combustion dust. Engulfment hazards include being swallowed in sand or grain; entrapment hazards include suffocation or entrapment by inwardly converging walls, or sloping floors. Mechanical hazards include conveyors or gears. Other risks that an entrant may encounter include poor lighting, unsecure footing, falling objects, temperature extremes and more.

What does the law say?

OSHA Standard 29 CFR 1910.146 specifies practices and procedures in order to protect employees employed in the general industry from permit space hazards. A permit space is a confined space that has one or more of the following characteristics: a space that contains or holds a possibility to contain a hazardous atmosphere; a space that holds a material that can potentially engulf somebody entering the space; a space that has an internal configuration that might entrap or asphyxiate an entrant; or a space that holds any other recognized health or safety hazards.

Employers must determine through workplace evaluations if there are any permit spaces. In case permit spaces are present in a workplace, the employer must inform exposed workers of their existence, locations, and the hazards they present. As per OSHA, “This can be done by posting danger signs such as “DANGER—PERMIT-REQUIRED CONFINED SPACE—AUTHORIZED ENTRANTS ONLY” or using an equally effective means.” Employers must also create a written permit space program and provide the same to workers or their representatives.

If employees, however, are not required to enter and work in permit required confined spaces, employers must prevent them from entering these spaces by taking necessary and useful measures.

How Can Confined Space Fatalities Be Prevented?

Each confined space may present a typical hazard different from another confined space of a similar nature; however, below are some general safety policies that should be applied to prevent confined space fatalities. The following steps have been advocated by the National Institute for Occupational Safety and Health (NIOSH) that all managers, supervisors, and workers must understand and familiarize themselves with.

1. Recognition & Training

Workers must be made aware, through proper training, exactly what a confined space is and includes. They must also understand the hazards that may be faced while they are in these confined spaces. Training should emphasize on the fact that any lapse in precautions can lead to the death of a worker.

2. Testing, Evaluation, and Monitoring

A qualified person should test the confined space before an entry is made. He or she should determine whether the space is safe to enter. A confined space should be tested for its oxygen level, flammability, and toxic substances. The space should be evaluated for LOTO procedures, ventilation, PPE-required communications systems to be employed, special tools needed, and methods to isolate space by electrical or mechanical means.

3. Rescue

Rescue procedures should be charted out prior to entry. Each type of confined space should have a specific rescue operation. Each entry should be assigned a standby person when required. The standby person should be outfitted with rescue equipment like a safety line affixed to the worker working in the confined space, protective clothing, or self-contained breathing apparatus. The safety line attached should be used by the standby person to rescue the worker. Frequently practicing rescue procedures should be a part of the training. The aim behind practicing rescue operations repeatedly is to avoid any chances of error while performing actual rescue operations and ensuring a calm and systematic response to an emergency.

Confined Space

OSHA acknowledges that because confined spaces can be present in almost every occupation, "their recognition is the first step in preventing fatalities." By placing Confined Space and Permit Required Signs outside all such areas you can ensure that workers are aware of risks, and that everyone takes the appropriate safety precautions. • These attention grabbing confined space signs inform everyone that a permit is required prior to entry. • Warn people that only authorized personnel should enter dangerous confined spaces. • Look through our extensive collection of Confined Space Signs and Permit Required Signs. If you don't find one that you like, you can custom design your own for no added cost! •

Here is a list of the most catchy safety slogans for the workplace.

10 fingers, 10 toes 2 eyes 1 nose…safety counts
10 fingers. 10 toes, If you are not safe Who knows?
A clean floor everyday keeps lost days away.
A spill, a slip, a hospital trip
A tree never hits an automobile except in self defense
Accidents Big Or Small, Avoid Them All
Accidents hurt, Safety doesn’t.
An ounce of prevention is worth a pound of cure
Are you part of the safety TEAM….(Together Employees Accomplish More)
Arms work best when attached to the body
At work at play, let safety lead the way.
Avoid the worst. Put safety first.
Be a safety hero – score an accident zero
Be alert! Accidents hurt.
Be aware Take care
Before you do it, take time to think through it.
Behind the wheel, anger is one letter away from danger.
Being safe is in your own hands.
Best gift you can give your family is YOU! Please be safe
Break the drive and arrive alive.
Chance takers are accident makers
Choose safety, for your family.
Click clack front and back
Click it or ticket!
Computer problems you can avoid, so you don’t have to get paranoid.
Courtesy and common sense promote safety.
Courtesy is contagious
Dare to be aware.
Do you have eye for safety or are you blinded by bad habits
Doesn’t matter how far. JUST BELT UP!
Don’t be a fool, cause safety is cool, so make that your rule.
Don’t be a fool. Use the proper tool.
Don’t be hasty when it comes to safety.
Don’t be safety blinded, be safety minded.
Don’t learn safety by accident.
Don’t leave Private information on a public computer screen
Eyes are priceless, eye protection is cheap.
Falling objects can be brutal if you don’t protect your noodle.
Fingers toes, If you are not safe Who knows?
Forget the nurse with safety first.
Forgot your hearing protection? Forget about hearing!
Get in high speed pursuit of safety
Get smart! Use safety from the start.
Give them a Brake!
Got crazy with the lighter? Call a firefighter.
Hard hats, they’re not just for decoration
Have another day by being safe today!
Hearing protection is a sound investment.
Housekeeping you skip may cause a fall or slip.
If everything comes your way, you are in the wrong lane.
If they email you asking for cash, be sure to throw it in the trash.
If they email you asking for Money, Say no thanks I won’t fall for it honey.
If you don’t know the sender, it might be a pretender
If you don’t think it will happen to you, find the person who had it happen to them
If you mess up, ‘fess up
Is better to lose one minute in life… than to lose life in a minute.
It only takes one mistake to bring us all down; don’t let it be yours!
It’s easier to ask a dumb question than it is to fix a dumb mistake
Keep a grip on life and protect your hands
Keep safety in mind. It will save your behind.
Keeping your work area clean, helps keep hazards from being unseen.
Knock out…accidents
Know safety – no pain
Know safety No Accidents
Lead the way, safety today.
Learn from others mistakes, don’t have others learn from you.
Let’s all keep our heads, and other body parts, together
Life’s short, don’t rush it
Light up your tree – not your home
Make it your mission, not to live in unsafe condition.
Make safety a reality and don’t be a fatality
My job provides my paycheck, but safety takes me home.
Near miss reported today, is the accident that does not happen tomorrow.
Never drive faster than your guardian angel can fly
Never give safety a day off
No Belt. No Brains
No safety – know pain
One bad day at the grinder could ruin your whole life
Only You can prevent forest fires!
Pencils have erasers–mishaps don’t!
Prevent a jam, don’t open spam
Protect your hands, you need them to pick up your pay check
Quench the thirst – safety first
Replacing a saw guard is easier than replacing a finger
Safe crane operation is uplifting
Safety – A small investment for a rich future
Safety by Choice, Not by Chance.
Safety comes in a can, I can, You can, We can be safe.
Safety doesn’t happen by accident
Safety first makes us last.
Safety First, Avoid the Worst.
Safety first, to last.
Safety first…because accidents last.
Safety fits like a glove; Try one on.
Safety Glasses – All in favor say EYE
Safety in – we win
Safety is a cheap and effective insurance policy
Safety is a continuing journey, not a final destination.
Safety is a frame of mind – So concentrate on it all the time.
Safety is a Frame of Mind, Get the Picture.
Safety is a full time job – don’t make it a part time practice
Safety is a mission not an intermission
Safety is about doing the right thing, even if no one is looking.
Safety is as simple as ABC – Always Be Careful
Safety is like a lock – But you are the key.
Safety is no accident
Safety is success by purpose – Not Accident.
Safety isn’t a hobby, it’s a living.
Safety isn’t expensive it’s priceless.
Safety isn’t just a slogan, it’s a way of life.
Safety makes good dollars and sense
Safety rules are there to follow. So take care and we will see you tomorrow.
Safety rules are your best tools.
Safety saves, Accidents cost you.
Safety starts with “S” but begins with “YOU”.
Safety starts with me.
Safety: more fun than running with scissors
Safety… It can charm you, or ALARM you!
Safety…Did it, done it, doing it tomorrow
Safety…one habit you never need to break
Save tomorrow. Think safety today.
Seat Belts are for kids – Hug them at home – Belt them in the car
Seatbelts save lives. Buckle up everytime.
Shortcuts cut life short
Speed Thrills but Kills.
Stay safe, someone at home is waiting for you.
Stop drop & roll
Success is no accident
The best car safety device is a rear-view mirror with a cop in it.
The door to Safety swings on the hinges of common sense
The only trip you take should be on vacation.
The safe way is the only way.
The stupid shall be punished
Think Safety, Because I Love You Man.
Think sharp….never handle broken glass with bare hands.
Think smart before you start.
Those precious fingers don’t ignore, Or they could end up on the floor.
Those who work the safest way- live to see another day
To avoid a scene keep your work place clean.
To prevent a drastic call, Install a firewall
Tomorrow: Your reward for working safely today.
Trying to make up time could cost you your life.
Unsafe acts will keep you in stitches
Watch where you walk or you might need a walker.
Watch your step – it could be your last tomorrow
whats holding you back?
When you gamble with safety ..You bet your life.
While on a ladder, never step back to admire your work
Wipe Up and avoid a Slip Up!
Work safe today–heaven can wait.
Work together…work safely.
Working safely may get old, but so do those who practice it.
Your first mistake could be your last
Your reward for working safely today.
Your wife will spend your 401K; If you get killed at work today

Slips and trips

What causes slips and trips

Slip and trip accidents can happen for a number of reasons, but all too frequently we jump to conclusions about why they happen rather than really looking for the true cause or, we decide that it is just one of those things and do nothing.

The following should help you to understand what causes a slip or trip and give you some ideas on what you can do to stop accidents from happening again. What you may find is that there are a number of options open to you that are quite straightforward and relatively easy to implement.

The diagram below is the slip and trip potential model. The bubbles highlight the main factors that can play a part in contributing to a slip or trip accident. One or more may play a part in any situation or accident. Click on each bubble for more information

Flooring

• The floor in a workplace must be suitable for the type of work activity that will be taking place on it.
• Where a floor can't be kept dry, people should be able to walk on the floor without fear of a slip despite any contamination that may be on it. So it should have sufficient roughness. 
• The floor must be cleaned correctly to ensure that it does not become slippery or keeps its slip resistance properties (if a non slip floor)
• The floor must be fitted correctly
  • to ensure that there are no trip hazards
  • to ensure that non slip coatings are correctly applied
• The floor must be maintained in good order to ensure that there are no trip hazards e.g. holes, uneven surfaces, curled up carpet edges
• Ramps, raised platforms and other changes of level should be avoided, if they can’t they must be highlighted

Stairs should have:

• high visibility, non slip, square nosings on the step edges
• a suitable handrail
• steps of equal height
• steps of equal width

Contamination

Most floors only become slippery once they become contaminated. Prevent contamination and you reduce or even eliminate the slip risk.

Contamination can be classed as anything that ends up on a floor e.g. rainwater, oil, grease, cardboard, product wrapping, dust etc. the list is endless. It can be a by-product of a work process or be due to adverse weather conditions. If product ends up on the floor it is costing the company money.

First think about whether you can eliminate the problem, e.g.

• Fit effective canopies to external entranceways to stop rainwater from entering a building · Fix leaking machines
• Change the system of work

If not, can the contamination be controlled e.g.: -

• drip trays for leaks
• lids on cups and containers
• good sized mats at building entrances to dry feet

If you are relying on the floor to be good enough to cope with the contamination and still be non-slip you need to remember that the more viscous (the thicker) the contamination the rougher a floor needs to be in order for slips not to happen. 

Working at Height

Working at height remains one of the biggest causes of fatalities and major injuries. Common cases include falls from ladders and through fragile roofs.  

Work at height means work in any place, including at or below ground level (for example in underground workings), where a person could fall a distance liable to cause injury.

This section shows how employers can take simple, practical measures to reduce the risk of any of their workers falling while working at height.

Case study

What do I have to do?

You must make sure that all work at height is properly planned, supervised and carried out by people who are competent (someone who has the skills, knowledge and experience) to do the job. This must include the use of the right type of access equipment.

To prevent or minimise risk when planning for work at height, consider what needs to be done and take a sensible, risk-based approach to identify suitable precautions.

Control measures

There is a simple hierarchy of control measures (as described below) which you should follow to minimise the risk of a fall from height. The hierarchy should be followed systematically and only when one level is not reasonably practicable may the next level be considered.

Those in control of the work need to:

• avoid work at height where they can
• use work equipment to prevent falls where work at height cannot be avoided
• where the risk of a fall cannot be eliminated, use work equipment to minimise the distance and consequences of a fall if one occurs
• always consider measures that protect all those at risk, ie collective protection measures (scaffolds, nets, soft landing systems) before measures that only protect the individual, ie personal protection measures (a harness)

Dos and don’ts of working at height

Do….

• make sure the surface/access equipment in use is stable and strong enough to support the worker’s weight and that of any equipment. Any edge protection should be wide enough and strong enough to prevent a fall
• as much work as possible from the ground or partly from the ground, for example assemble structures on the ground and lift them into position with lifting equipment
• take precautions when working on or near fragile surfaces, eg an asbestos cement roof, to prevent a fall or to minimise the distance and consequences in the event of a fall
• ensure workers can get safely to and from where they want to work at height and also consider emergency evacuation and rescue procedures
• make sure everyone involved is competent to do the work they are responsible for, including those who plan and organise it
• choose the most appropriate equipment for the type of work being done and how often it will be used
• provide protection from falling objects
• make sure equipment used for work at height is well maintained and inspected regularly

Don’t…

• overload ladders – the person and anything they are taking up should not exceed the highest load stated on the ladder
• overreach on ladders or stepladders – keep your belt buckle (navel) inside the stiles and both feet on the same rung throughout the task
• use ladders or stepladders if the nature of the work is deemed to be ‘heavy’ or if the task will take longer than thirty minutes or so to complete
• use ladders if workers cannot maintain three points of contact (hands and feet) at the working position. If this is not possible, consider an alternative safe system of work
• let anyone who is not competent (someone who doesn’t have the skills, knowledge and experience to do the job) carry out work at height  

Gas Stove Safety Tips

The stove is one of the appliances in your home that you likely use most. Stoves come in different types, and one of those is the gas stove. Gas stoves use propane or natural gas to ignite a flame at the cooking surface that directly heats cooking vessels. The flame and temperature are easily controlled, making it a favorite for those who enjoy cooking. But a gas stove uses a highly combustible gas, so with this type of system, you must take extra safety precautions

Pay Attention to Gas Odors

• If you smell an unusual odor around your kitchen that you can identify as gas, or you hear a hissing sound coming from the stove while it is not being used, your stove may have a gas leak. A gas leak can fill up the room quickly, and the slightest spark can set off an explosion that can seriously injure those in the immediate area. If you suspect the stove has a leak, turn off the gas supply to your stove and open the windows in the kitchen and nearby rooms. Leave the house immediately, and call the fire department or gas company to come to inspect your system before you use it again.

Inspect the Pilot Light

• A pilot light is a small flame that is constantly lit. It burns because a small supply of gas feeds it continually. When you turn up the gas to light the cooking surface, the pilot light is responsible for catching the burner on fire so you can use the stove. Typically you can look near the bottom of your unit and see the small blue flame burning. If the pilot is not lit, the slow gas feed through the line can fill your oven or even the room with gas, leading to an explosion hazard. If you notice the pilot has gone out, turn off the gas supply and open windows to clear the air. Once the gas has dissipated, turn the gas back on and relight the pilot according to your stove's instruction manual. Some gas stoves use an electronic ignition and do not have a pilot light; therefore, you won't see a blue flame on these models.

Clean the Burners

• Keep burners clean at all times on your gas stove, which is especially important since these types of stoves use an open flame. The flames can set particles of spilled food or other debris on fire and cause dangerous flareups, according to the Gas Stove website.

Keep Handles Turned to the Side

• Keep the handles of all pots and pans turned to the side, and never let them hang over the front edge. Since a gas stove heats directly with open flames, the entire pan can get hot, especially if the handles are made of metal. When handles protrude from the edge of the stove, they are more likely to be bumped accidentally and may even be knocked off the stovetop, causing burns and other injuries.

Install a Carbon Monoxide Detector

• If you have a gas stove, you should have a carbon monoxide detector in your home nearby. Carbon monoxide is present when any type of fuel is burned, and gas stoves are no exception. These detectors alert you if the level of carbon monoxide, which is odorless and colorless, gets too high in the house.

Tips for Avoiding Slips and Falls

Falls are the leading cause of injury in the workplace. Keep these tips in mind to avoid an injury:

• As you walk, keep an eye on the floor in front of you for spills.
• If you see a spill, never just walk by it. Always clean it up or call someone to clean it up.
• Wear nonskid shoes when you work in kitchens, outdoors, or any other place where you will commonly be walking on slippery surfaces.
• Never climb on shelving units or storage units to get things. Use only approved ladders.
• Never lean on railings, even if they look solid. They could be improperly secured, and you could fall.
• Always use safety harnesses when working at heights.

Tips for Lifting Properly

You may work with patients who need help getting around or at a factory where you're lifting boxes on a continual basis. No matter who or what you may be lifting, there are some key points to consider:

• If you are approaching a box and don't know what's in it, try moving it a little with your foot first to see how easily it moves. This will help you gauge how heavy the box is.
• Always wear nonskid shoes when you are lifting often or lifting potentially heavy objects.
• Never bend at the waist and lift the box up with your back. Keep your upper body straight and parallel with your lower legs. Grab the item and push up with your legs, not with your back.
• Never jerk your body around when lifting. You may feel fine after doing this once, but repeated occurrences can easily lead to injury in even the healthiest workers.

Fire Safety Tips

Some jobs carry an increased risk of fire, but understanding fire safety is important for any occupation. Keep these tips in mind:

• Have a fire plan in place for your worksite, and make sure your employees understand it fully. Having a fire drill every now and then is a good way for employees to keep escape routes, meeting spots, and procedures in mind.
• Avoid the use of so-called "power strips" whenever possible. They are often prone to overuse and can start a fire if too many appliances are plugged into them.
• Keep cleaning chemicals and other work chemicals in a well-ventilated room. Many chemicals emit vapors that are highly flammable and which can be set off with something as small as a spark from a faulty wire.
• Know where all the fire extinguishers are throughout your worksite and know how to use them.
• Remember that grease fires cannot be fought by dousing them with water. Oil is hydrophobic and also is the fuel source in grease fires. Water will simply splash the oil around and spread the fire even further.

Planning for a Safe Workplace

Falls, lifting injuries, and fires are dangerous and common in the workplace, but that's just the beginning. There are many possible safety issues that can occur at your office or factory. Sometimes the best workplace safety arises out of simple good planning and smart thinking.

Every single workplace should have a safety committee and safety plan in place. If you don't have safety committees at your workplace, then propose one. If you work at home, you are the safety committee. Working at home or for a very small business isn't a reason to get out of safety planning.

If you don't have a safety plan in place yet, follow these steps when you recognize a workplace safety issue:

1. Make sure that everyone else in your workplace is aware of the problem.
2. Notify your supervisor.
3. File any reports or documents about the problem.
4. Follow up. Telling someone there's a problem is not a guarantee that the problem will be resolved satisfactorily. Report it and later follow up to make sure the problem was addressed.

5 things safety leaders do to make employees mock safety

I have met parents who do at least some of these things; some of them do them all. It occurs to me that if parents with good intentions can make their kids hate sports, safety leaders are equally as capable of doing things that make their employees mock safety.

Five common mistakes of safety leaders:

They treat employees as equipment, not people

Safety leaders can get so caught up in the metrics and pressures of making their workplaces the safest in their industry that they forget these “exposures” are real people.  No human being is programmed the same. It takes innovative ways and many reminders to deliver a successful and sustainable message. If employees can’t learn from you, you are a waste of their time.

They talk (TALK) about change

Safety leaders are all about change. They can tell you every aspect of the organization that needs to “change here, change there.” The fact is that without buy-in from many departments or key decision makers, change is impossible. When change does not occur, safety leaders need to take a candid look at themselves and their own efforts to be part of the team. Successful safety leaders could be master politicians. Ineffective safety leaders are a joke.

They know it all

The safety industry is filled with “know-it-alls.” You can easily spot them because they often answer questions with a smug attitude that conveys the message: “What were you thinking, stupid?” A “know-it-all” does not have the capacity to grow as a leader. Why would a trainer or long-time employee want to waste their time trying to interact with someone who already knows everything?

Employees who appear to be following a safety know-it-all’s direction are probably looking for ways to push that person off the proverbial cliff. (These same employees are probably in the break room right now having a good laugh about safety.)

They are not an employee advocate

I have seen this time and time again: Safety leaders are on a quest to connect with their employees, claiming that they genuinely care about their concerns, input and well-being. However, when something goes wrong and people are called on the carpet, they blame the employees.  If safety is only cited during punitive actions, then employees associate safety with hardship. And if you are the safety leader, you certainly are not their advocate.  You are the enemy and they will laugh hysterically when you fail.

They don’t own it

I see this occur most often with newly appointed safety leaders who allow the safety manual or a safety policy to justify their existence. Here’s an example:  While doing a walk-through with a new safety manager at a plastic injection mold manufacturer, I noticed he had to remind employees to wear eye protection. After reminding them, he would try to be their friend.  He told one employee, “I know you do your job right and your chance of getting hurt is low, but I have to remind you because our insurance company requires us to have a safety policy and it says that eye protection is required in the shop area.”

Translation: “This stupid safety manual that we don’t even need in the first place says you have to wear eye protection. It is not me talking, but the insurance carrier. Don’t be mad at me, just put on your goggles so we don’t get in trouble.” It is no wonder this safety leader was never taken seriously. He ultimately was fired because the facility had no signs of safety improvement or a safety culture.

He didn’t see it coming. Do you?

–

UL gives  safety professionals more of the tools they need to proactively address risks, reduce costs and keep people safe, healthy and on the job.

    Subdural hematoma

A subdural hematoma is a collection of blood on the surface of the brain.

Causes

Subdural hematomas are usually the result of a serious head injury. When one occurs in this way, it is called an "acute" subdural hematoma. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death.

Subdural hematomas can also occur after a very minor head injury, especially in the elderly. These may go unnoticed for many days to weeks, and are called "chronic" subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In the elderly, the veins are often already stretched because of brain atrophy (shrinkage) and are more easily injured.

Some subdural hematomas occur without cause (spontaneously).

The following increase your risk for a subdural hematoma:

• Anticoagulant medication (blood thinners, including aspirin)
• Long-term abuse of alcohol
• Recurrent falls
• Repeated head injury
• Very young or very old age

Symptoms

• Confused speech
• Difficulty with balance or walking
• Headache
• Lethargy or confusion
• Loss of consciousness
• Nausea and vomiting
• Numbness
• Seizures
• Slurred speech
• Visual disturbances
• Weakness

In infants:

• Bulging fontanelles (the "soft spots" of the baby's skull)
• Feeding difficulties
• Focal seizures
• Generalized tonic-clonic seizure
• High-pitched cry
• Increased head circumference
• Increased sleepiness or lethargy
• Irritability
• Persistent vomiting
• Separated sutures (the areas where growing skull bones join)

Exams and Tests

Always get medical help after a head injury. Older persons should receive medical care if they shows signs of memory problems or mental decline, even if you do not think they have had an injury. An exam should include a complete neurologic exam.

Your doctor may order a brain imaging study if you have any of the following symptoms:

• Confused speech
• Difficulty with balance or walking
• Headache
• Inability to speak
• Lethargy or confusion
• Loss of consciousness
• Nausea and vomiting
• Numbness
• Recent cognitive decline in an elderly person, even without a history of brain injury
• Seizures
• Slurred speech
• Visual disturbance
• Weakness

A CT scan or MRI scan likely would be done to evaluate for the presence of a subdural hematoma.

Treatment

A subdural hematoma is an emergency condition.

Emergency surgery may be needed to reduce pressure within the brain. This may involve drilling a small hole in the skull, which allows blood to drain and relieves pressure on the brain. Large hematomas or solid blood clots may need to be removed through a procedure called a craniotomy, which creates a larger opening in the skull.

Medicines used to treat a subdural hematoma depend on the type of subdural hematoma, the severity of symptoms, and how much brain damage has occurred. Diuretics and corticosteroids may be used to reduce swelling. Anticonvulsion medications, such as phenytoin, may be used to control or prevent seizures.

Outlook (Prognosis)

The outlook following a subdural hematoma varies widely depending on the type and location of head injury, the size of the blood collection, and how quickly treatment is obtained.

Acute subdural hematomas present the greatest challenge, with high rates of death and injury. Subacute and chronic subdural hematomas have better outcomes in most cases, with symptoms often going away after the blood collection is drained. A period of rehabilitation is sometimes needed to assist the person back to his or her usual level of functioning.

There is a high frequency of seizures following a subdural hematoma, even after drainage, but these are usually well controlled with medication. Seizures may occur at the time the hematoma forms, or up to months or years afterward.

Possible Complications

• Brain herniation (pressure on the brain severe enough to cause coma and death)
• Persistent symptoms such as memory loss, dizziness, headache, anxiety, and difficulty concentrating
• Seizures
• Temporary or permanent weakness, numbness, difficulty speaking

When to Contact a Medical Professional

A subdural hematoma requires emergency medical attention. Call 911 or your local emergency number, or go immediately to an emergency room after a head injury.

Spinal injuries often occur with head injuries, so try to keep the person's neck still if you must move him or her before help arrives.

Prevention

Always use safety equipment at work and play to reduce your risk of a head injury. For example, use hard hats, bicycle or motorcycle helmets, and seat belts. Older individuals should be particularly careful to avoid falls.

Alternative Names

Subdural hemorrhage

References

Biros MH, Heegaard WG. Head injury. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 38.

80 Work Safety Tips to Remind 

Employees to Work Safe

Work Safety Tips 1-10

General Notices

1. Safety is a team effort. Ensure that every member of the crew knows the safety requirements before the job is started.
2. Safety is your responsibility.
3. Always communicate with co-workers during a job in order to maintain safety.
4. Don't create unnecessary hazards. Notify others of both new and old ones.
5. Never take shortcuts. Always follow correct procedures.
6. Wear metal mesh gloves to protect your hands when using sharp knives regularly.
7. Keep your work area clean and orderly.
8. If you make a mess, clean it up. Never let safety be someone else's job.
9. Keep access clear to emergency exits, equipment, and equipment shutoffs.
10. Prevent accidents by clearly identifying any hazards that cannot be removed.

Safety Tips for Work 11 - 20

It is everyones job

11. Safety should be your first thought, not an afterthought.
12. Safety is everyone's assignment.
13. You should wear a hard hat if there exists the hazard of falling objects.
14. Do not approach operating machinery from the blind side; let the operator see you.
15. Be alert to hazards that could affect you and your fellow employees.
16. Learn safe work practices.
17. When in doubt about performing a task safely, contact your supervisor for instruction and training.
18. Pay attention to your work surroundings.
19. Follow the safety instructions that you are given.
20. Always be alert and awake on the job.

Tips 21 - 30

Don't risk your safety at work.

21. Never take risks when it comes to your safety.
22. Learn where fire extinguishers and first aid kits are located.
23. Always perform your assigned task in a safe and proper manner; do not take shortcuts. The taking of shortcuts and the ignoring of established safety rules is a leading cause of employee injury.
24. Read and obey safety signs and tags.
25. Appropriate clothing and footwear must be worn on the job at all times.
26. Report any observed unsafe condition to your supervisor or employer.
27. You should not perform any task unless you are trained to do so and are aware of the hazards associated with the task.
28. Never remove or by-pass safety devises.
29. Maintain a general condition of good housekeeping in all work areas at all times.
30. Do not breath in hazardous fumes or chemicals, wear a breathing mask if your area does not have proper ventilation and you are using toxic chemicals.

Work Safety Tips 31 - 33

Lifting Tips

31. When lifting grip objects with both hands.
32. Lift with your legs and not your back.
33. Wear a back brace if your job requires consistent lifting.

Tool Safety Tips for Work 34 - 39

Tool Tips

34. Use the right tool for the right job.
35. Use tools correctly and for the intended purpose only.
36. Keep tools in good condition.
37. Put tools away after use, don't leave things lying around where they can fall or hit someone.
38. Tools carried in pockets or misplacing them can cause painful injuries.
39. Always wear your required protective equipment

Machine Safety Tips 40-45

When dealing with large machines

40. Never remove safety guards that are there to protect you or leave machinery running unattended that requires you to operate it.
41. Obey all operating instructions on machinery that alert you to hazards on the job.
42. Communicate with those around you so they know where you are, what you are doing and what your next move will be.
43. When near moving machines, avoid wearing jewelry or clothing that might get caught in the moving parts, such as large gloves, rings, bracelets or loose sleeves.
44. Keep fingers away from moving machinery.
45. Turn machines completely off before you put your hands into them to release a jam.

More Workplace Safety Guidlines 46-50

General Tips!

46. Stick to safe work practices.
47. Work Safely around the clock
48. Safe Accident Free Environment Takes You (Acronym for S-A-F-E-T-Y)
49. Safety is good for your health and happiness
50. When operating tow-motors, be on the lookout for Pedestrians Overhangs & Obstacles

Work Safety Tips 51-60

Sixty tips for your safety and health

51. Always wear gloves when handling parts with sharp edges that could cut you.
52. Inform co-workers of safety hazards that you see around them.
53. Be conscience of what other people around you are doing.
54. Drink plenty of fluids to prevent dehydration in hot weather.
55. When in a pinch it's better to be safe than sorry.
56. Accidents ARE preventable - work safely and follow instructions.
57. Shortcuts don't cut it.
58. Think before you act.
59. The safe way is the right way.
60. Replace damaged electrical cords, don't patch. It can be a fire hazard.

Workplace Safety Tips 61-70

Even more valuable tips!

61. When carrying a heavy load, turn by moving your feet, not by twisting your body. Twisting with your body can lead to back pain.
62. Use caution when working on ladders. Never climb a ladder that is wobbly or not secure.
63. Use machinery only if authorized and trained to use it.
64. Stay focused when working on elevated platforms, roofs, or up high and don't get distracted.
65. Read labels on heavy machinery alerting you to hazards.
66. Alert supervisors immediately if you see unsafe conditions or activities being performed.
67. Sit in an upright position when typing and operating a computer.
68. Don't work at potentially dangerous tasks if you are extremely tired, hung-over, or otherwise unfit for work.
69. Never walk in front of a forklift carrying a load, the operator may not see you.
70. Report serious injuries immediately to your supervisor.

Safety Tips 71-80

Ergonomics and Lifting Advice

71. Take short breaks during long periods of repetitive motion
72. Avoid sitting with an awkward posture.
73. Prevent ergonomic disorders by keeping wrists in a neutral position and not bent backwards.
74. When lifting objects keep them close to your body to avoid additional strain.
75. Always have a clear line of sight around you.
76. Grasp objects firmly and test the weight of the load if you are unsure if you can carry something heavy.
77. Lift weighty objects slowly and smoothly and do not bend at your waste, crouch with your feet keeping your back straight.
78. Turn your feet to change directions while lifting, don't twist your body, this puts strain on your back.
79. Wear dust masks in any areas with debris and flying particles in the air.
80. Sit at a computer with your feet flat on the floor.