Safety and Emergency Procedures
Safety work is mostly prevention: call light within reach, bed in the lowest position, wheels locked, side rails used only as ordered, floor dry, path clear, clothing and shoes that fit. The resident most likely to fall is one who is new, on a diuretic or sedative, confused, or in a hurry to reach the bathroom. Toileting schedules prevent more falls than any alarm.
Restraints are a legal minefield. A restraint is anything that restricts free movement and cannot be removed by the resident - belts, vests, mitts, and even a tray table or a raised side rail used to keep someone in bed. They require a physician's order, the least restrictive option, release and repositioning at least every two hours, and monitoring of circulation, skin, and needs. Never apply one as punishment or for staff convenience.
Fire: RACE - Rescue anyone in danger, Alarm, Contain by closing doors, then Extinguish or Evacuate. Pull the alarm and follow the facility plan; never use an elevator. PASS covers the extinguisher: Pull, Aim, Squeeze, Sweep.
Choking: if the resident can cough, encourage coughing. If the airway is completely blocked, call for help and give abdominal thrusts; use chest thrusts for an obese or pregnant resident; for an unresponsive resident begin CPR and use the AED when it arrives.
Seizure: protect the head, do not restrain, put nothing in the mouth, time it, turn the resident to the side afterward, and report.
Trap: choosing raised side rails as a fall-prevention answer for a resident who can climb over them.
Rule of thumb: prevent, position, and report - never improvise a restraint.