Responding to Medical Emergencies

Unless you’re a civil servant or medical professional, you probably don’t expect to encounter a medical emergency while you’re at work, but restaurant employees – especially those working front-of-house roles – may witness life-threatening crises like anaphylaxis, choking, and cardiac arrest. In many cases, the quick actions of a trained employee can help save the life of a customer suffering from one of these conditions. However, there’s plenty of debate about what restaurant employees can do and what assistance restaurants should be legally required or able to provide in response to medical emergencies.

Food Allergies

Because the prevalence of food allergies has reportedly been increasing but still only affects a portion of the population, it can sometimes be a controversial topic. Restaurant employees’ responses to someone informing them of a food allergy have also been complicated by “food allergy fakers,” or diners without food allergies who claim to be allergic to an ingredient they’re voluntarily abstaining from or simply don’t like.

However, anaphylaxis, a severe reaction to an allergen, can be fatal, especially if the allergic person has forgotten an epinephrine auto-injector like EpiPen. People who suffer from food allergies are careful about where and what they eat and generally travel with at least one auto-injector, but even the most vigilant food allergy sufferers may leave this potentially life-saving device at home and find themselves dealing with a dangerous reaction in the middle of a restaurant that may or may not have the medicine they need. Those were the circumstances that led to the death of a milk-allergic teen in Minnesota, whose family is now suing the restaurant.

A bill requiring restaurants to stock EpiPens failed in Virginia in 2014, in part due to concerns about the cost of EpiPens and the logistics of properly training employees to use them in an industry with a high turnover rate. In the United States, purchasing EpiPens requires a prescription, but the majority of states have passed or are considering epinephrine entity stocking laws that give restaurants and similar operations the option of stocking EpiPens and administering them to customers who are suffering from anaphylaxis. These laws generally specify training requirements that may include annual certifications and provide liability exemptions to protect employees who do administer the medication.

In states where restaurants are legally able to stock epinephrine auto-injectors that employees may administer, many operators wonder if their business should keep an EpiPen in the first aid kit. Injecting epinephrine is obviously much different than simply giving an injured customer a bandage, and whether a restaurant’s employees and managers are willing or able to be entrusted with the task will vary from one establishment to the next. If the cost of an EpiPen is a concern for your restaurant, consider stocking a different brand of auto-injector.

Choking Hazards

Earlier this year, a 42-year-old man died during an eating challenge at the Voodoo Doughnut location in Denver. This tragedy serves as a reminder that restaurants, even if they offer eating challenges, are usually not legally obligated to have someone on staff who is trained or certified in life-saving measures. Choking is a common hazard in restaurants because everyone, not just those participating in eating competitions, is at risk, from children trying to swallow too-big pieces of food to adults not chewing their food properly because they are focused on the lively conversations at their dinner table.

Despite this potential danger, only a fraction of states require restaurants to post information about ways to dislodge food. Traditionally, the recommended technique for this has been abdominal thrusts, which is more commonly known as the Heimlich Maneuver. There is now some debate over whether abdominal thrusts or back blows are more effective, but the Red Cross recommends beginning with back blows before proceeding to abdominal thrusts.

Most states have Good Samaritan laws that will protect employees from liability if they perform necessary first aid on a customer, but there are no laws requiring restaurant employees to provide assistance. Even if they will be protected from legal retaliation, employees who haven’t been trained in first aid procedures may not be confident enough in their abilities to intervene and perform abdominal thrusts or back blows on a customer who is choking. Despite the state-mandated presence of unattractive first aid posters, many restaurant employees who successfully perform the Heimlich maneuver on a choking victim likely learned the technique from their days as a Girl or Boy Scout or because they previously took a first aid class.

However employees have learned to perform abdominal thrusts, it’s a skill that has helped save the lives of diners from Bethesda, Md., to Corona Del Mar, Calif. To help ensure the safety of their customers, restaurant operators located in states with applicable Good Samaritan laws can try to schedule at least one person per shift who is capable of performing abdominal thrusts. Because people who were previously employed as lifeguards and nannies are usually required to hold a first aid certification, restaurants may already have an employee who can perform abdominal thrusts or CPR, another important life-saving technique we will talk about next.

Cardiac Arrest

The Good Samaritan laws that protect employees who perform the Heimlich maneuver also protect employees who perform CPR on someone who is suffering from cardiac arrest, which can often be caused by a heart attack but can happen to people of all ages and because of multiple conditions. Bystanders and first responders used CPR and a defibrillator to revive a 71-year-old man after he suffered a heart attack at a restaurant in Illinois, and in Bristol, Tenn., a teenaged Pal’s employee used her CPR training to keep an unresponsive toddler alive until paramedics arrived.

According to the Harvard Medical School, “Doing CPR keeps blood circulating until trained and better-equipped first responders arrive on the scene to jump-start the heart back into a normal rhythm.” There are two types of CPR, mouth-to-mouth resuscitation and hands-only, but mouth-to-mouth resuscitation is not always necessary in the case of someone who is suffering from cardiac arrest. Someone who is suffering from a heart attack will not require CPR unless he or she goes into cardiac arrest. In either situation, an employee should immediately call 911.

An AED, or automated external defibrillator, is another option for responding with first aid to cardiac arrest. It’s unlikely that most restaurants will own one of these portable machines, so having an employee capable of accurately performing CPR can be the difference between life and death for a customer suffering from cardiac arrest. Performing CPR at a rate of 100 to 120 compressions per minute is recommended, and it’s often said that this matches up to the beat of “Stayin’ Alive” by The Beegees. However, restaurant employees who receive CPR certification should be more qualified to perform this first aid than the employees of Dunder Mifflin.

Ariana Keller
Ariana Keller

Ariana Keller was raised on the banks of the Chattahoochee River in south Alabama, where she learned to fish and love football. She moved to Knoxville with her family when she was 12 and later graduated from the University of Tennessee with a degree in English. Passionate about Marvel Comics, Harry Potter, and all things geeky, she spends her free time playing tabletop and video games, collecting beer caps from craft breweries around the country, and celebrating the Cubs' 2016 World Series win. She is an advocate for animal rescue and lives in Knoxville with her husband and their two adopted pets: a hound dog named Beau and a Maine Coon mix named Vesper.

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