3.02 na role in safety

Understand safety and emergency care skills within the nurse aide range of function.

Unit A Nurse Aide Workplace FundamentalsEssential Standard NA3.00 Understand infection control, safety and emergency skills within the nurse aide scope of practice. Indicator 3.02 Understand nurse aide’s safety and emergency care skills within the nurse aide range of function

3.02 Nursing Fundamentals 7243 1

Nurse aide students must Nurse aide students must hold hold currentcurrent certification in certification in HEALTHCARE PROVIDER HEALTHCARE PROVIDER BASIC LIFE SUPPORT BASIC LIFE SUPPORT and and be assessed for skill be assessed for skill retention prior to clinical!retention prior to clinical!

REQUIREMENT:

1 OUNCEPREVENTION

1 POUND

The Bottom Line

Prevention, Prevention, Prevention, Prevention, Prevention, Prevention, Prevention, Prevention, Prevention,Prevention, Prevention, Prevention,Prevention, Prevention, Prevention.Prevention, Prevention, Prevention.

NNational PPatient SSafety GGoals for Long Term Care:Long Term Care:1.1.Identify residents correctlyIdentify residents correctly2.2.Use medicines safelyUse medicines safely3.3.Prevent InfectionPrevent Infection4.4.Check residents medicationsCheck residents medications5.5.Prevent residents from fallingPrevent residents from falling6.6.Prevent bed soresPrevent bed sores

NPSG impacted greatly by Nurse Aide WorkNPSG impacted greatly by Nurse Aide Work3.02 Nursing Fundamentals 7243 5

NNational PPatient SSafety GGoals for Long Term Care:Long Term Care:

Identify residents Identify residents correctly correctly NPSG.01.01.01NPSG.01.01.01

Use at least Use at least two ways two ways to to identify residents. identify residents. For example, use For example, use the resident’s name and date of birth or last four the resident’s name and date of birth or last four digits of SS number. digits of SS number.

Provide care to right resident

Use identification bracelets Ask resident to state name

Use I.D. systems that involve photographs

Realize that care to wrong resident can threaten life

Prevent Prevent Infection Infection NPSG.07.01.01NPSG.07.01.01

Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or World Health Organization.

Prevent residents from Prevent residents from falling falling NPSG.09.02.01NPSG.09.02.01

Find out which residents are Find out which residents are most likely to fall. most likely to fall. For example, is the For example, is the resident taking any medications that might make resident taking any medications that might make them weak, dizzy, or sleepy? Take action to prevent them weak, dizzy, or sleepy? Take action to prevent falls for these residents. falls for these residents.

Greater Risk of Falls

• Age related factorsAge related factors

• Awareness of Awareness of surroundingssurroundings

• Decreased VisionDecreased Vision

• Hearing ImpairedHearing Impaired

• Decreased ability to Decreased ability to smell smell

• Decreased sensitivity to Decreased sensitivity to touchtouch

• ImmobilityImmobility

• MedicationsMedications

Report observations to Report observations to supervisor that lead supervisor that lead you to believe a you to believe a resident is prone to resident is prone to fallingfalling

Preventing Falls

Falls account for 70%

of accidents in healthcare facilities

FFor or YYour our IInformationnformation

Answer call signals promptlyAnswer call signals promptly

Keep frequently used articles Keep frequently used articles within reach of residentwithin reach of resident

Preventing Falls

Lock brakes on movable Lock brakes on movable equipmentequipment

–wheel chairswheel chairs–stretchers and mechanical stretchers and mechanical

liftslifts–beds beds –commodescommodes

Preventing Falls

Properly position residents Properly position residents in:in:

–bedbed

–wheel chairwheel chair

Preventing Falls

OBSERVE OBSERVE NO LIFT NO LIFT OR OR LIMITED LIFT LIMITED LIFT POLICIES POLICIES

TO PREVENT FALLS AND TO PREVENT FALLS AND INJURY TO RESIDENT INJURY TO RESIDENT

AND NURSE AIDEAND NURSE AIDE

Preventing Falls

Report any facility structure hazard Report any facility structure hazard immediately that could lead to fallsimmediately that could lead to falls

– frayed carpetingfrayed carpeting

– loose or broken side railsloose or broken side rails

– lights that don’t worklights that don’t work

Preventing Falls

Prevent Prevent bed sores bed sores NPSG.14.01.01NPSG.14.01.01

Find out which residents are most likely to have bed sores. Take action to prevent bed sores in these residents.

Bed sores will be discussed in Indicator 5.02 3.02 Nursing Fundamentals 7243 19

GENERAL GENERAL SAFETY SAFETY RULESRULES

GENERAL SAFETY RULESGENERAL SAFETY RULES

Walk in halls and on stairs - Walk in halls and on stairs - never runnever runKeep to the right-hand side Keep to the right-hand side of the hallof the hallApproach swinging doors Approach swinging doors with cautionwith cautionUse handrails going up and Use handrails going up and down stairsdown stairs3.02 Nursing Fundamentals 7243 21

Keep halls and Keep halls and stairs free of stairs free of obstaclesobstaclesCheck labels on all Check labels on all containers prior to containers prior to using contentsusing contentsWipe up spilled Wipe up spilled liquids immediatelyliquids immediately

Pick up litter and place it in Pick up litter and place it in the proper containerthe proper container

Follow instructions of your Follow instructions of your supervisor for resident caresupervisor for resident care

Report injuries promptlyReport injuries promptly

Never use damaged or frayed Never use damaged or frayed electrical cordselectrical cords

TAGTAG and and TAKE OUT TAKE OUT OF SERVICEOF SERVICE!!!!!!!!

Report broken or Report broken or malfunctioning malfunctioning equipment equipment immediatelyimmediately

Check linen for Check linen for personal items personal items contained in folds contained in folds prior to sending to the prior to sending to the laundrylaundry

Report unsafe Report unsafe conditions conditions immediatelyimmediately

Ask for an explanation Ask for an explanation of things you don’t of things you don’t understandunderstand

Elevate side rails for Elevate side rails for residents at risk of residents at risk of falling, per facility falling, per facility policypolicy3.02 Nursing Fundamentals 7243 26

’S R

Age related Age related

Decreased Decreased strengthstrength

Slower movementSlower movement

Difficulty Difficulty maintaining maintaining balancebalance

Tremors that may Tremors that may affect balanceaffect balance

’S R

Awareness of Awareness of surroundingssurroundings

Some totally Some totally unawareunaware

unconsciousunconscious

comacoma

Some suffer from Some suffer from dementiadementia

confusedconfused

disorienteddisoriented3.02 Nursing Fundamentals 7243 28

’S R

Decreased visionDecreased vision

Difficulty seeing Difficulty seeing objectsobjects

In danger of In danger of falling or falling or trippingtripping

Difficulty reading Difficulty reading labels or labels or containerscontainers

’S R

Hearing impairedHearing impaired

– May not hear May not hear warning warning signals or signals or alarmsalarms

– May not hear May not hear approaching approaching equipmentequipment

’S R

Smell and touchSmell and touch

Reduced smell Reduced smell unaware of unaware of smoke or gas smoke or gas fumesfumes

Decreased Decreased sensitivity to sensitivity to heat and coldheat and cold easily burnedeasily burned

’S R

Inability to Inability to move move independentlyindependently

Crippling Crippling diseasesdiseases

ArthritisArthritis

ParalysisParalysis

’S R

Medications can:Medications can:

Affect balanceAffect balance

Reduce awarenessReduce awareness

Cause confusion or Cause confusion or disorientationdisorientation

Cause drowsinessCause drowsiness

Affect coordinationAffect coordination

Make fearful and Make fearful and uncooperativeuncooperative

PREVENTING BURNSPREVENTING BURNS

Burns are the Burns are the second most second most

common hazard common hazard to residentsto residents

Preventing BurnsPreventing Burns

• Check water Check water temperature in temperature in bath or shower bath or shower with bath with bath thermometer or thermometer or with your handwith your hand

Water temperature Water temperature should be should be NONO HOTTERHOTTER than than

105 105 degrees Fdegrees F3.02 Nursing Fundamentals 7243 36

• ResidentResident must must verifyverify thatthat the the temperaturetemperature of of the water is the water is comfortable or comfortable or not. not.

This is a little to warm!

• Report areas Report areas where water where water temperature temperature seems too hotseems too hot

• Monitor Monitor smoking smoking practicespractices

When bathing the resident or When bathing the resident or providing a soak, providing a soak,

1)1)ASK THE ASK THE RESIDENTRESIDENT TO TO FEEL THE WATERFEEL THE WATER

2)2) ANDAND VERIFYVERIFY THAT THE THAT THE TEMPERATURE OF THE WATER IS TEMPERATURE OF THE WATER IS COMFORTABLE TO THEMCOMFORTABLE TO THEM

• Provide assistance at mealtime to prevent spilling hot liquids

• Use facility equipment according to written policies

• Monitor use of electrical appliances used by resident

• Avoid overexposure to sunlight

PREVENTPREVENT

POISONINGPOISONING

Preventing PoisoningPreventing Poisoning

• Store toxins in locked cabinetsStore toxins in locked cabinets• Store toxins away from resident Store toxins away from resident

areasareas

• Never leave toxic products where Never leave toxic products where they might be ingestedthey might be ingested

Preventing PoisoningPreventing Poisoning

• Have identifying labels on all Have identifying labels on all containerscontainers

• Never use unlabeled substanceNever use unlabeled substance

Preventing ChokingPreventing Choking

• Encourage residents to Encourage residents to use their dentures when use their dentures when eatingeating

• Assist to cut food into Assist to cut food into small piecessmall pieces

• Report difficulty in Report difficulty in swallowingswallowing

Be certain the Be certain the HOBHOB is is

elevatedelevated before attempting before attempting

to to feedfeed a resident! a resident!

Prevent Choking

Residents with feeding tubesfeeding tubes usually have the HOB elevated 30-45 degrees30-45 degrees.

Be certain the Be certain the resident resident has swallowed has swallowed before continuing to feed.before continuing to feed.

Prevent Choking

Residents with feeding tubes should never have the bed flat for extended periods of time. Follow instructions regarding residents’ position to prevent residents from aspirating.

Preventing SuffocationPreventing Suffocation

• Never leave unattended in Never leave unattended in bathtubbathtub

• Immediately transport from Immediately transport from areas where smoke or gas areas where smoke or gas fumes are noticedfumes are noticed

• Properly apply and check Properly apply and check vest and safety belt vest and safety belt restraintsrestraints

Preventing Spread of MicroorganismsPreventing Spread of Microorganisms

Follow Standard Follow Standard Precautions and Precautions and Transmission Transmission Based Precautions.Based Precautions.

Wash hands Wash hands before and before and after careafter care

Preventing Other InjuriesPreventing Other Injuries

• Move equipment around corners Move equipment around corners with cautionwith caution

• Be careful of residents’ feet, Be careful of residents’ feet, hands, arms, and elbows when hands, arms, and elbows when transporting residents in transporting residents in wheelchairswheelchairs

• Monitor residents who wander away

• Follow instructions when providing care

• Keep bed in lowest position except when giving bedside care

• Use night lights in rooms• Have residents wear

shoes/slippers with non-skid soles

• Check crutches, canes and walkers for non-skid tips

• Keep call signal within Keep call signal within easy reach easy reach

• Report immediately any Report immediately any observations indicating observations indicating resident is a danger to resident is a danger to himself or others.himself or others.

BODY BODY MECHANICSMECHANICS

There is There is intentional repeat intentional repeat of some of some HSIIHSII course course content in content in Nursing Fundamentals.Nursing Fundamentals.

Academic and skill competence must be Academic and skill competence must be maintainedmaintained at a at a very high level for direct very high level for direct resident care. resident care.

Repeating course content distributes learning Repeating course content distributes learning over time and increases long term memory. over time and increases long term memory.

Body Mechanics 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

• Purpose of Good Body Mechanics

–Maximize strength–Minimize fatigue

–Avoid muscle strain and injury

–Assure personal and resident safety

• Never bend over from waist to pick up object

• Lift firmly and smoothly • Keep object close to body• Keep back straight

• 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

• Get help if object or resident appears too heavy

• Keep feet apart to provide wide base of support

• Pivot or turn with feet

• Use short steps to turnUse short steps to turn

• Turn entire body without Turn entire body without twisting back and necktwisting back and neck

• Pull or push when Pull or push when possible instead of liftingpossible instead of lifting

• Use body weight to help Use body weight to help push or pullpush or pull

• When reaching for When reaching for an object, an object, evaluate distanceevaluate distance

• Face in direction Face in direction you are working you are working to prevent to prevent twistingtwisting

• Adjust beds to Adjust beds to waist level when waist level when giving resident giving resident carecare

• Be sure body is in Be sure body is in good alignment at good alignment at all timesall times

FIREFIRESAFETYSAFETY

There is There is intentional repeat intentional repeat of some of some HSIIHSII course course content in content in Nursing Fundamentals.Nursing Fundamentals.

Academic and skill competence must be Academic and skill competence must be maintainedmaintained at a at a very high level for direct very high level for direct resident care. resident care.

Repeating course content distributes learning Repeating course content distributes learning over time and increases long term memory. over time and increases long term memory.

Fire SafetyFire SafetyEveryone is responsible for

preventing fires

If fire occurs, know what to do3.02 Nursing Fundamentals 7243 68

Fire SafetyFire Safety

• Major fire hazards

–faulty electrical equipment and wiring

–overloaded electrical circuits

–plugs not properly grounded

–clutter - paper/rags3.02 Nursing Fundamentals 7243 69

• Major fire hazards (continued) –unsafe practices when

oxygen is in use

–smoking

–spontaneous combustible materials

• Elements necessary to start fire

–fuel - material that will burn

–heat - flame or spark–oxygen

• 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 procedures3.02 Nursing Fundamentals 7243 72

• Fire Safety Activities– Be aware of all fire

hazards and report them immediately

• Watch for frayed electrical wires

• Never overload circuits• Use three-prong

grounded plugs• Never use extension

cords• Control clutter3.02 Nursing Fundamentals 7243 74

• Dispose of rags properly• Empty ashtrays in metal

containers• Empty wastebaskets in

proper receptacles• Report odors of smoke

or burning• Keep fire exits clear3.02 Nursing Fundamentals 7243 75

• Control smoking practices:

– limit to specific areas

– never allow smoking in bed

– have large ashtrays available

• Control smoking practices:

– observe use of matches/lighters

– directly supervise residents when smoking, as necessary

In Event Of FireIn Event Of Fire

Stay Stay calmcalm as you as you

RACERACE3.02 Nursing Fundamentals 7243 78

RemoveRemove residents from IMMEDIATE DANGER; otherwise, DEFEND IN PLACE

AActivate ctivate thethe ALARM ALARM

ConfineConfine the fire the fire

CClose all windows and lose all windows and doorsdoors

CChokehoke off oxygenoff oxygen3.02 Nursing Fundamentals 7243 81

Extinguish Extinguish if you canif you can

Empty Empty the extinguisherthe extinguisher3.02 Nursing Fundamentals 7243 82

Use of Fire ExtinguisherUse of Fire Extinguisher

• Carry upright then PASSPASS• PPull the ull the safety pin

• AAim at the base of the fire

• SSqueeze handle down• SSpray in a sweeping motion at base

of fire

Relocate Relocate residents per residents per evacuation policy if evacuation policy if directed to do so.directed to do so.

Some agencies teach RACE plus an addition “R”

Remember Remember these these important important GGuidelines:uidelines:G Shut off air conditioningG Shut off oxygenG Shut off lightsG Never use elevators

OXYGEN OXYGEN SAFETYSAFETY

Oxygen PrecautionsOxygen Precautions

• Oxygen precautions– Never have open flames

or smoking in area– Remove flammable

liquids from area– Do not use electrical

equipment in area

• Oxygen precautions

– Post “Oxygen in Use” sign

– Remove cigarettes and matches from room

– Use cotton blankets and clothing

DO NOT DO NOT LET THE LET THE RESIDENTS’ NASAL RESIDENTS’ NASAL CANNULACANNULA TOUCH THE TOUCH THE FLOORFLOOR. . Pathogens on the Pathogens on the floor will contaminate the floor will contaminate the cannula.cannula.

DISASTERS / DISASTERS / CATASTROPHESCATASTROPHES

Disaster / Catastrophe Types

• Natural originNatural origin

– floodflood

–earthquakeearthquake

–hurricane/tornadohurricane/tornado

Disaster / Catastrophe TypesDisaster / Catastrophe Types

• Human disastersHuman disasters

–airplane/bus/train airplane/bus/train accidentsaccidents

–explosionsexplosions–nuclear waste nuclear waste

accidentaccident

–blackoutsblackouts

Workplace Violence… Workplace Violence… a potential Disaster!a potential Disaster!

Healthcare is impacted Healthcare is impacted by by verballyverbally and and sometimes sometimes physicallyphysically abusive abusive patientspatients, , familiesfamilies and and visitors.visitors.

Verbal abuse often goes Verbal abuse often goes unreported and is thought to be unreported and is thought to be “just part of the job”.“just part of the job”.

70% of Nurses are assaulted on 70% of Nurses are assaulted on duty during their career.duty during their career.

The majority of healthcare worker The majority of healthcare worker violence takes place on evening violence takes place on evening and night shifts.and night shifts.

OSHA [1996]. Guidelines for preventing workplace violence OSHA [1996]. Guidelines for preventing workplace violence for health care and social service workers. Washington, DC: for health care and social service workers. Washington, DC: U.S. Department of Labor,U.S. Department of Labor,

Workplace Violence… Workplace Violence… a a potential Disaster!potential Disaster!

StopStop this PowerPoint and this PowerPoint and view the PowerPoint view the PowerPoint produced by produced by Vanderbilt Vanderbilt University Medical Center. University Medical Center. Then, return to this Then, return to this PowerPoint.PowerPoint.

Disaster PlansDisaster Plans

Facilities are required Facilities are required to have disaster plansto have disaster plans

• Responsibilities in a disasterResponsibilities in a disaster– Remove residents from Remove residents from

immediate dangerimmediate danger– Report to facility and follow Report to facility and follow

directions for your roledirections for your role– Know your facility’s disaster Know your facility’s disaster

planplan– Assist with evacuationAssist with evacuation

–Help remove and secure Help remove and secure equipment, supplies, and recordsequipment, supplies, and records

–Think before you act; don’t waste Think before you act; don’t waste timetime

–Remain calmRemain calm–Carry out responsibilities in Carry out responsibilities in

confident manner confident manner

MEDICAL MEDICAL EMERGENCIESEMERGENCIES

The Choking ResidentThe Choking Resident

The Choking Resident - CauseThe Choking Resident - Cause

Choking occurs when Choking occurs when the throat is blocked the throat is blocked or closed up and air or closed up and air cannot get to the cannot get to the airway.airway.

The Choking ResidentThe Choking Resident

Airway may be blocked by: Airway may be blocked by:

–Food or liquids (meat Food or liquids (meat most common food)most common food)

–Blood or mucusBlood or mucus–Foreign objects Foreign objects

including the tongueincluding the tongue

–VomitusVomitus

Treating a Choking ResidentTreating a Choking Resident

– Stay nearStay near– Encourage coughing - most Encourage coughing - most

effective way to dislodge effective way to dislodge obstructionsobstructions

– Never slap coughing Never slap coughing resident on back: can cause resident on back: can cause object to fall lower into object to fall lower into trachea trachea

If victim is coughing, do not intervene:If victim is coughing, do not intervene:

Signs of severe foreign body airway Signs of severe foreign body airway obstructionobstruction

–Unable to speakUnable to speak–No air movementNo air movement–Grasping throat - Grasping throat -

distress signal distress signal Abdominal thrusts, chest thrusts and back blows Abdominal thrusts, chest thrusts and back blows are effective for relieving severe foreign body are effective for relieving severe foreign body airway obstruction. airway obstruction.

Tilting head back in Tilting head back in

unconsciousunconscious person may clear person may clear airway since this pulls airway since this pulls tongue forwardtongue forward

SKILLSKILL 3.02A3.02AForeign Body Airway Obstruction Foreign Body Airway Obstruction

(FBAO) Relief: Conscious Resident(FBAO) Relief: Conscious Resident

Training Lab AssignmentTraining Lab AssignmentEngage in the Skill Acquisition Process for:Engage in the Skill Acquisition Process for:

Heart Attack - Signs and SymptomsHeart Attack - Signs and Symptoms

• Chest discomfortChest discomfort–pressure, fullness, squeezing, or pressure, fullness, squeezing, or

painpain– in center of chest behind in center of chest behind

breastbone or spread to either breastbone or spread to either shoulder, neck, jaw, or armshoulder, neck, jaw, or arm

–usually lasts longer than a few usually lasts longer than a few minutes – comes and goesminutes – comes and goes

Heart Attack - Signs and SymptomsHeart Attack - Signs and Symptoms

• FaintingFainting• SweatingSweating• NauseaNausea• Shortness of breath Shortness of breath

Accident/Emergency SceneAccident/Emergency Scene

• If certified in CPR, offer assistanceIf certified in CPR, offer assistance

• Defer to those with more experience Defer to those with more experience and trainingand training

• Seek assistanceSeek assistance

– in facilityin facility

• use emergency lightuse emergency light• use call signaluse call signal

• send another resident send another resident for helpfor help

• call for help call for help 3.02 Nursing Fundamentals 7243 110

• Seek assistance Seek assistance –at home or at accident sceneat home or at accident scene

• dial 911 operator or emergency dial 911 operator or emergency numbernumber

• give locationgive location• give phone numbergive phone number• relate type of emergencyrelate type of emergency• give number of people needing helpgive number of people needing help• relate requested informationrelate requested information

Cardiopulmonary ResuscitationCardiopulmonary Resuscitation

• Agencies providing CPR Agencies providing CPR curriculum:curriculum:–American Heart AssociationAmerican Heart Association

–American Red CrossAmerican Red Cross

• You must be trained to administer You must be trained to administer CPRCPR

• Activate the emergency medical Activate the emergency medical system or your facility’s emergency system or your facility’s emergency planplan

• CPR must be started immediately to CPR must be started immediately to be effectivebe effective

• Follow facility policy for Advanced Follow facility policy for Advanced Care DirectiveCare Directive

• Methods of administering CPR

–one-person CPR–two-person CPR

Convulsive Disorders (Seizures)Convulsive Disorders (Seizures)

• Causes:Causes:

– infectious diseaseinfectious disease

–omitted medicationomitted medication

–head injuryhead injury–strokestroke–seizure syndromeseizure syndrome

Convulsive Disorders (Seizures)Convulsive Disorders (Seizures)

• TypesTypes–PartialPartial–GeneralGeneral

• Tonic-clonic (grand Tonic-clonic (grand mal)mal)

• Absence (petit mal)Absence (petit mal)–Unclassified Unclassified

Convulsive Disorders (Seizures)Convulsive Disorders (Seizures)Take ActionTake Action

• Summon helpSummon help

• Stay with residentStay with resident

• Protect from injuryProtect from injury

– lower to floor if appropriatelower to floor if appropriate–move objects away that might move objects away that might

cause injurycause injury

• Do not restrain or put any object Do not restrain or put any object into mouth into mouth

• Loosen constricting Loosen constricting clothing (around neck)clothing (around neck)

• Place pillow under head Place pillow under head and turn face to one sideand turn face to one side

• Note time and type of Note time and type of seizureseizure

• Provide rest for resident after Provide rest for resident after seizureseizure

–very tiredvery tired

–may be confusedmay be confused–often disoriented often disoriented

Loss of Consciousness – Fainting Loss of Consciousness – Fainting

• Caused by temporary Caused by temporary reduction of blood to reduction of blood to brainbrain

Loss of Consciousness – Fainting Loss of Consciousness – Fainting

• Early signs and symptoms:–dizziness–decreased pulse and BP–pallor and perspiration–nausea–cold skin–numbness and tingling of extremities

Loss of Consciousness – FaintingLoss of Consciousness – FaintingTake Action Take Action

• Summon helpSummon help• Stay with residentStay with resident• Have resident sit or lie downHave resident sit or lie down• Loosen tight clothingLoosen tight clothing• Position head lower than heartPosition head lower than heart

–sitting - head between legssitting - head between legs– lying down - elevate legs lying down - elevate legs

Loss of Consciousness – FaintingLoss of Consciousness – FaintingTake Action Take Action

• Monitor pulse and respirationsMonitor pulse and respirations

• Have resident rest for 5-10 Have resident rest for 5-10 minutes before movingminutes before moving

• Provide blanket if coldProvide blanket if cold

SHOCK – CausesSHOCK – Causes

• Severe injurySevere injury

• Excessive loss of body Excessive loss of body fluidsfluids

• PainPain

• Respiratory and/or cardiac Respiratory and/or cardiac arrestarrest

• AnxietyAnxiety

• Low or falling blood Low or falling blood pressurepressure

• Weak, rapid pulseWeak, rapid pulse• Cold, moist, pale Cold, moist, pale

skinskin• Rapid respirationsRapid respirations

SHOCK – SHOCK – Signs and Symptoms

• ThirstThirst• RestlessnessRestlessness• Confusion and Confusion and loss of loss of consciousnessconsciousness

SHOCK – Take ActionSHOCK – Take Action

• Summon helpSummon help

• Stay with residentStay with resident

• Keep resident lying Keep resident lying downdown

• Control hemorrhageControl hemorrhage

• Keep resident warm Keep resident warm

HemorrhageHemorrhage

• TypesTypes–InternalInternal–ExternalExternal

HemorrhageHemorrhage

• Signs and SymptomsSigns and Symptoms– InternalInternal

• painpain• shockshock• vomiting bloodvomiting blood• loss of loss of

consciousnessconsciousness– ExternalExternal

• can usually be seen can usually be seen

Hemorrhage – Take ActionHemorrhage – Take Action

• InternalInternal

–Summon helpSummon help

–Stay with Stay with residentresident

–Keep warm, Keep warm, flat and quiet flat and quiet until help until help arrives arrives

• ExternalExternal–Summon helpSummon help–Stay with residentStay with resident– Identify location of bleedingIdentify location of bleeding–Apply continuous, direct Apply continuous, direct

pressure over bleedingpressure over bleeding

• ExternalExternal– If bleeding not controlled, apply If bleeding not controlled, apply

pressure over artery above pressure over artery above bleeding sitebleeding site

– If no pain or broken bones, If no pain or broken bones, elevate wounded area above heart elevate wounded area above heart while maintaining pressurewhile maintaining pressure

• ExternalExternal–keep resident keep resident

comfortable, comfortable, warm and quiet warm and quiet until help until help arrivesarrives

Reporting EmergenciesReporting Emergencies

• Never panic; remain Never panic; remain calmcalm–Try few slow deep Try few slow deep

breathsbreaths

–Observe surroundingsObserve surroundings

–Assess resources Assess resources available available

Reporting Emergencies Reporting Emergencies

• Evaluate situation–check victim

–determine safety of environment

• Call or send for help immediately

• Determine treatment priorities

Reporting Emergencies Reporting Emergencies

• Report emergencies accuratelyReport emergencies accurately

– If help is not available, contact:If help is not available, contact:

• 911 or emergency number911 or emergency number

• PolicePolice

• Fire departmentFire department• Telephone operatorTelephone operator

• Local EMS Local EMS 3.02 Nursing Fundamentals 7243 138

–Name–Location–DescriptionDescription

of scene–Information

about injuries

–Type of help Type of help neededneeded

–Number of people Number of people needing helpneeding help

• Report emergencies accurately Report emergencies accurately by stating:by stating:

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

Understand Understand safetysafety and and emergency emergency care care skills within the nurse aide skills within the nurse aide range of function.range of function.

ENDEND 3.023.02

3.02 Nursing Fundamentals 7243

3.02 na role in safety

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