Worker Collapse at a Thika Construction Site
At 14:20 on a construction site in Thika, a 32-year-old casual worker collapses near the concrete mixer. He is unresponsive, lying on his back, and breathing noisily with a snoring sound. A colleague is about to pour water into his mouth. The site first-aid kit is locked in the supervisor’s office; the supervisor is 20 minutes away. The site has 60 workers, one trained first-aider who is off-site, and no ambulance on standby. The nearest hospital is 8 km away. The guard is the only person with a phone with credit and has been asked to “do something.” The ground is dusty and hot; a crowd is forming. An ambulance has been called and is expected in 25 minutes.
1. What are the immediate first-aid priorities, and why must water not be given?
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The priorities are danger, response, airway and breathing. The worker is unresponsive and making a snoring sound, which suggests the airway is partly blocked. Water must not be poured into his mouth: an unresponsive person cannot swallow, and fluid can enter the lungs and worsen the blockage. The guard should check for normal breathing, open the airway using a head-tilt and chin-lift unless a neck injury is suspected, and place him in the recovery position on his side. He should monitor breathing continuously and send for the first-aid kit and AED if available. He should not move the worker unless there is immediate danger, and should not give food or drink. If breathing stops, CPR should begin if the guard is trained.
2. How should the guard organise the crowd, the ambulance call and the handover?
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The guard should clear a space around the worker, keep the crowd back for air and privacy, and assign specific people to meet the ambulance at the gate and to fetch the first-aid kit and supervisor. He should confirm the ambulance call, give the site location, access point and a contact number, and state that the worker is unresponsive but breathing. On arrival, he should give a clear handover: what happened, time of collapse, breathing status, changes, first aid given and known medical information. He should not discuss the worker’s personal details with the crowd, and should record the names of witnesses.
3. What should be recorded afterwards, and what follow-up issues does the case reveal?
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Record the time, location, task being performed, witnesses, first aid given, ambulance arrival and handover, and the worker’s condition as observed. Report the locked first-aid kit, the off-site first-aider and the lack of ambulance arrangements to the site safety officer and the guard’s supervisor. Keep records confidential and factual, and avoid speculating about the cause. Follow up to ensure the first-aid kit is accessible, trained first-aiders are on every shift, and emergency contact details are displayed. The guard should also complete the company accident or incident form.