Unit 4-safety And Emergency Procedures

Unit 4 Safety and Emergency Procedures Nurse Aide I Course

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Introduction to SAFETY AND EMERGENCY PROCEDURES Personal safety and the well-being of residents is a vital component of the health care system. If safety rules are ignored, the nurse aide or another individual could be seriously injured or die. DHSR Approved Curriculum-Unit 4

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Introduction to SAFETY AND EMERGENCY PROCEDURES This unit explores general safety rules, safety measures that prevent accidents, fire safety and prevention, disaster plans, and responsibility in emergency situations. The nurse aide is expected to respond immediately and effectively to illness, injury, and life-threatening circumstances. DHSR Approved Curriculum-Unit 4

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4.0

Identify ways to prevent accidents and other emergencies. 4.1 Adhere to general safety rules. 4.1.1 List 16 rules of general safety.

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General Safety Rules • Walk in halls and on stairs never run • Keep to the right-hand side of the hall • Approach swinging doors with caution • Use handrails going up and down stairs DHSR Approved Curriculum-Unit 4

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General Safety Rules (continued) • Keep halls and stairs free of obstacles • Check labels on all containers prior to using contents • Wipe up spilled liquids immediately DHSR Approved Curriculum-Unit 4

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General Safety Rules (continued) • Pick up litter and place it in the proper container • Follow instructions of your supervisor for resident care • Report injuries promptly • Never use damaged or frayed electrical cords DHSR Approved Curriculum-Unit 4

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General Safety Rules (continued) • Ask for an explanation of things you don’t understand • Elevate side rails for residents at risk of falling, per facility policy

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General Safety Rules (continued) • Check linen for personal items contained in folds prior to sending to the laundry • Never use malfunctioning equipment • Report unsafe conditions immediately DHSR Approved Curriculum-Unit 4

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4.1.2 Recognize factors that increase the resident’s risk of injury.

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Factors That Increase The Resident’s Risk Of Injury • Age related – Decreased strength – Slower movement – Difficulty maintaining balance – Tremors that may affect balance DHSR Approved Curriculum-Unit 4

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Awareness of surroundings – Some totally unaware • unconscious • coma – Some suffer from dementia • confused • disoriented DHSR Approved Curriculum-Unit 4

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Decreased vision – Difficulty seeing objects – In danger of falling or tripping – Difficulty reading labels or containers DHSR Approved Curriculum-Unit 4

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Hearing impaired – May not hear warning signals or alarms – May not hear approaching equipment DHSR Approved Curriculum-Unit 4

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Smell and touch – Reduced smell – unaware of smoke or gas fumes – Decreased sensitivity to heat and cold - easily burned DHSR Approved Curriculum-Unit 4

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Inability to move independently – Crippling diseases – Arthritis – Paralysis

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4.1.3 List six effects of medications that could cause the resident to have an accident.

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Factors That Increase The Resident’s Risk Of Injury (continued)

• Medications can: – Affect balance – Reduce awareness – Cause confusion/disorientation – Cause drowsiness – Affect coordination – Make fearful and uncooperative DHSR Approved Curriculum-Unit 4

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4.2 Identify safety measures that prevent accidents to residents.

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Preventing Falls • Falls account for 70% of accidents in health care facilities • Answer call signals promptly • Keep frequently used articles within reach of resident DHSR Approved Curriculum-Unit 4

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Preventing Falls (continued)

• Lock brakes on movable equipment – wheel chairs – stretchers and mechanical lifts – beds – commodes

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Preventing Falls (continued)

• Properly position residents in: – bed – wheel chair • Report observations to supervisor that lead you to believe a resident is prone to falling DHSR Approved Curriculum-Unit 4

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Preventing Falls (continued)

• Report any facility structure hazard immediately that could lead to falls – frayed carpeting – loose or broken side rails – lights that don’t work

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Preventing Falls (continued)

• Report broken or malfunctioning equipment immediately

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Preventing Burns • Second most common hazard to residents • Check water temperature in bath or shower with bath thermometer DHSR Approved Curriculum-Unit 4

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Preventing Burns (continued)

• Report areas where water temperature seems too hot • Monitor smoking practices DHSR Approved Curriculum-Unit 4

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Preventing Burns (continued)

• Provide assistance at mealtime to prevent spilling hot liquids • Use facility equipment according to written policies DHSR Approved Curriculum-Unit 4

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Preventing Burns (continued)

• Monitor use of electrical appliances used by resident • Avoid overexposure to sunlight DHSR Approved Curriculum-Unit 4

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Preventing Poisoning: Toxic Products • Store in locked cabinets • Store away from resident areas • Never leave products where they might be ingested

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Preventing Poisoning: Toxic Products (continued)

• Have identifying labels on all containers • Never use unlabeled substance

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Preventing Injury When Performing Care • Provide care to right resident • Use identification bracelets • Call resident by name

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Preventing Injury When Performing Care (continued)

• Use I.D. systems that involve photographs • Realize that care to wrong resident can threaten life

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Preventing Suffocation • Encourage residents to use their dentures when eating • Assist to cut food into small pieces • Report difficulty in swallowing DHSR Approved Curriculum-Unit 4

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Preventing Suffocation (continued)

• Never leave unattended in bathtub • Immediately transport from areas where smoke or gas fumes are noticed • Properly apply and check vest and safety belt restraints DHSR Approved Curriculum-Unit 4

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Preventing Spread of Microorganisms Wash hands before and after care

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Preventing Other Injuries • Move equipment around corners with caution • Be careful of feet when transporting residents in wheelchairs

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Preventing Other Injuries (continued)

• Monitor residents who wander away • Follow instructions when providing care • Keep bed in lowest position except when giving bedside care DHSR Approved Curriculum-Unit 4

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Preventing Other Injuries (continued)

• Use night lights in rooms • Have residents wear shoes/slippers with nonskid soles • Check crutches, canes and walkers for non-skid tips DHSR Approved Curriculum-Unit 4

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Preventing Other Injuries (continued)

• Keep call signal within easy reach • Report immediately any observations indicating resident is a danger to himself or others. DHSR Approved Curriculum-Unit 4

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4.3 Practice good personal body mechanics.

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Body Mechanics • Body mechanics: the coordination of body alignment, balance and movement • Job requirements for nurse aides include lifting, moving and transferring resident and lifting, moving and carrying objects DHSR Approved Curriculum-Unit 4

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Body Mechanics (continued)

• Purpose of Good Body Mechanics – Maximize strength – Minimize fatigue – Avoid muscle strain and injury – Assure personal and resident safety DHSR Approved Curriculum-Unit 4

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4.3.1 List 18 guidelines for good body mechanics.

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Guidelines for Good Body Mechanics • Never bend over from waist to pick up object • Lift firmly and smoothly • Keep object close to body • Keep back straight

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Guidelines for Good Body Mechanics (continued)

• Bend at hips and knees and get close to object prior to lifting • Grip objects firmly with both hands • Lift by pushing up with strong leg muscles DHSR Approved Curriculum-Unit 4

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Guidelines for Good Body Mechanics (continued)

• Get help if object or resident appears too heavy • Keep feet apart to provide wide base of support • Pivot or turn with feet DHSR Approved Curriculum-Unit 4

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Guidelines for Good Body Mechanics (continued)

• Use short steps to turn • Turn entire body without twisting back and neck • Pull or push when possible instead of lifting • Use body weight to help push or pull DHSR Approved Curriculum-Unit 4

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Guidelines for Good Body Mechanics (continued)

• When reaching for an object, evaluate distance • Face in direction you are working to prevent twisting DHSR Approved Curriculum-Unit 4

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Guidelines for Good Body Mechanics (continued)

• Adjust beds to waist level when giving resident care • Be sure body is in good alignment at all times

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4.4 Identify and discuss fire safety activities and potential fire hazards.

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Fire Safety Everyone is responsible for preventing fires

If fire occurs, know what to do DHSR Approved Curriculum-Unit 4

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Fire Safety • Major fire hazards – faulty electrical equipment and wiring – overloaded electrical circuits – plugs not properly grounded – clutter - paper/rags DHSR Approved Curriculum-Unit 4

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Fire Safety (continued)

• Major fire hazards (continued) – unsafe practices when oxygen is in use – smoking – spontaneous combustible materials DHSR Approved Curriculum-Unit 4

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Fire Safety (continued)

• Elements necessary to start fire – fuel - material that will burn – heat - flame or spark – oxygen DHSR Approved Curriculum-Unit 4

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Fire Safety (continued)

• Fire safety activities – Locate and learn • escape routes and fire escapes • use of all fire control equipment –fire doors –sprinkler system controls –fire extinguishers • fire drill procedures DHSR Approved Curriculum-Unit 4

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Fire Safety (continued)

• Fire Safety Activities – Be aware of all fire hazards and report them immediately

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Fire Prevention • Watch for frayed electrical wires • Never overload circuits • Use three-prong grounded plugs • Never use extension cords • Control clutter DHSR Approved Curriculum-Unit 4

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Fire Prevention (continued)

• Dispose of rags properly • Empty ashtrays in metal containers • Empty wastebaskets in proper receptacles • Report odors of smoke or burning • Keep fire exits clear DHSR Approved Curriculum-Unit 4

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Fire Prevention (continued)

• Control smoking practices: – limit to specific areas – never allow smoking in bed – have large ashtrays available DHSR Approved Curriculum-Unit 4

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Fire Prevention (continued)

• Control smoking practices: – observe use of matches/lighters – directly supervise residents when smoking, as necessary DHSR Approved Curriculum-Unit 4

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4.4.1 Discuss the precautions that should be taken when oxygen is in use.

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Oxygen Precautions • Oxygen precautions – Never have open flames or smoking in area – Remove flammable liquids from area – Do not use electrical equipment in area DHSR Approved Curriculum-Unit 4

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Oxygen Precautions (continued)

• Oxygen precautions – Post “Oxygen in Use” sign – Remove cigarettes and matches from room – Use cotton blankets and clothing DHSR Approved Curriculum-Unit 4

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In Event Of Fire • In event of fire – Keep calm – Move residents to safety – Sound alarm – Follow evacuation plan DHSR Approved Curriculum-Unit 4

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In Event Of Fire (continued)

• In event of fire – Close all windows and doors – Shut off air conditioning – Shut off oxygen – Shut off lights – Never use elevators DHSR Approved Curriculum-Unit 4

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Use of Fire Extinguisher • • • •

Carry upright Remove safety pin Push handle down Direct spray at base of fire

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FIRE

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4.5 Review and follow disaster procedures and plans for the health care facility.

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Disaster – Type Of Catastrophe • Natural origin – flood – earthquake – hurricane/tornado

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Disaster – Type Of Catastrophe (continued)

• Human disasters – airplane/bus/train accidents – explosions – nuclear waste accident DHSR Approved Curriculum-Unit 4

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Disaster Plans

Facilities are required to have disaster plans DHSR Approved Curriculum-Unit 4

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Disaster Plans (continued)

• Responsibilities in a disaster – Remove residents from immediate danger – Report to facility and follow directions for your role – Know your facility’s disaster plan – Assist with evacuation DHSR Approved Curriculum-Unit 4

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Disaster Plans (continued)

• Responsibilities in a disaster (continued): – Help remove and secure equipment, supplies, and records – Think before you act; don’t waste time – Remain calm – Carry out responsibilities in confident manner DHSR Approved Curriculum-Unit 4

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4.6

Discuss the emergency treatment of a choking resident. 4.6.1 Assist with clearing an obstructed airway.

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Treating a Choking Resident Causes of Choking • Choking occurs when the throat is blocked or closed up and air cannot get to the airway.

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Treating a Choking Resident (continued)

• Airway may be blocked by: – Food or liquids (meat most common food) – Blood or mucus – Foreign objects including the tongue – Vomitus DHSR Approved Curriculum-Unit 4

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Treating a Choking Resident (continued)

• Tilting head back in unconscious person may clear airway since this pulls tongue forward

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Treating a Choking Resident (continued)

• If victim is coughing, do not intervene: – Stay near – Encourage coughing most effective way to dislodge obstructions – Never slap coughing resident on back: can cause object to fall lower into trachea DHSR Approved Curriculum-Unit 4

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Treating a Choking Resident • Signals of severe foreign body airway obstruction – Unable to speak – No air movement – Grasping throat distress signal • Abdominal thrusts, chest thrusts and back slaps are effective for relieving severe foreign body airway obstruction. DHSR Approved Curriculum-Unit 4

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4.7 Demonstrate the procedure for relief of choking.

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4.8 Discuss and explain your responsibilities in assisting with resident who needs CPR.

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Cardiopulmonary Resuscitation (CPR) • Agencies providing CPR instruction: – American Heart Association – American Red Cross – EMS squads

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How To Recognize Heart Attack • Chest discomfort – pressure, fullness, squeezing, or pain – in center of chest behind breastbone or spread to either shoulder, neck, jaw, or arm – usually lasts longer than a few minutes – comes and goes DHSR Approved Curriculum-Unit 4

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How To Recognize Heart Attack (continued) • Fainting

• Sweating • Nausea • Shortness of breath

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Accident Scene • If certified in CPR, offer assistance • Defer to those with more experience and training

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Accident Scene (continued)

• Seek assistance – in facility • use emergency light • use call signal • send another resident for help • call for help DHSR Approved Curriculum-Unit 4

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Accident Scene (continued)

• Seek assistance – at home or at accident scene • dial 911 operator or emergency number • give location • give phone number • relate type of emergency • give number of people needing help • relate requested information DHSR Approved Curriculum-Unit 4

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Information To Remember About CPR • You must be trained to administer CPR • Activate the emergency medical system or your facility’s emergency plan

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Information To Remember About CPR (continued)

• CPR must be started immediately to be effective • Follow facility policy for Advanced Care Directive

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Cardiopulmonary Resuscitation (CPR) • Methods of administering CPR – one-person CPR – two-person CPR

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4.9 Explain responsibilities in assisting the resident for the following: – convulsive disorders – loss of consciousness – shock – hemorrhage DHSR Approved Curriculum-Unit 4

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Convulsive Disorders (Seizures) • Causes: – infectious disease – omitted medication – head injury – stroke – seizure syndrome DHSR Approved Curriculum-Unit 4

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Convulsive Disorders (Seizures) (continued)

• Types – Partial – General • Tonic-clonic (grand mal) • Absence (petit mal) – Unclassified DHSR Approved Curriculum-Unit 4

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Convulsive Disorders (Seizures) Specific Actions

• Summon help • Stay with resident

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Convulsive Disorders (Seizures) Specific Actions (continued)

• Protect from injury – lower to floor if appropriate – move objects away that might cause injury • Do not restrain or put any object into mouth DHSR Approved Curriculum-Unit 4

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Convulsive Disorders (Seizures) Specific Actions (continued)

• Loosen constricting clothing (around neck) • Place pillow under head and turn face to one side • Note time and type of seizure DHSR Approved Curriculum-Unit 4

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Convulsive Disorders (Seizures) Specific Actions (continued)

• Provide rest for resident after seizure – very tired – may be confused – often disoriented

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Loss of Consciousness – Fainting • Caused by temporary reduction of blood to brain

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Loss of Consciousness – Fainting (continued)

• Early signs and symptoms: – dizziness – decreased pulse and BP – pallor and perspiration – nausea – cold skin – numbness and tingling of extremities DHSR Approved Curriculum-Unit 4

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Loss of Consciousness – Fainting Specific Actions

• • • • •

Summon help Stay with resident Have resident sit or lie down Loosen tight clothing Position head lower than heart – sitting - head between legs – lying down - elevate legs DHSR Approved Curriculum-Unit 4

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Loss of Consciousness – Fainting Specific Actions (continued)

• Monitor pulse and respirations • Have resident rest for 5-10 minutes before moving • Provide blanket if cold

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SHOCK Causes

• • • •

Severe injury Excessive loss of body fluids Pain Respiratory and/or cardiac arrest • Anxiety DHSR Approved Curriculum-Unit 4

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4.9.1 List seven symptoms of approaching shock that you might observe during resident care.

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SHOCK Signs and Symptoms

• Low or falling blood pressure • Weak, rapid pulse • Cold, moist, pale skin • Rapid respirations DHSR Approved Curriculum-Unit 4

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SHOCK Signs and Symptoms (continued)

• Thirst • Restlessness • Confusion and loss of consciousness

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SHOCK Specific Actions

• Summon help • Stay with resident • Keep resident lying down • Control hemorrhage • Keep resident warm DHSR Approved Curriculum-Unit 4

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Hemorrhage • Types – Internal – External

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Hemorrhage (continue)

• Signs and Symptoms – Internal • pain • shock • vomiting blood • loss of consciousness – External • can usually be seen DHSR Approved Curriculum-Unit 4

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Hemorrhage Specific Action

• Internal – Summon help – Stay with resident – Keep warm, flat and quiet until help arrives DHSR Approved Curriculum-Unit 4

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Hemorrhage Specific Action (continued)

• External – Summon help – Stay with resident – Identify location of bleeding – Apply continuous, direct pressure over bleeding DHSR Approved Curriculum-Unit 4

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Hemorrhage Specific Action (continued)

• External – If bleeding not controlled, apply pressure over artery above bleeding site – If no pain or broken bones, elevate wounded area above heart while maintaining pressure DHSR Approved Curriculum-Unit 4

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Hemorrhage Specific Action (continued)

• External – keep resident comfortable, warm and quiet until help arrives DHSR Approved Curriculum-Unit 4

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4.9.2 Report emergencies accurately and immediately.

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Reporting Emergencies • Never panic; remain calm – Try few slow deep breaths – Observe surroundings – Assess resources available DHSR Approved Curriculum-Unit 4

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Reporting Emergencies (continued)

• Evaluate situation – check victim – determine safety of environment • Call or send for help immediately • Determine treatment priorities DHSR Approved Curriculum-Unit 4

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Reporting Emergencies (continued) • Report emergencies accurately – If help is not available, contact: • 911 or emergency number • Police • Fire department • Telephone operator • Local EMS DHSR Approved Curriculum-Unit 4

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Reporting Emergencies (continued)

• Report emergencies accurately by stating: – Type of help needed – Name – Number of people – Location – Description of needing help scene – Information about injuries DHSR Approved Curriculum-Unit 4

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Reporting Emergencies (continued)

• Know your limitations • Provide care and reassure victims • Keep bystanders away from victims

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