Rule 54 explained: this guide covers what it means, who it applies to, the step-by-step process, documents required, fees, due dates and penalties in India — so you can stay compliant with confidence and avoid costly mistakes.
Rule 54 requires first aid boxes, a certified first aider on each shift, training for at least 33 percent of workers and arrangements to evacuate seriously injured employees. It adds a separate set of first aid station requirements for mines.
In every factory, mine, building or other construction work, beedi and cigar premise, motor transport undertaking, dock work and plantation, the employer must keep adequate first aid boxes or cupboards (contents in Annexure I) readily accessible, with one fully equipped box in every department or section and a certified worker or supervisor in charge each shift. At least 33 percent of workers must be trained, with refreshers every three years. Mines have first aid stations in listed places and a mine-specific box list in Annexure III.
The Code source
Sections 23 and 24 of the Occupational Safety, Health and Working Conditions Code, 2020 (the OSH Code) cover health, working conditions and welfare facilities as prescribed; first aid is a matter the rules fill in. See our section 23 explainer and section 24 explainer.
Central Rules apply where the Central Government is the appropriate Government. Where the State Government is the appropriate Government, the State's own OSH rules apply. For a first aid and medical-readiness review of your sites, see our labour law compliance service.
The duties, sub-rule by sub-rule
| Sub-rule | Duty |
|---|---|
| (i) | In every establishment or part where employees are at work, first aid boxes or cupboards in adequate numbers, with necessary items, readily accessible during working hours. A notice with details of first aid facilities, the name and contact details of the person in charge and the nearest hospitals is displayed conspicuously in English or Hindi and the local language |
| (ii) | In each shift, every box is in the charge of a worker or supervisor holding a first aid treatment certificate, readily available during working hours. At least one fully equipped box in every department or section. The number of boxes must increase where a department or section has more than 200 employees. The illustrative contents are in Annexure I; the employer may add items |
| (iii) | For mines, the illustrative contents are in Annexure III; the employer may add items |
| (iv) | At least 33 percent of workers in every establishment are trained in first aid; refreshers every three years; where women workers are employed, at least one woman worker is trained. Trainers must have the medical qualifications listed in the sub-rule |
| (v) | Every injury or illness during work is reported to the supervisor for surveillance; adequate and suitable arrangements for speedy evacuation or referral of seriously injured or ill employees to the nearest dispensary or hospital |
| (vi) | An injured employee reports to the certified first aider; if unable, the person who first comes to know reports it |
| (vii) | If the first aider thinks the injury needs immediate medical attention, a qualified medical practitioner is called or the matter is brought to the notice of the occupier or their representative |
| (viii) | The employer or representative ensures speedy transportation to the nearest dispensary or hospital, preferably by a proper ambulance van |
| (ix) | Additional provisions for mines (below) |
The text refers to "the number of boxes has to increase" for departments over 200 employees without giving a ratio. The employer decides a sensible increase and records it.
First aid trainers: sub-rule (iv)
Training must be given by a trainer with a medical qualification included in the First Schedule, Second Schedule or Part II of the Third Schedule of the Indian Medical Council Act, 1956. A person with Part II qualifications must also meet the condition in section 13(3) of that Act, or be covered by Chapter VI of the National Medical Commission Act, 2019, or hold a diploma or degree in industrial health, public health or emergency medicine, or be an Associate Fellow in Industrial Health (AFIH) or equivalent. Check a trainer's certificate against this list before booking a course.
Annexure I: what goes in the box
The annexure lists 17 items, including sterilised dressing pads (small, medium, large), large sterilised burn dressings, sterilised cotton, Cetrimide solution (1%-3%) or 10% Povidone Iodine, scissors, tweezers, tourniquet and disposable gloves, adhesive tapes, elastic crepe and roller bandages, eye pads, analgesic strips (Paracetamol 650 mg), antacid and ORS sachets, analgesic spray, polythene wash bottles with saline or distilled water, splints, resuscitation equipment such as an ambu bag, tablets such as aspirin and isosorbide dinitrate, anti-allergic medicine and eye drops, and a first aid leaflet with emergency numbers of nearby hospitals. The annexure is illustrative; the employer may add more.
Check the dates on any medicines in the box on a fixed schedule. The text sets no schedule, so decide your own and record it.
Mines: sub-rule (ix)
| Item | Requirement |
|---|---|
| Training | Adequate and suitable arrangements to train workers and supervisors in first aid |
| First aid station | At every mine, equipped as in Annexure V (stretcher with two blankets, inflatable splints, patient examination table, and a first aid box with Annexure I contents) |
| Above ground | At the top of every shaft or incline where men or material are normally wound or hauled; in every workshop; at every screening plant and loading place; and at every other place where more than 50 persons are employed at one time |
| Opencast | At every shovel or dragline loading point; at rest shelters and portable rest shelters, if any; at the pumping station; at the refuelling station; at the dump yard; and at every other place where more than 50 persons are employed at one time |
| Below ground | At the bottom of every shaft where men or material are normally wound, and at or near every plant; near the drive end of every haulage; and in or at the entrance to every district or section. No station needed within 300 metres of another |
| In charge | A person in charge keeps equipment in good order and replenishes it; each station is under a worker or supervisor with a first aid certificate from an institute recognised by the Central or State Government |
| Records | An up-to-date list of all first aid stations is kept in the mine office |
| Carrying outfit | Every supervisor or official with a valid first aid certificate carries a first aid outfit on duty: one large and one small sterilised dressing, adhesive bandage, skin closure strips, cotton balls, antiseptic solution and rounded-tip scissors, securely packed against dirt and water |
The printed text numbers some of these clauses (iv) to (vii) under (ix) in a way that overlaps with the main sub-rules (iv) to (vii). Read them as part of the mines provision.
Consequences
Rule 54 states no penalty of its own. Contravention is dealt with under the Code's penalty provisions; see our section 94 explainer. For the older Factories Act framework on first aid, see our guide to welfare provisions under the Factories Act.
Practical examples
Example 1. A factory with 300 workers has a stores department of 250 employees. Because the department has more than 200 employees, the employer increases the number of boxes in it and keeps a certified first aider in charge on each shift.
Example 2. A construction firm with 90 workers must train at least 33 percent, which is 29.7, so 30 workers is the safe figure (the text does not address fractions), and keep a refresher cycle of every three years. If women are on site, at least one woman is trained.
Example 3. A below-ground mine has a first aid station at the entrance to District 4. A new haulage drive end is only 200 metres from it, so under the proviso no additional station is required there, though a station is still needed where other listed places exist.
Need help with first aid compliance?
First aid compliance lives in logs: who is certified, when refreshers are due, and what is in each box. Our labour law compliance team can help you build a first aid register and a training calendar that tracks the 33 percent target.
Key takeaways
- Rule 54 covers seven kinds of workplace.
- First aid boxes follow Annexure I; mines also use Annexures III and V.
- A certified worker or supervisor is in charge of each box in each shift.
- At least 33 percent of workers must be first aid trained, with refreshers every three years and at least one woman where women are employed.
- Evacuation arrangements are required, preferably by ambulance van.
- State rules apply where the State is the appropriate Government.
Read next
- Rule 53: canteen
- Rule 55: ambulance room
- Rule 56: shelter and rest room
- Welfare provisions under the Factories Act: canteen, shelter, crèche, first aid
Disclaimer: Based on the Occupational Safety, Health and Working Conditions Code, 2020 (as enacted) and, where noted, the Occupational Safety, Health and Working Conditions (Central) Rules, 2026 (G.S.R. 345(E), 8 May 2026), as on 30 September 2026. The Code is in force from 21 November 2025; some provisions may be notified later, and State Governments make their own rules for establishments where the State is the appropriate Government. Verify the current position before acting.