Safety and Emergency Procedures
Concepts you must understand
Safety questions usually test prevention and priority. Fall prevention: keep the bed low and locked, wheels braked, call light and personal items within reach, non-skid footwear on, floor clear, and answer call lights promptly. Check on residents who cannot call for help. Follow facility policy on bed rails; rails are a safety device, not a restraint, but full side rails used to keep a person in bed can be considered a restraint.
Restraints require a physician's order, the least restrictive option, and frequent monitoring with release, repositioning, and needs checks at intervals set by policy (commonly every 15 minutes for circulation, hydration, toileting, and range of motion). Never apply a restraint as punishment or for staff convenience.
Fire: know RACE (Rescue, Alarm, Contain, Extinguish/Evacuate) and PASS (Pull, Aim, Squeeze, Sweep). In a fire, move residents in immediate danger first and follow the facility's evacuation plan; do not use elevators.
Choking: if the resident can cough forcefully, encourage coughing. If they cannot speak, breathe, or cough, activate the emergency response and begin abdominal thrusts.
Seizures: protect the head, ease the person to the floor, loosen tight clothing, turn to the side, do not restrain or put anything in the mouth, and time the seizure.
Traps in questions
Trying to "catch" a falling resident - lower them gently to the floor instead. Leaving a resident alone in a bathroom or on a toilet. Using water hotter than facility policy allows (usually around 105°F). Applying restraints without an order.
Rule of thumb
Safety first, then the task: before any procedure, ask what could harm this person right now.
Worked example: A resident begins to slide from a chair. The wrong answer is to grab and lift them. The right answer is to widen your stance, lower the resident to the floor protecting the head, stay with them, and call for help.