Procedure No. WYN032.087 Page: 1 of 14 Reviewed 9/2/14 Effective: 9/10/14 Supersedes: 04/11/14 Preparer: Owner: Approver: Occupational Health Nurse Supervisor Occupational Health Nurse Supervisor OH-MI Canada Hub Manager Revision History Revision Date Revision Number 8/12/13 New 04/9/14 1 9/2/2014 2 Details of Change Changes to reflect new Corporate Case Management Standard, BC009.042 and need to address issues within Wyandotte Contracted employee population. Note name change of Wyandotte M-15 formerly Wyandotte Medical Management Standard to Wyandotte Medical Plan, WYN032.087 Changes made section 4.1 to reflect change in emergency dialing from 9-911 to 0-911 Changes made work instructions based on recent incidents, added contract authorization form and changed work hours for Concentra Woodhaven location. Also modified Appendices B, C and D and removed post-accident drug and alcohol testing section and reference.
Procedure No. WYN032.087 Page: 2 of 14 1. PURPOSE To provide emergency medical services for work related or non-work related illnesses / injuries at the Wyandotte site. This site standard supports the BASF Corporate Medical Case Management Standard, BC009.042 and provides a management system to ensure BASF Employees, Contracted Employees and Contractor Employees affected by a workplace injury or illness receive prompt, effective medical treatment. The plan serves to meet the Site Medical Plan required under BC009.042. 2. DEFINITIONS 2.1. Employee An individual who performs services for, and under the direction and control of, BASF Corporation. Such direction and control includes the results to be accomplished and the methods and means by which results are accomplished. 2.2. Contracted Employee An individual engaged through a third party for whom BASF provides direct supervision of his or her day-to-day activities and direction as to how an activity is to be performed. 2.3 Contractor Employee A non-basf employee engaged through a third party for whom BASF does not provide supervision of his or her day-to-day activities and direction as to how an activity is to be performed. These workers are covered by the Contractor s Medical program and Medical Plan. 2.4 Serious or Life Threatening Incident An injury or illness causing a substantial risk of death; loss or substantial impairment of the function of a bodily member, organ, or mental faculty that is likely to be permanent; or an obvious disfigurement that is likely to be permanent. Examples include: Unconscious person who doesn t wake or respond when shaken. Heart attack (suspected) involving pain in the chest, especially if it is crushing or like indigestion and lasts more than five minutes. The pain may spread to arms and jaw. Breathing difficulty especially if the person is unable to speak more than a few words or has blue lips or mouth. Abdominal pain that is severe and undiagnosed. Bleeding that does not stop after at least 10 minutes of continuous pressure. Burns which are bigger than the size of a hand and/or cause severe pain that is not relieved with simple painkillers, or if the person has difficulty breathing.
Procedure No. WYN032.087 Page: 3 of 14 Convulsions or seizure or any kind regardless of whether or not the person has no history of convulsions (for example epilepsy or brain injury) Pain (severe) after a fall or other trauma when the person is unable to sit up, stand or walk. Electrical shock of any kind Caustics in the eye or area of skin exposure larger than palm-sized. Symptomatic chemical exposures or inhalation of exposures with delayed effects, e.g., phosgene. Any condition perceived by the employee s management team, EHS, or the employee as serious or life-threatening. 2.5 Non-Life Threatening Medical Emergency Any medical emergency with no signs of any serious illness/ injury as listed in section 2.3. Examples may include, but are not limited to, minor lacerations, pulled muscles, possible foreign body in eye, and skin irritation from chemical exposure. 2.6 First Aid Treatment As defined by OSHA for Recordkeeping and use for BASF Responsible Care treatment classifications: Visit to medical provider solely for observation or evaluation. Conduct of diagnostic procedures, e.g., x-rays and blood tests, including administration of prescription medications solely for diagnostic purposes (e.g., eye drops to dilate pupils). Using non-prescription medication at non-prescription strength Tetanus immunizations Cleaning, flushing or soaking surface wounds Wound coverage (butterfly bandage, steri-strips, a liquid bandage which is used to only cover a wound) Hot or cold therapy Non-rigid type of support (e.g. elastic wrap) Temporary immobilization for transport Drilling finger or toe nail or draining fluid from a blister Eye patch Removing foreign body from eye with irrigation/cotton swab Removing splinters/foreign body from all other areas by irrigation, tweezers, swab, etc. Finger guard Massage Drinking fluids for relief of heat stress
Procedure No. WYN032.087 Page: 4 of 14 2.7 Medical Treatment Treatment beyond first aid as defined by OSHA for Recordkeeping and used for responsible care treatment classifications, e.g.: Diagnostic tests with positive injury or illness findings (x-rays, CT scan, etc.) Sutures or a type of derma-bond material to close a wound Physical therapy or chiropractic manipulation is prescribed or given Rigid splints IV fluids for heat stress Prescription medications (including OTC medications given at prescription level) Immunizations other than tetanus, when administered as treatment for an injury or exposure event. 2.8 Level II Responder A BASF or contracted employee working on BASF sites who is prepared to move quickly to the scene of a medical emergency or a mass casualty incident (MCI) and who is trained to provide basic pre-hospital medical emergency treatment to an injured or sick person before professional healthcare providers are available. Skills include Level I first aid responder training as well as administrating emergency oxygen, medications or antidotes, if described in SOPs and approved by the Site Occupational Health Physician (SOHP), where permissible by law. Level II responders are not necessarily medical professionals. Every level II responder must have formal training at least once in every two years that includes pre-hospital cardiac life support and trauma life support training in addition to that provided to level I responders. For reference purposes, refer to BASF Global Medical Emergency Preparedness and Emergency Response Guidelines - Appendix A. 2.9 Medical Emergency Response Team (MERT) Members of the Medical Emergency Response Team are volunteers with Basic First Aid training to provide for the patient as a first responder, when Site Medical Department staff is not available, and until community emergency medical services (EMS) arrive for life-threatening medical emergencies. Provide initial treatment for non-life threatening conditions. All have agreed to respond to site emergency medical calls when present on site.
Procedure No. WYN032.087 Page: 5 of 14 2.10 Recordable Injury or Illness Work-related injuries or illnesses that result in: Death Loss of consciousness Days away from work Restricted work activity or job transfer Medical treatment beyond first aid Significant injury/illness diagnosed by a physician 2.11 Site Medical Plan A brief summary of the expected actions of workers, their supervisors, and the site emergency medical response team that is intended for general distribution and posting around the site. It describes which medical providers to consult and whom to notify when medical attention is needed by workers. 2.12 Transitional Work Modified or alternative duties or work hours designed to meet an employee s temporary functional limitations upon release to return to work following an occupational or non-occupational injury or illness. [Refer to BC004.039 Transitional Work Procedure] 2.13 Work Related An event or exposure occurring in the work environment that causes or contributes to the condition or significant aggravates a preexisting condition. OSHA defines the work environment as "the establishment and other locations where one or more employees are working or are present as a condition of their employment. The work environment includes not only physical locations, but also the equipment or materials used by the employee during the course of his or her work." 3. SCOPE Applies to all BASF Corporate Wyandotte Employees and Contracted Employees. Contractor Employees are covered by their own program which must be in accordance with BASF Case Management procedure, WYN032.087, including the requirement to promptly report all work-related injuries and illnesses to their supervision according to BC032.010 Incident Notification and Reporting.
Procedure No. WYN032.087 Page: 6 of 14 4. WORK INSTRUCTIONS 4.1 Life Threatening or serious Medical Emergency: Contact Emergency Medical Services (Wyandotte Fire Responders) via calling 0-911 and Activate Medical Emergency Response Team (MERT) for immediate assistance via channel 6 on site radio and follow building guidelines described in department emergency procedures. Contact Security via radio on emergency channel 6 or at extension 6240. Designate personnel to go to Security to direct emergency personnel to the appropriate building/area on site where medical care is required. In addition personnel shall also be located outside the building/area to direct medical personnel to the appropriate area. Contact Medical Department via radio (if available) on emergency channel 6, by phone extensions 6443 or 6422, by cell phone (734-626-0239) or utilize on-call schedule list as needed. Call Wyandotte Henry Ford Hospital ER Charge Nurse at (734-324-8401) Call EHS On Call phone at (734) 558-1072. If incident involves an exposure to a chemical, including inhalation, splash, contact, etc. then a Safety Data Sheet (SDS) must accompany the injured person to the emergency room. 4.2 Non-life threatening medical emergencies: Communication Activate Medical Emergency Response Team (MERT) for immediate assistance via channel 6 on site radio. Contact Security at extension 6240. Contact MERT member(s) in your unit/department via Emergency Public Access System (if available in your unit/building) or via phone extension from MERT Roster. Contact Medical Department via radio (if available) on emergency channel 6, or phone extension 6443 or 6422, by cell phone (734-626-0239), or utilize on call schedule list as needed). If incident involves an exposure to a chemical, including inhalation, splash, contact, etc. then a Safety Data Sheet (SDS) must accompany the injured person to either the Wyandotte on-site medical department or to the designated medical provider.
Procedure No. WYN032.087 Page: 7 of 14 Provide the following information to the responders: 1. Location of medical emergency 2. Type of medical emergency (i.e., responsive/non-responsive, breathing difficulty, fall, cut, or chemical burn) 3. Designate co-worker to wait outside of building/area to direct emergency personnel to location of emergency 4.3 Designated Medical Providers If non-life threatening medical care is needed, utilize off site Medical Providers (Concentra) when the Wyandotte Site Medical Clinic is unavailable or during off hours. Also, if an employee or contract employee is injured, a supervisor or designee must transport them to the off-site Medical Provider. All employees and contract employees who seek medical care during off hours must contact their supervisor who will then contact the Wyandotte Medical Department. BASF has established a working relationship with two Concentra locations that are to be used for all non-life threatening injuries and illnesses where the Wyandotte Medical Department is not available. Locations for both Concentra locations are to be posted throughout the site and all employees must be aware of this requirement for seeking medical attention for non-life threatening injuries and illnesses. When sending an injured employee or contract employee to Concentra for offsite medical treatment, each department on the Wyandotte site should send the Concentra Authorization for Examination or Treatment Form. Concentra Locations: Concentra Urgent Care Woodhaven Location 19200 West Road Woodhaven, MI 48183 Phone: (734) 287-3415 Fax: (734) 287-4213 After hours: (735) 955-7000 Hours of Operation Monday Friday 7 am 9 pm Saturday 8 am 4 pm Holiday Hours 10 am 4 pm Concentra Urgent Care Airport Romulus 11700 Metro Airport Center Drive Suite 104 Phone: (734) 955-7000 Fax: (734) 955-7006 After Hours: (734) 955-7000 Open all holidays for Injury Care and Drug Screens. Please call for Urgent Care Hours Open 24 hours
Procedure No. WYN032.087 Page: 8 of 14 Whenever an Employee or Contracted Employee seeks medical care for a potentially work-related condition which is outside of their scheduled work hours, they should telephone their supervisor and the site nurse to inform them that they have required medical care and provide specifics as to why they feel their medical condition is work related. This notice should be made as soon as possible following discharge from the clinic, hospital emergency department, or physician s office, but no later than the morning of the next calendar day. BASF Wyandotte Primary Medical Provider Contract Physician Dr. John Bernick, MD 1609 Biddle Ave., Wyandotte, MI (734) 324-6443 or (734) 324-6422 4.4 Family Notification If capable, the employee/contracted employee are responsible for notifying their emergency contact in the event of an emergency, or non-life threatening situation. If employee/contract employee is not capable of calling, their supervisor should work with HR/MSP to identify the designated emergency contact and to ensure appropriate contact is made, including follow-up calls. 4.5 Injury/Illness Incident Response Prompt Reporting By Affected Personnel Employees, Contracted Employees and Contractor Employees must promptly report all work-related injuries and illnesses to their supervision in accordance with BC032.010 Incident Notification and Reporting. Contractor supervision must notify BASF EHS and operations management personnel immediately upon discovery of an injury or illness involving contractor employees. For Employees and Contracted Employees, the site s BASF Medical Department should be consulted regarding fitness for duty. For Contractor Employees, the contractor company s medical plan should be followed. 4.6 Initial Response On Site Evaluation and First Aid When the injury or illness is considered to be non-serious or non-life threatening, first aid should be immediately initiated. The Wyandotte Medical Emergency Response Team (MERT) along with the Wyandotte Site Medical Department should be utilized for first aid, and to provide additional treatment, as required, to stabilize the condition of more seriously injured workers until they are transported to a medical facility. Refer to BC009.029 First Aid for preparedness and implementation of first aid practices.
Procedure No. WYN032.087 Page: 9 of 14 Symptomatic employees /contracted employees with potentially work-related conditions should be evaluated by the site s medical department as soon as feasible. During off hours, the site nurse should be consulted, utilizing the on-call schedule, to arrange follow up care. If a symptomatic Employee or Contracted Employee cannot be immediately evaluated by the medical department, transitional duty for the remainder of the shift may be instituted after a telephone consultation with the site nurse. If an Employee or Contracted Employee determines they need treatment after leaving their work location for an on-the-job injury or illness, refer to section 4.3 of this medical plan. 4.7 Injury/Illness Incident Response Medical Treatment When a work-related injury or illness occurs that requires treatment beyond first aid, the following actions are required: The Employee or Contract Employee will be accompanied to the medical facility by a member of his/her management team, or designee, except in circumstances where doing so would interfere with responding to the incident. The member of management attending to the injured or ill worker must notify Operations Management, EHS and Human Resources that the Employee or Contracted Employee is/will be receiving medical treatment for an injury/illness. At the Wyandotte site this information will be incorporated into the Injury Treatment and Communication Checklist which needs to be developed for each group. Should the affected worker not be capable of notifying his or her own emergency contact, Operations Management, EHS or Human Resources will notify the person who the injured/ill worker has designated as his or her emergency contact. Should the injured/ill Employee or Contracted Employee need to be admitted into a hospital, regardless if it is overnight for observation, or because of the seriousness of the injury or illness, the member of management attending to the worker must notify Operations Management, EHS and Human Resources. The injured or ill Employee or Contracted Employee should be discouraged from driving themselves to either a clinic or hospital Emergency Department. Transportation should be provided for them by the site. After the medical visit is completed, the site shall arrange to have the worker transported to their home or back to their car if the Employee or Contracted Employee is released to drive by the healthcare provider.
Procedure No. WYN032.087 Page: 10 of 14 4.8 Post Injury/Illness Follow-up Communications The Wyandotte site medical department should make weekly status inquires of the site physician regarding specifics of the injured/ill employee s recuperation until such time they are released for return to work, especially when the worker is on transitional duty. In accordance with the BASF Corporate Transitional Work Procedure, BC004.039 and the Wyandotte Post Accident Testing Procedure, the site medical department, Operations Management, EHS, Human Resources and for contract employees the Contracted Employee Managed Service Provider (MSP) will work together to determine and manage medical care, including return to work. Refer to the flow chart (WYN032.087A) referenced in section 6 of this procedure. 5. RESPONSIBILITIES 5.1. Employee/Contracted Employee Immediately report any potential work injury/illness to supervisor. Employees need to be aware to report any non-occupational injury to their Supervisor prior to starting work. If an employee or contract employee has a non-work related injury, they must be instructed to contact their supervisor prior to coming into work. Their supervisor will provide further instructions on whether or not the employee should come into work. For contact employees the contract employee should also contact their vendor to report a non-work related injury and that time off may be required pending any accommodations by the employer. If this is a work related injury/illness, and non-life threatening off-site treatment is provided, give Concentra Authorization for Examination or Treatment form at treating facility. Forms located in Related Documents, in Security Building, in Trauma Bags and within Supervisor Office locations and Department bulletin boards. For non-life threatening medical care, the BASF employee or contract employee will use Concentra as its designated Medical Provider for the Wyandotte site. The Wyandotte Henry Ford Hospital should only be used for a life-threatening emergency. For BASF employees, upon discharge, return the completed medical provider s Return to work form to your supervisor and the medical department. For contract employees, upon discharge, return the completed Return to work form to your BASF direct Supervisor and a copy to the designated Contracted Employee Managed Service Provider (MSP). BASF
Procedure No. WYN032.087 Page: 11 of 14 management and the defined MSP will communicate return to work provisions with BASF Site Medical and BASF Site Environmental, Health and Safety (EHS) representatives. 5.2. Supervisor / Shift Leader/Department Management Supervision needs to clearly ask the employee or contract employee if the injury/illness occurred at work. If not, supervisors need to immediately contact their management and determine if any work accommodations can be made to prevent aggravation of a non-occupational injury. If not the employee or contract employee needs to be sent home and return only with a completed return to work form from their personal physician. Arrange transportation to and from hospital for non-life threatening injury/illness if required. Employees should not transport themselves to the local Medical Provider, Concentra but should be transported by their supervisor or designee. If work related illness/ injury: 1. Notify Medical via cell phone (734) 626-0239 or through the department phone at 6443 or 6422, or utilize on call schedule list as needed as soon as possible when the injury is a BASF or contracted employee. When a contracted employee is injured, a Managed Service Provider (MSP) representative is also copied on the initial AIM report and will determine the appropriate agency vendor (as described on the yellow contact card). 2. Provide Off-site Emergency Services (via employee or whoever accompanies employee) with: a. For non-life threatening incidents, complete the Concentra Authorization for Examination or Treatment form for BASF or Contracted employees. b. Safety Data Sheets (SDS) if chemical exposure occurred 3. Notify the Wyandotte Environment, Safety and Health (EHS) On-Call phone at (734) 558-1072, and others having a need to know, through established departmental protocol. Each Wyandotte Department shall develop and post in their work area(s) a Medical Injury Treatment and Communication Checklist (WYN032.087B) as well as the Medical Provider Maps/Location information (WYN032.087C). Refer to WYN032.087B in the related documents section of this procedure for an example checklist that may be used to develop a department specific medical injury treatment and communication checklist.
Procedure No. WYN032.087 Page: 12 of 14 4. Immediately contact your respective leadership representative and the Wyandotte Site General Manager, Greg Pflum via cell phone at (513) 293-5257. Return to work following treatment: After the employee returns from being treated: For BASF employees: Fax copy of completed Return to work form to the Wyandotte Site Medical Department (fax # 734-324-6594) and mail the original via interoffice mail after the employee returns from being treated. All return to work forms need to be reviewed by department management, Wyandotte Site Medical and EHS to determine if any work restrictions or days away from work would apply. In all situations every effort should be made to accommodate and provide the employee with a return to work as opposed to a time off from work in accordance with the BC Transitional Work Procedure, BC004.039. For Contracted employees: Provide a copy of the Return to work to their employment agency, the Contracted Employee Managed Service Provider (MSP) and Site Medical. In addition any work restrictions or days away from work need to be communicated to the Wyandotte Site EHS group for purposes of managing the OSHA 300 Log. 5.3. Security If requested, transport equipment (AED, oxygen, & trauma bag) / escort Site Medical and EMS to incident. Maintain supply of Concentra Authorization for Examination and Treatment forms in the Security Building. Notify Medical staff on-call person if BASF employee and transported off-site. Directs the arrival of emergency services onto the site and to the proper location. 5.4 Contracted Managed Service Provider (MSP) Has responsibility for the coordination of all contracted employee incidents with contract employer agency representatives as well as for communication of information to BASF Wyandotte Medical, department management representatives and EHS representatives. When a contracted employee is injured, a Managed Service Provider (MSP) representative is also copied on the initial AIM report and will determine the appropriate agency vendor (as described on the yellow contact card) to communicate information relative to the contracted incident.
Procedure No. WYN032.087 Page: 13 of 14 5.5 Medical Establish Case management with hospital/ clinic provider, employee, insurance carrier and others as needed. In addition the Site Medical Program Contact will maintain and implement the site medical program and communicate the requirements of this procedure to the Site Emergency Response Coordinator (SERC). 5.6 Emergency Responder Includes both Level I MERT Responders and Level II responders who are expected to provide initial treatment for medical emergencies until outside medical personnel arrive on site. 5.7 Environment, Health and Safety (EHS) Department Responsible with helping to coordinate the administration of this procedure at the Wyandotte site to ensure adequate implementation. In addition works with Site Medical Program Contact and the Contracted Employee Managed Service Provider to provide site-wide training on this procedure. 5.8 Site Emergency Response Coordinator The individual designated by the Site manager as having responsibility for the site s Medical Emergency Response planning and administration of this procedure at the site. 5.9 Human Resources The group that is responsible for assisting operations with notification of emergency contacts when individuals are not capable of making such notification. In addition the HR group is responsible for the administration of the Drug and Alcohol Testing policy on the site.
Procedure No. WYN032.087 Page: 14 of 14 6. RELATED DOCUMENTS Description of Procedure Corporate No. Wyandotte No. Medical Case Management BC009.043 Wyandotte Case Management Flowchart WYN032.087A Wyandotte Case Management Flow Chart Wyandotte Injury Treatment and Communication Checklist - Template WYN032.087B Wyandotte Injury Treatment and Communication Checklist - Template Incident Notification and Reporting BC032.010 WYN032.008 Concentra Authorization for Examination or Treatment Form WYN032.087C - Concentra Authorization for Examination or Concentra Medical Provider Maps/Location Information Transitional Work Procedure BC004.039 Treatment Form WYN032.087D - Concentra Medical Provider Maps/Location Information