Incidents & Accidents · Mandatory · Construction

First Aid Treatment Record

A record of all first aid treatment administered on site. It captures the casualty details, nature of injury or illness, treatment given, and outcome.

Last reviewed: 29 March 2026 — This guide reflects UK law as of this date. MHSWR 1999 remains current with no amendments enacted as of 29 March 2026. Next scheduled review: 29 March 2027.

1. First Aid Treatment Records — Clinical Log for Every Treatment

The first aider's clinical log documenting every treatment — including minor dressings that may not reach the accident book. It provides a clinical timeline for the treating doctor or hospital. It provides trend data — patterns of minor injuries indicating persistent hazards. It also creates an evidence trail for the first aider, demonstrating appropriate assessment, the right treatment, and the right referral decisions.

Mental health first aid — 2024 L74 update explicitly includes mental health in first aid needs assessment

Construction workers have disproportionately high rates of mental health issues. The updated HSE L74 (2024) explicitly requires mental health consideration in first aid needs assessments. Sites should consider designating a mental health first aider (MHFA England or equivalent). Treatment records should document mental health support provided as well as physical treatment.

2. First Aid Treatment Record — What to Document

Field	Content
Date and time	When treatment was given.
Patient details	Name, employer, trade/role.
Nature of complaint	Injury or illness. Mechanism of injury if known.
Assessment	Level of consciousness; breathing; pulse; visible injuries; pain.
Treatment given	Wound cleaning/dressing; splinting; RICE; CPR; AED use. Note: first aid boxes should not contain medications generally.
Referral decision	Returned to work; sent home; referred to GP; sent to hospital by ambulance.
Hospital referral	Ambulance (called by whom); private vehicle; A&E address.
Follow-up required	Any follow-up assessment needed?
First aider details	Name, qualification, certificate number, expiry date.
Accident book cross-reference	Entry made in accident book: yes/no. Reference.

3. Common Mistakes

First aider certificate allowed to expire before renewal

FAW and EFAW certificates are valid for 3 years. Renewal must be completed before expiry, not after. An expired certificate means the holder is no longer qualified and cannot count toward site provision. The register must track expiry dates and trigger renewal at least 3 months in advance.

Treatment record not maintained separately from accident book

These are different records with different purposes. The accident book records the incident description. The treatment record captures clinical detail. Merging them risks GDPR non-compliance and reduces the quality of both.

No first aid box inspection or restocking

First aid boxes must be maintained in good order. An empty box at the time of a serious injury is a compliance failure. Weekly inspection and restocking after use should be documented in the equipment register.

Not considering mental health

Construction has elevated mental health challenges. The 2024 L74 explicitly requires mental health consideration in needs assessments. Sites should designate a mental health first aider, display mental health resources, and subscribe to an Employee Assistance Programme.

Treatment records not stored securely

Treatment records contain sensitive health data under GDPR with special category protections. They must be kept in locked filing or password-protected digital systems. They should not be in open files or visible to other workers.

4. Frequently Asked Questions

How many first aiders are required?▾

There is no fixed number — the requirement is “adequate and appropriate” per the needs assessment. HSE guidance for high-risk environments: fewer than 5 workers requires 1 appointed person; 5 to 50 workers requires at least 1 FAW or EFAW holder; more than 50 workers requires 1 FAW per 50 workers. The principal contractor assesses for the total workforce. Remote sites need more.

What is the difference between FAW and EFAW?▾

FAW (First Aid at Work): 3-day course covering the full range including CPR, AED, wounds, fractures, and medical emergencies. Required for higher-risk environments including most construction. EFAW (Emergency First Aid at Work): 1-day course covering emergency response only. Both are valid for 3 years. Annual refresher is recommended. HSE no longer requires approved training providers — quality must be demonstrated.

What should a construction first aid box contain?▾

There is no mandatory list — contents reflect the needs assessment. HSE minimum suggests: guidance leaflet, sterile plasters, sterile eye pads, triangular bandages, safety pins, wound dressings, and disposable gloves. For higher-risk sites: eye wash, conforming bandages, trauma dressings, and space blankets. No medications.

Can a first aider administer medication?▾

First aiders are not trained to administer medication. Exceptions: assisting a person with their own prescribed medication (adrenaline auto-injector, GTN spray) if they are unable to self-administer. Paracetamol and OTC medications should not be administered unless covered by employer policy and specific training. First aid boxes should not contain medications.

Generate your First Aid Treatment Record on Construction Suite

Construction Suite walks you through every required section with a guided Q&A — built to MHSWR 1999 — and generates a professionally formatted document in minutes.

Get started free