• Ensuring effective communication — by voice, observation or electronic means — so that employees can contact a supervisor or emergency medical services when necessary. Electronic devices (such as cell phones) can only be used if reception in the area is reliable. If an electronic device does not provide reliable communication (for instance, cell phone coverage is inadequate), the employer must ensure a means of summoning emergency medical services..
• Responding to signs and symptoms of possible heat illness, including first aid measures and how emergency medical services will be provided.
• Implementing procedures for contacting emergency responders and, if necessary, transporting employees to a place where they can be reached by a medical provider. Cal/OSHA guidance states that procedures must include immediate steps to keep a stricken employee cool and comfortable once emergency service responders have been called.
• Ensuring that clear and precise directions to the work site are available to give to emergency providers when needed. For instance, the guidance states that mobile crews must be provided with a map of their location or detailed directions they can provide to emergency responders.

Additional employer obligations apply when signs or symptoms of heat illness appear:

• If a supervisor observes, or an employee reports, signs or symptoms of heat illness, the supervisor must take immediate action commensurate with the illness’ severity.
• If the signs and symptoms indicate severe heat illness (such as decreased consciousness, staggering, vomiting, disorientation, irrational behavior or convulsions), the employer must implement emergency response procedures.
• Any workers who display or report any signs or symptoms of heat illness must not be left alone or sent home without being offered on-site first aid or emergency medical services.

Cal/OSHA guidance states that employers are not required to provide medical personnel on site and supervisors and employees are not expected to have medical expertise.

• Establishing emergency response procedures at non-fixed, remote and hard to access worksites is especially important.

1. 8 CCR secs. 3395(f), 3396(f)