Safety, Infection Control, and Emergency Response
What the exam expects
This domain combines medical asepsis with emergency action. Wash hands with soap and water for at least 20 seconds - and always with soap and water, not alcohol rub, when caring for a resident with C. difficile or norovirus, because alcohol does not kill spores. Standard precautions mean treating all blood, body fluids, secretions, non-intact skin, and mucous membranes as potentially infectious. Know the PPE sequence: gown, mask, goggles, then gloves when donning; gloves come off first, then goggles, gown, and mask last, with hand hygiene after. Transmission-based precautions add contact, droplet, or airborne (N95 respirator) measures on top of standard precautions. Sharps go into a puncture-resistant container without recapping. For spills, remove visible material first, then disinfect.
Safety and emergency actions
Know RACE for fire (Rescue, Alarm, Confine, Extinguish/Evacuate) and PASS for the extinguisher (Pull, Aim, Squeeze, Sweep). Falls prevention means bed low and locked, call light in reach, non-skid footwear, clutter removed, and answering calls promptly. For choking, encourage coughing first; if the airway is obstructed and the resident cannot speak or breathe, give abdominal thrusts, and start CPR if they become unresponsive. During a seizure, protect the head, do not restrain, put nothing in the mouth, time the event, and turn the resident to the side afterward. CPR for adults is 30 compressions to 2 breaths at 100–120 per minute, about 2 inches deep. Restraints require a provider's order and frequent checks for circulation, position, and needs.
Traps
Alcohol rub will not do for C. diff. The mask is removed last, not first. Elevators are not used during a fire. Never leave a resident alone in a bathroom or on a toilet. Never place anything in the mouth of a seizing resident.