Safety and Emergency Response
What this domain covers
This domain asks what you do before, during, and right after an unsafe event: falls, fires, seizures, choking, bleeding, poisoning, and disasters. The best answer usually protects the resident first, keeps you with the resident, and gets the nurse there fast.
Core concepts
Fall prevention means a low bed, locked wheels, call light within reach, non-skid footwear, a clear path, adequate lighting, and frequent checks on high-risk residents. Restraints require a specific order and are never a substitute for supervision. If a resident begins to fall and you are close, lower them gently to the floor while protecting the head; do not try to catch them or drag them back to bed, and do not move them if injury is suspected - cover them, stay, and call for help.
For fire, use RACE: Rescue anyone in danger, pull the Alarm, Contain the fire by closing doors, then Extinguish or Evacuate. For a seizure, protect the head, move furniture away, do not restrain the limbs or put anything in the mouth, time the seizure, and report it. For choking, ask whether the person can speak; if they cannot, call for help and begin abdominal thrusts. For bleeding, wear gloves and apply direct pressure.
Traps that appear in questions
- Leaving a resident alone on the floor to go find help instead of staying and using the call light or shouting.
- Writing that an incident report was completed in the progress notes. Incident reports are separate internal documents; the chart records only objective facts about the resident's condition and the care given.
- Inducing vomiting after a poisoning, or giving food or drink to an unconscious resident.
Rule of thumb
Stay, protect, call. Never leave a resident in an unsafe position to look for someone.
Worked example
A resident with a history of seizures stiffens and falls to the floor. Correct action: ease furniture away, cushion the head, loosen tight clothing at the neck, time the event, stay with the resident, turn them to the side once jerking stops, and report the seizure and its length to the nurse.