Deep Creek Planning Package (Leaders Pack)

Table of Contents
Deep Creek Planning Package (Leaders Pack) ................................................................................................... 1
Participant Information ................................................................................................................................. 2
Overview .................................................................................................................................................... 2
Participant Role ......................................................................................................................................... 2
Leader / Supervisor’s Role ......................................................................................................................... 2
Emergency Contact.................................................................................................................................... 3
Staff............................................................................................................................................................ 3
Camp Logistics Outline .................................................................................................................................. 4
Expedition Day 1 ........................................................................................................................................ 4
Expedition Day 2 ........................................................................................................................................ 4
Expedition Day 3 ........................................................................................................................................ 4
Vehicles...................................................................................................................................................... 4
Camp Sites ................................................................................................................................................. 5
Phone Procedures ..................................................................................................................................... 5
Emergency Response Contacts.................................................................................................................. 5
Emergency Response Procedure ............................................................................................................... 6
Expedition Organisational Roles .................................................................................................................... 7
Route Planning Sheet (Route Card): .............................................................................................................. 8
Menu Plan...................................................................................................................................................... 9
Equipment List for 3 Day Expedition ........................................................................................................... 10
Incident Form .............................................................................................................................................. 11
Accident Report Form.................................................................................................................................. 13
Risk Assessment........................................................................................................................................... 14
Maps ............................................................................................................................................................ 20
Medical Summary ........................................................................................................................................ 23
(to be attached) ....................................................................................................................................... 23

Page 1 of 23
Participant Information
Overview
The Bushwalk at Deep Creek C.P. is designed as an introduction to expeditions in an outdoor education
context. During this time you will be carrying your own food, water, cooking equipment, tent, medication,
personal toiletries and sleeping equipment for 2 nights and 3 days. You will receive further instruction in
navigation, camp-craft, group management, emergency response and environmental education
methodology.
You will be given an opportunity to lead in pairs under staff supervision for sections of the walk,
allowing you to practice group management strategies with your peers in preparation for group leadership
roles with dependants. To promote greater learning about the natural environment you will be required to
present a ‘micro-tutorial’ as part of the assessment for the topic, whereby each student researches an
allocated aspect of the natural environment and throughout the walk attempts to engage the rest of the
group in learning about this topic. Each night there will be a debrief about what was learned about
bushwalking, leadership, camp skills and the environment. The experience is intended to prepare you for
your mentor role with the 14-day quest experience.
The following is a summarised guide to expedition timing, but there may be individual differences
for each trip. The actual expeditions are for three days and two nights. Arrangements for collection of
expedition equipment will be finalized prior to the date of the camp. On the day of departure, we meet at
Flinders University, outside G building in car park 13.

Participant Role
Whilst on the expedition, you will be camping in tents, and moving campsites each night. You will take it in
turns leading the group under supervision of the field supervisor who will intervene as required to
maximise student learning and to ensure safety of the group. You will provide and cook your own meals.
The group will always travel only as fast as the slowest member and routes will be changed to
accommodate individual group members should this be required. You must contribute appropriately to the
group, it’s functioning and achievement of common goals. You will also be required to adhere to quality
camping and leave no trace principles.

Leader / Supervisor’s Role

All Field Trip Supervisors have completed either a certificate IV or Bachelor degree (most with education
degrees), have a minimum of Bushwalking Leadership Certificate and will carry a mobile phone and group
first aid kit. Where possible they will meet with your group prior to expedition. At 8.30 am leaders will meet
their groups, check plans and that all safety equipment is taken by students. The field trip supervisor will
outline expectations and clarify any organisational tasks that need to be done, including leadership roles.

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The field trip supervisor will give feedback at the end of each day in a debriefing session to leaders and
group members and will provide marks for group members at the end of the expedition.

Emergency Contact
During the expedition, students are asked not to turn on their mobile phones. Should there be an
emergency, all details and emergency contact information will be recorded in the Field Trip Pro-forma that
will be registered on FlinSafe and left a nominated contact person (Joss Rankin or Stan Flavel).

Staff
Dave Rawson Group TBC 0412 158 302

Walter Olenich Group TBC 0417 808 169

Joss Rankin Group TBC 0402 714 798

Our Group
Group Number:

Group Leader:

Participants:

Group Goals and Norms:

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Camp Logistics Outline
Expedition Day 1
8.00 am: Staff arrive to collect vehicles and transport to G Building. Check leader packs.
8.30 am. Students arrive. Loading gear, checking group, meeting leaders, clarify
responsibilities.
9.00 am: Checking and briefing by leaders.
9.00-9.30: Departure.
10.30: vehicle 1 (staff TBC) to headquarters
vehicle 2 (staff TBC) to headquarters
vehicle 3 (staff TBC) to Aaron Creek picnic area

Expedition Day 2
Walking through Deep Creek C.P. See group specific walk plans. 2 groups HQ to AC (E-W), 1 group AC to HQ
(W-E)

Expedition Day 3
Approx 3.30 pm: Return to Flinders University. Return and clean equipment and vehicles.
Approx 4.00 pm: Final debrief with leaders
Approx 4.30 pm: Dismissal
Please note that this timetable is not guaranteed. A range of factors may impact on these times (group
overdue, vehicle breakdown, traffic, wet equipment, etc.) Please do not make plans that rely on these
return times.

Vehicles
3 vehicles have been booked this year:
Group 1 – staff TBC to drive vehicle 1 to HQ start point
Group 2 – staff TBC to drive vehicle 2 to HQ start point
Group 3 – staff TBC to drive vehicle 3 to Aaron Creek Picnic Area

At the end of the walk

Group 1 – staff TBC to drive vehicle 3 with staff TBC from Aaron Creek to HQ to collect vehicle 1 then to
bakery
Group 2 – staff TBC to go with staff TBC in vehicle 3, collect vehicle 1, return to collect group then to bakery
Group 3 – staff TBC to drive vehicle 2 to bakery

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Camp Sites
Wednesday Night

Tapanappa 10, 11 and 12 Groups 1 and 2

Eagle Water Hole Group 3

Thursday Night

Cobbler Hill 1 and 2 Group 1

Eagle Water Hole Group 2

Tapanappa 10 and 11 Group 3

Phone Procedures
1. Camp leaders to turn phone on from 7pm-8pm whilst on camp.
2. Camp leaders to turn phone on from 12.00 pm on the last day.
3. No news is good news, no contact needed unless incident or emergency has occurred (follow
emergency response procedures below).
4. In an emergency and unable to get phone reception rescue-me or equivalent are provided.
5. Other (student) phones not to be used unless emergency
6. Notification of any incidents to university contact. To be done as soon as practical following
management of event.

Emergency Response Contacts

Phone Coverage - Telstra – reasonable (excellent on high ground)
Hospital Victor Harbor 8552 0500
Flinders Medical 8204 5511
Royal Adelaide 7074 0000

Emergency Services Emergency 112

SA Police Assistance 131 444
Victor Harbor Police 8558 2014

National Parks Ranger (24hrs) 8598 0263

University Contact Stan Flavel 0407 600 358

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Emergency Response Procedure

Incident Apply first aid if necessary and manage the group

Keep record and monitor

Contact university contact as soon as practical

If exit is needed then exit according to route plan strategy for location and contact student
emergency contact to collect

If no option for collection, alter trip to exit to nearest vehicle

Emergency Have students Call emergency response from mobile 000 or 112 (follow incident report
form included)

Manage group and apply first aid

Debrief group to what is happening. Group members positioned to help identify casualty
site for emergency services.

Prepare group and victim for evacuation via route plan strategy

Contact university contact and emergency contact as soon as practical

Contact or leave message with other group leaders

The effective management of any incident in the field will, for the most part rely on sound judgement and
decision making from the group leaders on the scene.

University to be consulted regarding student and staff support and counselling.

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Expedition Organisational Roles
The expeditions are planned by your group with advice and support from staff.
Organisational Role Details
1. Co-ordinators Ensure all other roles are completed.
TBC Ensure Expedition pro-forma is filled out and returned to course coordinator
Introduce supervisor and group if needed
Ensure Fieldwork & Safety Checklist is complete
Ensure all clean up tasks are completed
2. Transport Prior to departure:
(Assist drivers with Check oil, coolant, tyres, trailer lights & connections
Navigation etc) Ensure each vehicle has vehicle first aid kit and tool kit.
TBC Ensure all equipment is loaded and secured.
Fill vehicle at fuel stops and wash windscreen as needed.
Ensure head count correct at each stop.
Obtain travel map for the route taken and distribute to rest of group
Supervise vehicle cleaning at end of trip
Create signs for vehicles
3. Medicals and Download medical form and distribute copies to all group members
Menus Collect medicals and collate information on field trip pro-forma
TBC Attach completed medical sheets to field trip pro-forma
Check any payments required and ensure receipt number and date paid are recorded in field trip pro-forma
Ensure menu plans are completed and an example included
4. Route Plan Establish route for expedition.
TBC Establish emergency exits for area.
Complete route card in field trip pro-forma
Inform group of plans
5. Emergency Establish potential emergency exits in conjunction with route planners and emergency services contacts
procedures Group emergency equipment (eg phone)
TBC Establish emergency plan(s) for the areas
Establish & check phone numbers and location of local emergency services
Collate information in field trip proforma
6. Trip Intentions Complete National Parks trip intentions form and attach to field trip proforma
TBC Check camp sites bookings and cross check with rout plans
Check appropriate bookings have been made
7. Equipment Cross check with emergency group to ensure group equipment collected and issued, including trowel, maps,
TBC compasses, tool kit, shelters, spots, walkie talkies and first aid kits.
Coordinate borrowing, drying and returning of equipment
Assist with distribution and return of equipment as required
8. Ecological Assist with reducing ecological footprint by encouraging minimal packaging, facilitating recycling, and
footprint collecting any recyclables upon return to Flinders University
ALL Monitor during the camp experience

Organisational Role Micro Tutorial Group 1 Group 2 Group 3

Coordinator 1 Choice
Coordinator 2 Choice
Transport 1 Invasive Species
Medicals and Menus 1 Aboriginal culture
Medicals and Menus 1 Aboriginal culture
Route Plan 1 Sustainable practices and Strategies
Route Plan 2 Sustainable practices and Strategies
Emergency Procedures 1 Flora and Fauna
Emergency Procedures 2 Flora and Fauna
Trip Intentions Astronomy
Equipment 1 Camp fire games
Equipment 2 Camp fire games

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Route Planning Sheet (Route Card):
1 sheet for each day
Student Groups are responsible for their own route plans. Below is the planning card to complete and provide on the
day of the walk. Please see attached maps and camp outline for the general planned routes.
Group: ________ Area: ______
Dates: ________ Day: ___Activity___ _____________
Field trip supervisor: ______________________________Student coordinator:____________________________
Prepared by:__________________________________________________________________________________
Map [s]: ________________________________________________________
Stage Objective Bearing km height time for E. T. A Terrain/Remarks/Evac
(describe and grid ref) (grid ref) (initial) + or - stage Route for Stage
Start

+
totals -
Evacuation and phone range routes:
1. 2. 3.

Time Calculations (Naismith’s Rule): For novices: 3-4km/hr for easy terrain; 2-3 km/hr for light scrub; 1-2 km/hr for heavy scrub,
scrambling. Add 1 hour for every + 500m, add 1 hour for every - 1000m.

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Menu Plan
Day One Day Two Day Three
Breakfast At Home

Lunch

Dinner At Home

Snacks

Drinks

Suggestions:
Breakfasts: Cereals, muesli with powdered milk, porridge, muffins with spreads such as jam, peanut butter, fresh
fruit.

Lunch: Pitta bread, crackers, rice slices topped with cream cheese, cheese, metwurst, tuna, tomato, lettuce, alfalfa,
capsicum, spreads, and fresh fruit

Dinners: Pasta, rice or noodle dishes enhanced with dehydrated vegetables and fresh vegetables, spices, tuna,
sauces. Deserts of cheesecake, jelly, rice pudding, chocolate mousse, cookies, hot chocolate. Can be supplemented
with cup a soups or two minute noodles.

Snacks: Dried fruit, fruit cake, scroggin- a mixture of dried fruit, nuts, seeds, lollies, chocolate (be aware of allergies)

Drinks: Water, Milo, drinking chocolate, tea, coffee, cup a soup.

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Equipment List for 3 Day Expedition
(this is a general list – please consider weather forecast)

Personal Clothing Food and Water

2 shirts with collars and sleeves Water (6L minimum) no fill ups
1 pair of shorts Food planned with partner (lightweight)
1 pair of pants Items suitable per pair
1-2 wool or fleece jumpers Tent/fly sheet can be borrowed
Thermals (top and bottom) Ground sheet can be borrowed
2 -3 Underwear and socks Trangia (no other stoves) can be borrowed
Legionnaires or brimmed hat Fuel bottle can be borrowed
Beanie Methylated spirits
Walking shoes Matches / lighter
Rainjacket can be borrowed Tea towel
Sunglasses Small detergent and scourer
Personal Toiletries 10m chord
Suncream and lip balm Repair tape
Personal first aid kit Map and compass can be borrowed
Personal Medication Optional Items
Toiletries (toothbrush, paste, sanitizer, etc) Spare pair of track shoes or sandals
Baby wipes (no showers) Woollen or fleece gloves
Portable toiletries (trowel/paper/sanitizer) Waterproof pants
Personal Equipment Camera
Headtorch and spare batteries Cards
Pencil and Notebook Book to read
Pocket knife Small sewing kit
Bowl and cup PLB
Utensils (spoon and fork) Leg gaiters
Personal repair kit Leave Behind
Money for bakery, etc… Cigarettes
Sleeping bag with hood (atleast 0 deg comfort rating) can be Non-prescription drugs
borrowed but must provide liner sheet
Sleeping mat can be borrowed Alcohol
Whistle Electronic devices other than communication
Rucksack can be borrowed Inflated egos
Mobile phone Music devices
Micro tutorial info and copy for leader Judgement
Worries

Group Equipment

 Trowel and toilet paper

 Emergency shelter
 PLB and GPS
 First aid kit and medical information

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Incident Form
(YOU MUST FILL IN THIS FORM FOR AN ACCIDENT THAT HAS CAUSED INJURY OR WHERE CONDITIONS REQUIRE
MEDICATION OR ONGOING TREATMENT)

Name (patient)……………………………………………………………..…………… Date………………………………

Summary - Emergency Services Contact Information

We require an ambulance. My name is………………………………… We are a University group. Our location

is…................................................................................................................................. (grid reference and description)
We have a casualty who is a ……………………..year old male/female whose Chief Compliant is:
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………......(symptom)
The patient states/witnesses state: (Mechanism of injury/History of present illness)
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
Observations patient found (describe position). Patient exam reveals (observation / injury). Vital Signs at (time).
Patient Exam
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
Vital Signs
NORMAL 1 2 3 4 5 6
TIME
General
details

HR 50-100bpm

RR 12-20
(breaths/min)

SCTM PINK/WARM/DRY

TEMP 37 deg

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HISTORY
Symptoms…………………………………………………………………………………………………………………………………………………………………….
Allergies……………………………………………………………………………………………………………………………………………………………………….
Medications………………………………………………………………………………………………………..……………………………………………………….
Pertinent medical history…………………………………………………………………………………………………………………………………………….
Last intake/output………………………………………………………………………………………………………………………………………………………
Events…………………………………………………………………………………………………………………………………………………………………………

ASSESSMENT (Problem list)………………………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………………
………………..…………………………………………………………………………………………………………………………………………………..

PLAN (Plan for each problem on assessment sheet)……………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………..

ANTICIPATED PROBLEMS…………………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………………………..

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Accident Report Form

Date of Accident_____________ Time of Accident ________________

Student Involved ____________________________

Location of Accident ___________________________________

Nature of Injury

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_____________ ____________________________________________________________

Description of Accident

________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Action taken by staff member

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Name of witness or others present

_________________________________________________________________________

_________________________________________________________________________

Medical Referral ____________________________________________________________

Signature ________________________ Date _________________

Leader in Charge signature _______________________

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Risk Assessment

FIELD TRIP RISK ASSESSMENT FORM

Department Location Area Supervisor

CEPSW DEEP CREEK CONS. PARK Joss Rankin and Walter Olenich
Assessed by: Date Review Date
Joss Rankin & Dave Barber 25/9/19 to 27//9/19 28/06/19

Item Hazard P C RA Control Action by

Appropriate licences & training, appropriate vehicle. Driver has rest Field Trip Leaders
Motor vehicle accident U M M
Field Trip: General break every 2 hours and all Participants

Field Trip Leaders

Exposure to elements U m M Monitor local conditions, sunscreen, appropriate shelter
and all Participants

Sufficient water, at least 1.5 litres per person per day, appropriate Field Trip Leaders
Heat Stress/ Dehydration U M M
clothing and all Participants

Field Trip Leaders

Medical emergency U M M Appropriate medication, mobile communication
and all Participants

Field Trip Leaders

Bites and Stings U M M Mobile communication, first aid kit
and all Participants

Field Trip Leaders

Slippery surface, footing U M M Appropriate footwear, team lifting, limit size of loads
and all Participants

Field Trip Leaders

Manual handling U m M Appropriate footwear, team lifting, limit size of loads
and all Participants

Field Trip Leaders

Natural disaster (e.g. bushfire) U M M Emergency planning, communication, street directory
and all Participants

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 Item Hazard P C RA Control Action by
Field Trip Leaders
Alcohol/recreational drug use U M M No alcohol/recreational drugs on field trips
and all Participants

On arrival emergency evacuation points to be identified and local Field Trip Leaders
Emergency Evacuation U M M
procedures followed. To be communicated to participants and all Participants

Mobile coverage to be checked and phones charged and can be re- Field Trip Leaders
Lack of communication P M M
charged. Consider satellite phone and all Participants

Can you identify any NO  Adequately controlled. No further action required, proceed to Summary of Risk and Signature block.
further hazards?
Further hazards identified. Proceed further with Risk Assessment
YES

ADDITIONAL HAZARDS

Item Hazard P C RA Control Action by

Licensed drivers, Restricted speed on program

Field Trips: General/ Transport to site Vehicles serviced and roadworthy, university vehicles, commercial licensed Field Trip Leaders
HU M M
Bushwalking Motor vehicle, Bus operators and all Participants

Safety brief by group leader

State appropriate/acceptable behaviours

Vehicle accidents due to traffic Field Trip Leaders
U M M Supervision by leader/ staff
Public roadways and all Participants
All to apply common sense and traffic awareness

Follow road rules, Monitor group numbers

Monitoring of group/ individual progress by leader, rest of group

Field Trip Leaders
Fatigue L m M Ensure adequate rest breaks
and all Participants
Amend program if considered necessary

Exposure to elements U m M Monitor local conditions, sunscreen, appropriate shelter Field Trip Leaders

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 Item Hazard
Tenting/ Overnight Camping,
equipment failure
Poor self/ group Hygiene
Heat stress/ Dehydration
Inadequate nutrition and hydration
Field Trips: Bushwalking
Slippery surface, footing
(cont.)
Page 16 of 23
P C RA Control Action by
Equipment/ clothing checks pre departure and all Participants
Appropriate site
* Emergency response plan
Self monitoring
Briefing pre-departure.
Approved DE&H camping sites, long drop toilets, rain water tanks on site.
Camping stoves (trangias) all participants trained in correct use prior to trip.
Field Trip Leaders
U m m Self, group and leader monitoring when in use, cooking circles
and all Participants
All tents/camping equipment inspected and repaired pre/ post field outings, all
participants trained in correct use.
Carry appropriate clothing (thermals, waterproofs, hats, fleece tops etc.) for
conditions
Safe hygiene practices adopted, use of anti-bacterial washes.
Eating utensils cleaned after each use Field Trip Leaders
U m m
Correct toiletry techniques, trowels, loo paper carried by all participants, and all Participants
appropriate waste disposal practices demonstrated prior to departure, all
participants demonstrate competency in safe food, waste management.
Sufficient water and spare available, appropriate clothing, hats, sun bloc,
Field Trip Leaders
L M M sunglasses, amend program as required
and all Participants
Monitor weather forecasts
Briefing pre-departure
Monitoring by group leader/ self monitoring by participants
Field Trip Leaders
U m M Rain water at camping sites, ensure sufficient carried to cover for 2 days,
and all Participants
monitor self, group use
Menu plans established pre departure, appropriate variety, quantity carried.
Enclosed/ solid footwear, team lifting, limit size of loads Field Trip Leaders
U M M
Safety briefing to group and all Participants
 Item Hazard P C RA Control Action by
Appropriate footwear, team lifting, limit size of loads Field Trip Leaders
Manual handling U M M
Demonstration of correct techniques by leader and all Participants

Emergency planning, communication, first aid training Field Trip Leaders

Remote Area Work U F H
GPS carried by all groups and all Participants

Emergency planning, communication

Monitor weather forecasts

Natural disaster (e.g. bushfire)
Field Trip Leaders
U M M Safety brief to group
and all Participants
Proceed to designated evacuation location (ie: Forest HQ, Tapanappa C.G.,
Tent Rock Rd.)

No alcohol/recreational drugs on field trips Field Trip Leaders

Alcohol/recreational drug use U M M
Group monitored, amend program and /or student removal by parents/taxi and all Participants

Prior training/ demonstration by leader

Loss/ lack Of Equipment/ Constant monitoring throughout activity Field Trip Leaders
U N N
inappropriate use Personal responsibility for issued items and all Participants

Spares available

Monitor weather
Field Trip Leaders
Electrical storms P M M Move to safe location
and all Participants
Amend program

Identified in advance Field Trip Leader

Hazardous locations (Generic) U M M
Review route plans/ identify safe route and all Participants

Field Trips: Bushwalking Specific location dangers (ie: Crux Identified in advance Field Trip Leaders
U M M
(cont.) points) Review route plans/ identify safe route and all Participants

Prior training Field Trip Leaders

Poor Navigation strategies U M M
Establish trip intentions and all Participants

Page 17 of 23
 Item Hazard P C RA Control Action by
Constant monitoring of group position

GPS carried by all groups while in the field

Apply control measures. Return to last known position phone trip leader.
DECS ratios.

Student briefing pre departure

All participants issued with route plan/map emergency contact numbers Field Trip Leaders
Lost HU N M
All participants to carry whistles and all Participants

Front and back markers or other control measures

Route plans, trip intentions lodged with Parks (Deep Creek HQ) prior to
departure

Field Trip Leaders

Participant mis-behaviour U m M Instructors appropriately qualified or experienced
and all Participants

SUMMARY OF RISK Review the risk measured, and the controls, then please select the relevant risk summary statement:
A The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is not currently significant

B The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant, however controls are in place that reduce risk to
acceptable levels 
C The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant. Interim controls are in place to reduce risk to
acceptable levels.

Signed: (Field Trip Leader) Joss Rankin Date: 28/06/19

Signed: (Field Trip Leader’s Supervisor) Date:

Signed: (School Dean, Nominee or Work Area Manager) Date:

Page 18 of 23
 GUIDE TO ASSESSING RISKS AND IDENTIFYING HAZARDS

Probability - Risk Factors → Consequence - Risk Factors →

Very Likely Fatality

Probably occur immediately or within a short period of time May cause death or loss of facility
VL F

Likely Major
Probably occur in time Severe injury or illness or major property damage
L M

Possible Could happen occasionally Minor

Minor (usually reversible) injury or illness resulting in days off work or minor property damage
P m

Unlikely First Aid

Could eventually happen First aid level treatment
U FA

Highly Unlikely Negligible

Has potential to occur, but probably never will No medical treatment
hU N

Forms of Hazard
Physical Mechanical action, impact, electrical exposure, heat/cold, noise, vibration, explosion etc.
Chemical Corrosive liquid, toxic gases, noxious fumes etc.
Ergonomic Height of workbench, design of chair, set-up of a work station etc.
Radiation x-ray machine, infrared beams etc.
Psychological Stress from using equipment without proper training or instruction, interpersonal conflict
Biological Sharps, specimen containers carrying infected material, viruses from A/C system
Sources Environment Substances Equipment/plant Work systems
Risk Matrix Probability Control Hierarchy
Very Likely Possible Unlikely Highly
Elimination Is it necessary
Consequence likely unlikely

Fatality F Extreme High High High Medium Substitution Is there a less hazardous alternative

Major injury M High High High Medium Medium Isolation Eg Restrict access, use in a closed container, fume
cabinet

Minor injury m High Medium Medium Medium Medium Engineering Eg Trolleys to move loads, guards on machinery, Fume
cupboard

First aid FA Medium Medium Medium Low Low Administration Eg: Training, Safe Work Procedure, signage

Negligible N Medium Medium Low Low Low PPE - Personal Eg: Gloves, respirator, safety glasses
Protective Equipment

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Maps

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Page 21 of 23
Page 22 of 23
Medical Summary
(to be attached)
Please list all participants including staff and volunteers

Group Number:

Name Phone Number *Relevant medical information including allergies Medications Emergency contact Emergency contact
person/next of kin phone number

Page 23 of 23