Clarification on the use of a cold therapy only setting on a therapeutic device is first-aid

August 9, 2018 Tomasina Barton CoolSystems, Inc. DBA Game Ready 1800 Sutter St. Suite 500 Concord, California 94520 Dear Mr. Barton: Thank you for your letter to the Occupational Safety and Health Administration (OSHA) regarding 29 CFR Part 1904 - Recording and Reporting Occupational Injuries and Illnesses. Specifically, you ask whether the use of a cold therapy only setting on a therapeutic device is considered first aid for purposes of OSHA recordkeeping. In your letter, you state that your company has developed a care system device that has a dual modality, offering a separate cold therapy and compression therapy functionality. We understand that when treating an injury, cold water flows from a device through a hose onto one side of a wrap, and that air flows from the device through a hose to the other side of the wrap. The cold and compression components are operated independently and the user can experience the benefits of active cold therapy with "pressure off" selected. You also state that the "pressure off" setting does not affect the functionality of the cold therapy delivered through the wrap. Section 1904.7(b)(5)(ii) of OSHA's recordkeeping regulation requires employers to record work-related injuries and illnesses that result in medical treatment beyond first aid. Under Part 1904, medical treatment does not include "first aid" as defined in paragraph 1904.7(b)(5)(ii). The section specifically states that "using hot or cold therapy" is first aid. See, subparagraph (E). Section 1904.7(b)(5)(iii) goes on to state that the list of first aid treatments in section 1904.7(b)(5)(ii) is a comprehensive list of first aid treatments. Any treatment not included on the list is not considered first aid for OSHA recordkeeping purposes. In determining whether the use of the cold therapy only setting on your device constitutes first aid or medical treatment under the recordkeeping regulation, OSHA's Directorate of Technical Support and Emergency Management consulted with the OSHA Office of Occupational Medicine and Nursing (OOMN). A review of the literature description on your care system was discussed and analyzed. After completing the review, OSHA has determined that applying only the cold therapy component of your device (with no compression) is first-aid for injury and illness recordkeeping purposes. As noted above, section 1904.7(b)(5)(ii)(E) states that the use of cold therapy to treat a work-related injury or illness is first aid. However, please note that the use of air compression therapy is not included on the list of first aid treatments in section 1904.7(b)(5)(ii). Accordingly, when the air compression component of your device is used, either with or without cold therapy, to treat a work-related injury or illness, the case must be recorded on the OSHA 300 log. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Sincerely, Amanda L. Edens, Director Directorate of Technical Support and Emergency Management

Not legal advice. This page republishes 29 CFR Part 1904 as published by the eCFR and explains it. The recordkeeping duty is the employer’s. Where the rule requires judgement, Job13 says so rather than guessing — run your own case through the free check.