Safety and Emergency Procedures
Safety questions usually describe an emergency and then ask for your first action. The answer is almost never documentation or calling the family.
Core concepts
- Fall prevention: bed in the lowest position, brakes locked, call light and personal items within reach, non-skid footwear, good lighting, clear pathways, prompt answers to calls. Report any new confusion or change in balance - both predict falls.
- Fire: RACE - Rescue anyone in immediate danger, Alarm, Contain (close doors), Extinguish or Evacuate. PASS for the extinguisher: Pull, Aim, Squeeze, Sweep. Never use water on an electrical fire and never prop fire doors.
- Restraints: only to treat a medical symptom, only with an order, only the least restrictive device, and never for convenience, discipline, or staffing. Release, reposition, check circulation, offer food, fluids, and toileting, and document.
- Oxygen safety: no smoking, no open flame, no petroleum-based ointments, no wool or synthetic fabrics that spark.
- Incident reports: factual, objective, per facility policy, never mentioned in the medical record, and never assigning blame.
Traps
"Do not move the resident" is correct after a fall with possible injury, but in a fire you do move the resident out of danger. Another trap: charting "incident report filed," which belongs in the report, not the chart.
Rule of thumb
In any emergency: keep yourself and the resident safe, call for help, and stay with the resident. Never leave someone alone on a toilet, in a tub, or on a shower chair.
Worked example
You find a resident on the floor. Do not lift them. Stay, check responsiveness and breathing, call for the nurse, keep them warm and still, and note exactly what you saw and what the resident said.