Safety, Emergency Procedures, and Restraints
Preventing the fall before it happens
Most safety questions come back to a few basics: bed low and locked, call light and personal items within reach, non-skid footwear, clear pathways, spills wiped immediately with a wet-floor sign, and adequate lighting. Use a gait belt for transfers and never lift a resident by the underarms or by pulling on the arms. Use mechanical lifts per policy. Report any change in balance or new weakness.
Fire response follows RACE: Rescue anyone in immediate danger, pull the Alarm, Contain the fire by closing doors, then Extinguish or Evacuate per policy. Small fires use PASS on the extinguisher - Pull, Aim, Squeeze, Sweep. Horizontal evacuation moves residents past fire doors first.
For choking, use abdominal thrusts if the airway is blocked and the resident cannot speak or cough. For a seizure, protect the head, do not restrain or put anything in the mouth, and time it. For unresponsive residents, call for help and start CPR/AED if trained and authorized.
Restraints are the highest-risk topic. A restraint is anything that limits freedom of movement and cannot be removed by the resident - including some side rails and lap belts. Restraints require a physician's order, the least restrictive option, use only for a documented safety need, regular release and circulation checks per policy, and never punishment, convenience, or staff shortage. Try alternatives first: toileting schedules, activities, repositioning, alarms, family presence. Never tie a restraint to side rails or leave a restrained resident alone.
An incident report is an internal, factual document - do not chart that a report was filed in the medical record.
Rule of thumb: RACE for fire; no restraint without an order and frequent checks.