Safety and Emergency Response
What you must understand
Fall prevention is the core of daily safety: bed in the lowest position, brakes locked, call light within reach, non-skid footwear, clear pathways, adequate lighting, a toileting schedule, and answering call lights promptly - most falls happen on the way to the bathroom.
Restraints are a last resort, not a convenience. They require a physician's order for a specific medical symptom, the least restrictive device first, the shortest possible time, a quick-release knot never tied to side rails, frequent circulation checks and release per facility policy, and removal as soon as possible. Full side rails used to keep a resident in bed are a restraint, not furniture.
Emergencies
- Fire: RACE - Rescue, Alarm, Contain, Extinguish or Evacuate. Pull-Aim-Squeeze-Sweep for extinguishers. Never use an elevator.
- Choking: encourage coughing; if the airway is truly blocked and the resident is conscious, give abdominal thrusts; if unconscious, ease them to the floor and call for help and CPR.
- Seizure: protect the head, do not restrain and put nothing in the mouth, time the seizure, turn the resident to the side afterward, and report.
- Body mechanics: wide base, bend the knees, keep the load close, do not twist, and get help or use a lift rather than improvising.
Traps
Restraining a confused resident as a first response to falling; leaving a resident alone in a bathroom; assuming a fall must be reported only if the resident is hurt (report every fall); and blocking a fire door with equipment.
Rule of thumb
The safest restraint is the one you never apply: try positioning, toileting, distraction, and closer observation first, and document what you tried.