APPENDIX 4B – FIRST AID RESPONSE PLAN FOR KNOWN by kch10832

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									                                     University of Sydney First Aid Arrangements - September 2006
APPENDIX 4B – FIRST AID RESPONSE PLAN FOR KNOWN CONDITION

STAFF MEMBER DETAILS

Name …………………………………………………………………………………………….

Work area/ location ……………………………………………………………………………..

Department ……………………………………………………………………………………….

TREATING DOCTOR DETAILS

Name ………………………………………………………………………………………………

Phone ………………………………Fax ………………… Email ………………………………

RELATIVE/ CONTACT PERSON DETAILS

Name ………………………………………………………………………………………………..

Work Phone ……………………Home Phone ………………… Mobile ………………………

HEAD OF DEPARTMENT

…………………………………………………………………..

NOMINATED FIRST AID OFFICERS IN BUILDING
Name                  Extension  Mobile                        Location



IN THE EVENT OF (insert symptoms/ presentation details here) we have agreed to the
following first aid responses:
1. protect the person from harm
2. follow the X section of the first aid manual
3. call an ambulance if … dial 0-000
4. etc – insert specific details of plan relevant to person’s needs

TREATING DOCTOR …………………………………………………………..Date ………..
Sign off on plan or recommend changes and fax back to Head of Department/ Nominated First
Aid Officer/ Other on Fax …… … … … … (insert relevant number)

SIGNATURES OF ALL PARTIES CONSULTED

Person named ………………………………………………………                               Date ……………

Head of Department ………………………………………………… Date ……………

NFAO ………………………………………………………………… Date ……………

NFAO ………………………………………………………………… Date ……………

NFAO ………………………………………………………………… Date ……………

Other University Officer ……………………………………………                       Date ……………

Position ………………………………………………………………..

								
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