Safety, Emergency, and Restorative Care
Core concepts
Safety questions test prevention and the correct first action. Fall prevention means keeping the call light within reach, the bed low and locked, the floor clear, non-skid footwear on, and the resident oriented to the room. Use a gait belt for transfers and ambulation, and use body mechanics: feet apart, back straight, load close, lift with the legs.
Restraints are a last resort and a rights issue. Any device that restricts movement, including a vest, wrist strap, or a raised bed rail the resident cannot lower, requires a physician order, a care-plan rationale, release and repositioning at least every two hours, and monitoring of circulation, breathing, and toileting. Try alternatives first: diversion, pain relief, toileting, activity, family presence.
Fire safety uses RACE: Rescue anyone in danger, Alarm, Contain the fire by closing doors, then Extinguish or Evacuate. A small fire uses PASS: Pull, Aim, Squeeze, Sweep. Non-ambulatory residents are moved by blanket drag or carried, never left behind.
For choking, a resident who can cough should be encouraged to cough; a complete obstruction in a conscious adult calls for abdominal thrusts. For a seizure, protect the head, do not restrain or place anything in the mouth, and time the event.
Traps
Questions ask whether to move a fallen resident (do not, until assessed). Incident reports are factual and are not placed in the chart; never assign blame or speculate about cause.
Rule of thumb
In any emergency, the first action is usually to stay with the resident, keep them safe, and call for help.