The employer must take appropriate steps prior to any accident (such as making arrangements with the service provider) to ascertain that emergency medical assistance will be promptly available when an injury occurs. An employer who contemplates relying on assistance from outside emergency responders as an alternative to providing a first-aid-trained employee must take a number of factors into account. However, the requirements that emergency medical services must be "reasonably accessible" or "in near proximity to the workplace" are stated only in general terms. Emergency medical services can be provided either on-site or by evacuating the employee to an off-site facility in cases where that can be done safely. OSHA has consistently taken the view that the reasonable availability of a trained emergency service provider, such as fire department paramedics or EMS responders, would be equivalent to the "infirmary, clinic, or hospital" specified by the literal wording of the standards. The other option for employers is to rely upon the reasonable proximity of an infirmary, clinic or hospital. OSHA recommends, but does not require, that every workplace include one or more employees who are trained and certified in first aid, including CPR. This option is, for most employers, a feasible and low-cost way to protect employees, as well putting the employer clearly in compliance with the standards. One option these standards provide employers is to ensure that a member of the workforce has been trained in first aid. The basic purpose of these standards is to assure that adequate first aid is available in the critical minutes between the occurrence of an injury and the availability of physician or hospital care for the injured employee. The primary requirement addressed by these standards is that an employer must ensure prompt first aid treatment for injured employees, either by providing for the availability of a trained first aid provider at the worksite, or by ensuring that emergency treatment services are within reasonable proximity of the worksite. Bureau of Mines, the American Red Cross, or equivalent training that can be verified by documentary evidence, shall be available at the worksite to render first aid. 50(c) provides: In the absence of an infirmary clinic, hospital, or physician, that is reasonably accessible in terms of time and distance to the worksite, which is available for the treatment of injured employees, a person who has a valid certificate in first-aid training from the U.S. Adequate first aid supplies shall be readily available. 151(b), provides: In the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Replies: OSHA's standard for first aid training in general industry. Does everyone have to be trained in first aid, including CPR and bloodborne pathogens? What if there is a career rescue squad within five miles of the workplace? Your clients are employed at various workplaces, including, but not limited to, doctors' offices, construction companies, daycare facilities, and retirement homes. You have been asked by several employers what OSHA's standards are for first aid, including CPR and bloodborne pathogens. Questions: You wrote that you teach first aid, including CPR, in the Winchester, VA, area. Your paraphrased questions and our replies are below. This reply letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not detailed in your original correspondence. You sent some questions regarding OSHA's standards on first aid, including CPR and bloodborne pathogens. We apologize for the delay in our response. Thank you for your August 16, 2005, letter to the Occupational Safety and Health Administration (OSHA).