Resident Safety and Emergency Procedures

1. Fall prevention

Falls are prevented by identifying risk and removing causes. Risk factors include a history of falls, weakness or unsteady gait, confusion, medications that cause dizziness, poor vision, and a wet or cluttered floor. Prevention includes keeping the bed in the lowest position, using non-skid footwear, keeping the call light within reach, clearing clutter and spills, and answering call lights promptly so the resident does not get up unassisted. The CNA reports any new weakness, dizziness, or unsteady walking so the care plan can be updated.

2. Choking and fire safety

Choking is recognized by the universal sign — hands at the throat — along with an inability to speak, cough, or breathe. A choking person needs help immediately. Abdominal thrusts are performed by trained responders; the CNA recognizes choking, calls for help right away, stays with the resident, and follows facility policy, without performing any maneuver the CNA is not trained to do.

Fire safety follows two standard responses. RACE guides the response: Rescue anyone in immediate danger, sound the Alarm, Contain the fire by closing doors, and Extinguish or Evacuate as trained. PASS guides extinguisher use by trained staff: Pull the pin, Aim at the base, Squeeze the handle, and Sweep side to side. The CNA knows both, plus the evacuation routes and where alarms and extinguishers are, and follows the emergency plan.

3. Seizure precautions and care

A resident with a seizure history may have precautions in the care plan, such as padded side rails or keeping the area free of sharp objects. During a seizure, the CNA protects the resident's head, clears the area of objects the resident could strike, and never puts anything in the resident's mouth (a person cannot swallow their tongue, and forcing objects in can injure or choke). The CNA notes when the seizure started and how long it lasts, stays with the resident, calls the nurse, and reports the duration and what was observed — body parts involved, breathing, and the resident's response.

4. Restraint alternatives and restraint care

Restraints are used only as a last resort, with an authorized order, when less restrictive measures have failed. Alternatives are always tried first: bed or chair alarms that alert staff when the resident tries to rise, engaging activities to reduce restlessness, frequent toileting, repositioning for comfort, and moving the resident near the nurses' station for closer observation. If a restraint is in place, the CNA checks the resident at least every 15 minutes and releases or repositions the restraint at least every 2 hours, while observing skin and circulation and offering food, fluids, and toileting. Any skin or circulation problem is reported to the nurse immediately.

How it works

1. The CNA spots risk early — dizziness, clutter, a low bed left high — and corrects it before a fall happens.
2. In an emergency, the first step is always recognition plus calling for help.
3. Protective actions (clearing the area, protecting the head, staying with the resident) are done within training and policy.
4. Restraints are avoided when possible and, when used, monitored on a strict schedule with alternatives considered first.

Common confusions

Memory aids

For fire safety, remember "RACE to the fire, PASS the extinguisher": Rescue, Alarm, Contain, Extinguish/Evacuate, then Pull, Aim, Squeeze, Sweep.

Quick review

Topic Recap

Resident safety means preventing falls by identifying risk and removing hazards (low bed, non-skid footwear, clear floors); responding to choking and fire by recognizing the danger and calling for help while following RACE/PASS and policy; and protecting a resident during a seizure by clearing the area, protecting the head, never placing anything in the mouth, and noting the duration. Restraints are a last resort, with alternatives tried first and strict monitoring (every 15 minutes, release/reposition every 2 hours) when in place.

Knowledge Check

1. What three bed-and-room measures most reduce fall risk?
2. During a seizure, what should the CNA never do and why?
3. What does RACE stand for?
4. How often must a restrained resident be checked, and how often released/repositioned?
5. What is tried before any restraint is used?

Answers and Rationales

1. Bed in the lowest position, non-skid footwear, and clear pathways — these remove the most common mechanical causes of falls.
2. Never put anything in the mouth — a person cannot swallow their tongue, and objects can injure or choke; instead protect the head and clear the area.
3. Rescue, Alarm, Contain, Extinguish/Evacuate — the ordered fire response.
4. Check every 15 minutes and release/reposition every 2 hours, observing skin and circulation and offering food, fluids, and toileting.
5. Restraint alternatives — alarms, activities, positioning, and frequent toileting — because restraints are a last resort that carry risks.