Safety and Emergency Procedures
What you must know
Safety starts with the environment. Keep the bed in the lowest position with wheels locked, side rails used only as ordered (never as a restraint), the call light and personal items within reach, non-skid footwear on, and clutter cleared. Answer call lights promptly and make scheduled rounds - most falls are linked to unmet toileting, pain, and equipment needs.
Restraints: physical or chemical restraints require a physician's order, the least restrictive device, and frequent monitoring - check circulation and skin, release and reposition at least every two hours, and offer fluids and toileting. Never tie a restraint to a side rail or bed frame, never use a restraint as punishment or convenience, and know that a device the resident cannot remove on their own counts as a restraint.
Fire: RACE - Rescue anyone in immediate danger, Alarm, Contain the fire (close doors), Extinguish or Evacuate. To use an extinguisher, PASS - Pull, Aim, Squeeze, Sweep. Know your facility's evacuation plan and where the nearest exit is.
Medical emergencies: For choking, encourage coughing, then give abdominal thrusts; if the resident becomes unresponsive, lower them to the floor and begin CPR. For a seizure, protect the head, loosen tight clothing, time it, do not restrain or put anything in the mouth. For suspected stroke, remember FAST (Face, Arms, Speech, Time) and call for the nurse immediately. Never leave a resident alone during an emergency - use the call system or call out for help.
Traps
Leaving a resident to get help; putting a finger in a seizing resident's mouth; giving fluids to an unresponsive resident; using a restraint without an order.
Worked example: You find a resident on the floor. Do not move them. Check responsiveness and breathing, call for help, stay with them, keep them warm, and report and document exactly what you found.