Works Paramedic
Extended emergency care beyond first aid, with mandatory training and refresher per DGUV Grundsatz 304-002. Required from larger headcounts or on construction sites with elevated risk.
DGUV Vorschrift 1 § 27 · DGUV Grundsatz 304-002
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What is a works paramedic?
A works paramedic provides extended emergency care in the workplace that goes beyond ordinary first aid. The role sits between the trained company first aider and the external emergency medical services. It exists to bridge the time gap until the rescue service arrives, which on remote sites or large premises can be considerable.
The legal anchor is DGUV Vorschrift 1 § 27, the general prevention regulation issued by the statutory accident insurers. It names three fixed triggers: more than 1,500 insured persons present at an operating site, 1,500 or fewer but more than 250 insured persons present where the type, severity and number of accidents call for paramedic staffing, and more than 100 insured persons present on a construction site. The 1,500 threshold applies to every type of operation, not only to commercial and administrative ones, and the construction-site threshold does not require an additional elevated hazard. Under § 27 (2) an employer may drop works paramedics only by agreement with the accident insurer. Below the thresholds, the risk assessment under § 5 ArbSchG decides, together with the occupational physician and the safety specialist.
Qualification follows DGUV Grundsatz 304-002. A first-aid qualification is the entry condition; on top of it come a basic course of at least 63 teaching units and an advanced course of at least 32 teaching units of 45 minutes each, at a body the accident insurer has assessed as suitable. Refresher training of 16 teaching units is required within every three years. That is where most operations slip: the refresher gets postponed, the expiry date sits in no list, and a shift runs without a validly qualified person.
The duties build on, but do not replace, the company first-aid organisation under § 24 to § 28 of DGUV Vorschrift 1. The works paramedic measures vital signs, manages wounds and shock, prepares the casualty for handover and assists the emergency physician. The role does not confer the right to practise medicine. Every instance of first aid must be documented under § 24 (6) DGUV Vorschrift 1 and kept available for five years, because that entry later carries the proof toward the accident insurer if a minor injury turns into a delayed claim.
Core duties of a works paramedic
- Provide extended emergency care beyond ordinary first aid until the rescue service arrives, within the scope of DGUV Grundsatz 304-002
- Assess and monitor vital signs, manage bleeding, shock, immobilisation and basic life support
- Maintain readiness of the sick bay, emergency bags and rescue equipment per the required first-aid materials
- Document every instance of first aid in the Verbandbuch under § 24 (6) DGUV Vorschrift 1, treat it confidentially and keep it available for five years
- Coordinate the handover to the emergency medical services and the emergency physician
- Support the company first-aid organisation and brief appointed first aiders
- Keep the personal qualification current through 16 teaching units of refresher training within every three years (§ 27 (6) DGUV Vorschrift 1)
- Cooperate with the occupational physician and the occupational safety specialist (Sifa)
- Report safety-relevant observations and near misses to the responsible manager
- Participate in emergency and evacuation drills on the premises or construction site
When must a works paramedic be appointed?
Providing works paramedics is the employer's duty under DGUV Vorschrift 1 § 27. This is not a rule of thumb applied by the accident insurers but an accident prevention regulation with three fixed triggers. Under § 27 (1) at least one works paramedic must be available where more than 1,500 insured persons are present at an operating site, where 1,500 or fewer but more than 250 insured persons are present and the type, severity and number of accidents call for paramedic staffing, or where more than 100 insured persons are present on a construction site. The construction-site threshold also applies where the employer subcontracts work and more than 100 insured persons in total are active at the same time.
The duty is not rigid, but the relief is not the employer's to grant. Under § 27 (2) DGUV Vorschrift 1, works paramedics may be dropped only by agreement with the accident insurer: at operations under paragraph 1 number 1 where the type, severity and number of accidents do not call for them, and on construction sites under paragraph 1 number 3 taking account of how quickly the accident location can be reached and how it connects to the public rescue service.
Below the thresholds the risk assessment under § 5 ArbSchG decides, together with the occupational physician and the safety specialist. Decisive factors are the distance and response time of the public rescue service, the type and severity of foreseeable injuries, shift patterns and the spatial layout of the site. The appointment should be made in writing, naming the scope of activity and confirming the valid 304-002 qualification. The employer must enable refresher training and ensure that enough qualified persons are available across all shifts.
- More than 1,500 insured persons present at an operating site (§ 27 (1) no. 1 DGUV Vorschrift 1)
- More than 250 and up to 1,500 insured persons present where type, severity and number of accidents call for paramedic staffing (§ 27 (1) no. 2)
- More than 100 insured persons present on a construction site, counting subcontracted workers together (§ 27 (1) no. 3)
- Dropping the requirement only by agreement with the accident insurer under § 27 (2) DGUV Vorschrift 1
- Long response times of the public rescue service to the site
- Result of the risk assessment under § 5 ArbSchG below the thresholds
Where works paramedics are typically required
- Large construction and civil engineering sites
- Steelworks, foundries and heavy industry
- Chemical and petrochemical plants
- Automotive and large manufacturing plants
- Logistics centres and large distribution warehouses
- Mining and tunnelling operations
- Power stations and energy infrastructure
- Shipyards and offshore installations
- Large events and stadiums
- Remote sites with long rescue-service response times
How CIVAC supports the works paramedic role
CIVAC covers the formal side of the works paramedic function in a role file. It holds the written appointment with the scope of the activity, the course certificates under 304-002, the later refresher courses and the deputy arrangement for holiday and sickness. Training is recorded per person, and the three-year refresher cycle runs as a scheduled task with a reminder, so the deadline becomes visible before it passes and nobody loses their status unnoticed.
Recurring duties come from templates for this role: checking the sick bay and the emergency bags, briefing the first aiders, taking part in emergency drills, each with an owner and a due date. Every completion writes to an append-only audit trail that later serves as evidence. When the accident insurer asks, the appointment, the current qualifications and the inspection history are in one view instead of scattered across files. If the person changes, the handover runs through the same role file, so open tasks and deadlines do not go with them.
Frequently asked questions about the works paramedic
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