First Aid vs. Medical Treatment for Recordkeeping
An injury that only needs first aid usually doesn’t go on the OSHA 300 log. One that needs medical treatment does. OSHA keeps a short, complete list of what counts as first aid. Anything not on the list is medical treatment.
- Construction
- General Industry
- Supervisors
Care comes first. These definitions are only for the paperwork. Never hold back treatment a worker needs to keep the log clean, and never discourage anyone from seeing a doctor. That’s illegal retaliation.
OSHA’s first aid list
These are first aid (not recordable on their own), and where each one crosses the line:
| First aid | Becomes medical treatment when… |
|---|---|
| Non-prescription medicine at non-prescription strength | A prescription drug is used, or a doctor recommends an over-the-counter drug at prescription strength |
| Tetanus shots | Other shots or vaccines are given as treatment (such as a rabies series) |
| Cleaning, flushing or soaking wounds on the skin | A wound needs debridement (cutting away tissue) or surgery |
| Bandages, gauze pads, butterfly bandages or Steri-Strips | The wound is closed with stitches, staples or surgical glue |
| Hot or cold therapy (ice packs, heat packs) | It’s part of physical therapy |
| Non-rigid support: elastic wraps, non-rigid back belts | A rigid splint, cast or brace with stays is used to immobilize the injury |
| Temporary splints, slings, neck collars or back boards used only to move the injured person | They’re used for treatment after transport |
| Drilling a fingernail or toenail to relieve pressure, or draining a blister | The nail is removed, or the wound is lanced or drained more deeply |
| Eye patches | — |
| Removing something from the eye with only water or a cotton swab | A tool, needle or other method is used, or the object is embedded |
| Removing splinters or debris (not from the eye) with water, tweezers, cotton swabs or other simple means | It takes cutting or other complex removal |
| Finger guards | — |
| Massage | It’s physical therapy or chiropractic treatment |
| Drinking fluids to relieve heat stress | IV fluids are given |
Rules that trip people up
- Who gives the care doesn’t matter. First aid given by a doctor is still first aid. Stitches done by anyone are still medical treatment.
- A doctor’s recommendation counts. If a doctor or other licensed health care professional recommends medical treatment, like a prescription, the case is recordable even if the worker doesn’t fill it.
- Tests aren’t treatment. Visiting a doctor, X-rays, blood tests and other diagnostic tests alone don’t make a case recordable.
- Medical treatment isn’t the only trigger. Days away, restricted work, loss of consciousness and certain diagnoses make a case recordable too. See Recordable or Not? Common Examples.
Keep good first aid records
- Write down every first aid case: date, name, what happened and what was done
- Note any follow-up: did the worker see a doctor later?
- Recheck the case if the injury gets worse; a first aid case can become recordable later
- Report the injury to the workers’ comp carrier if your state or policy requires it, even if it isn’t recordable
Standards & references
- 29 CFR 1904.7: General recording criteria, including the first aid list in 1904.7(b)(5)(ii)
- OSHA: Recordkeeping
- See also: Injury Recordkeeping & Reporting · First Aid Basics
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