Emergency ProceduresEmergency ProceduresTerminologyTerminology

Abbreviation for oxygenAbbreviation for oxygen

Agitation Agitation

Cardiac arrestCardiac arrest

CyanosisCyanosis

Diabetic ComaDiabetic Coma

DiaphoresisDiaphoresis

Disaster PlanDisaster Plan

Terminology #2Terminology #2DyspneaDyspneaEmergencyEmergencyEmergency codesEmergency codesEscape routesEscape routesFire planFire planFire pull boxFire pull boxHead injuryHead injuryHeimlich maneuverHeimlich maneuver

Terminology #3Terminology #3HemorrhageHemorrhageInsulin shockInsulin shockMittensMittensOxygen precautionsOxygen precautionsPallorPallorPostural supportsPostural supportsFalse imprisonmentFalse imprisonmentRespiratory distressRespiratory distress

Terminology #4Terminology #4

Respiratory arrestRespiratory arrest

Soft restraintsSoft restraints

StatStat

Universal safety signsUniversal safety signs

Universal choking signUniversal choking sign

UnconsciousnessUnconsciousness

AspirateAspirate

General Measures of safe General Measures of safe environmentenvironment

Wipe up spillsWipe up spills

Never run in hallsNever run in halls

Use contents of containers Use contents of containers with proper labelswith proper labels

Identify wet floorsIdentify wet floors

Tag and report broken Tag and report broken equipmentequipment

Report unsafe situationsReport unsafe situations

General Measures of Safe General Measures of Safe Environment #2Environment #2

Use 3-pronged plugsUse 3-pronged plugs

Check wrist band before any taskCheck wrist band before any task

Use side rails when appropriateUse side rails when appropriate

Resident to use handrails when Resident to use handrails when unstableunstable

Resident to wear non-skid footwear Resident to wear non-skid footwear when ambulatorywhen ambulatory

Lock wheelchair when transferingLock wheelchair when transfering

General Measures of Safe General Measures of Safe Environment #3Environment #3

Place signal light within reachPlace signal light within reach

Answer call lights promptlyAnswer call lights promptly

Use night lightsUse night lights

Refuse to do any task you don’t Refuse to do any task you don’t know how to doknow how to do

Know proper operation of Know proper operation of equipmentequipment

Keep bed in lowest positionKeep bed in lowest position

Oxygen Therapy Safety RulesOxygen Therapy Safety Rules

Oxygen is abbreviated O2Oxygen is abbreviated O2

Oxygen is a colorless, odorless, Oxygen is a colorless, odorless, tasteless gas essential for respirationtasteless gas essential for respiration

Some residents need supplemental Some residents need supplemental O2O2

Oxygen is supplied in portable tanks Oxygen is supplied in portable tanks or through wall outletsor through wall outlets

O2 increases risk of fireO2 increases risk of fire

Oxygen Therapy Safety Rules #2Oxygen Therapy Safety Rules #2Safety PrecautionsSafety Precautions

Place a “no smoking – oxygen in use” Place a “no smoking – oxygen in use” sign on room door and over bedsign on room door and over bed

Smoking is NEVER allowed either by Smoking is NEVER allowed either by resident or visitorresident or visitor

Keep O2 tubing open and free of Keep O2 tubing open and free of kinkskinks

Oxygen Therapy Safety Rules #3Oxygen Therapy Safety Rules #3Types of OTypes of O22 Equipment Equipment

Portable tanksPortable tanks

Wall outletsWall outlets

Resident equipmentResident equipment

Oxygen Therapy Safety Rules #4 Oxygen Therapy Safety Rules #4 Nursing Care Nursing Care

Make sure resident wears mask or Make sure resident wears mask or cannula at all timescannula at all timesMake sure O2 is turned off if not in Make sure O2 is turned off if not in use use Maintain water level in humidifier to Maintain water level in humidifier to reduce dryness reduce dryness Check for redness over top of ears Check for redness over top of ears where tubing rests and at nasal where tubing rests and at nasal passagespassages

Postural SupportsPostural Supports

Protective devices used to prevent Protective devices used to prevent the resident from harming self or the resident from harming self or othersothers

Used to prevent residents from:Used to prevent residents from:– Falling out of bed/chairFalling out of bed/chair– Crawling over side rails or end of bedCrawling over side rails or end of bed– Interfering with therapyInterfering with therapy– Hurting themselves or othersHurting themselves or others

Postural Supports #2 -TypesPostural Supports #2 -Types

Vest or jacket deviceVest or jacket device

Wrist or ankle deviceWrist or ankle device

Hand mitt deviceHand mitt device

Elbow support deviceElbow support device

Postural Supports #3 Postural Supports #3 Precautions when applying Precautions when applying

postural support devicespostural support devices

Place resident in good body Place resident in good body alignmentalignmentPad bony prominencesPad bony prominencesUse “quick release” bow-tie knotsUse “quick release” bow-tie knotsAllow some slack for movementAllow some slack for movementCheck for “2 finger” amount of space Check for “2 finger” amount of space

Postural Supports #4Postural Supports #4Check circulation frequentlyCheck circulation frequently

Tie support to movable part of bed frameTie support to movable part of bed frame

Remove support and reposition resident Remove support and reposition resident every 2 hoursevery 2 hours

Offer fluids frequentlyOffer fluids frequently

Offer bedpan or urinal on regular basisOffer bedpan or urinal on regular basis

Apply vest restraint with open area of vest Apply vest restraint with open area of vest on the fronton the front

Postural Supports #5 Postural Supports #5 Legal implications Legal implications

Must have a doctor’s orderMust have a doctor’s order

Resident rightsResident rights

Unnecessary restraint of resident Unnecessary restraint of resident could constitute false imprisonment could constitute false imprisonment

Postural Supports #6 Postural Supports #6 Psychological implicationsPsychological implications

Explain to resident and family the Explain to resident and family the reason for usereason for use

Provide reassurance and support to Provide reassurance and support to the resident and familythe resident and family

Resident Distress Resident Distress

Exp: heart attack, stroke, fainting Exp: heart attack, stroke, fainting episode, seizures, diabetic coma, episode, seizures, diabetic coma, insulin shock, hemorrhaging…insulin shock, hemorrhaging…

Signs and symptomsSigns and symptoms– Behavioral changesBehavioral changes– Changes in vital signsChanges in vital signs– Loss of consciousnessLoss of consciousness

Resident Distress #2Resident Distress #2

PallorPallor

CyanosisCyanosis

SweatingSweating

Agitation/confusionAgitation/confusion

New pain in chest, abdomen, head or New pain in chest, abdomen, head or extremitiesextremities

Sudden cessation of breathingSudden cessation of breathing

Shortness of breathShortness of breath

BleedingBleeding

Resident Distress #3Resident Distress #3

Immediate interventionsImmediate interventions

– Check resident for ABC’sCheck resident for ABC’s

Open AirwayOpen Airway

Check for BreathingCheck for Breathing

Check CirculationCheck Circulation

Resident Distress #4 ]Resident Distress #4 ]General rules for emergency General rules for emergency

situationssituations

Remain calmRemain calm

Call for help of licensed nurseCall for help of licensed nurse

Remain with residentRemain with resident

Intervene at level of competence as Intervene at level of competence as directed by licensed nursedirected by licensed nurse

Reassure the residentReassure the resident

Keep the resident warmKeep the resident warm

Heimlich ManeuverHeimlich Maneuver

Used to relieve obstructed airwayUsed to relieve obstructed airway

Causes of Airway ObstructionCauses of Airway Obstruction– Foreign bodyForeign body– TongueTongue– Small objectsSmall objects– VomitusVomitus– DenturesDentures

Heimlich Maneuver #2 Heimlich Maneuver #2 Signs of chokingSigns of choking

Respiratory difficultyRespiratory difficulty

High pitched soundsHigh pitched sounds

Inability to speak of coughInability to speak of cough

Universal chocking signUniversal chocking sign

Role During EmergenciesRole During EmergenciesBe preparedBe prepared– Know emergency codesKnow emergency codes– Know fire and disaster plansKnow fire and disaster plans– Know location of fire exit/extinguishersKnow location of fire exit/extinguishers

Call for assistanceCall for assistance

Move resident if in immediate Move resident if in immediate dangerdanger

Role During Emergencies #2Role During Emergencies #2

Remain calmRemain calm

Remain with residentRemain with resident

Keep resident comfortableKeep resident comfortable

Evacuate resident to safety according Evacuate resident to safety according to facility fire and disaster planto facility fire and disaster plan

Role During Emergencies #3 Role During Emergencies #3 R.A.C.E.R.A.C.E.

RemoveRemoveActivateActivateContainContainExtinguishExtinguish

Know and follow specific Know and follow specific facility policiesfacility policies

Ways to help during EmergenciesWays to help during Emergencies

Stay with the residentStay with the resident

Keep resident comfortable and quietKeep resident comfortable and quiet

Know and use facility/hospital codesKnow and use facility/hospital codes

Project confidenceProject confidence

Call for helpCall for help

Use calm voiceUse calm voice

Ways to help during Emergencies Ways to help during Emergencies #2#2

Be sure residents or visitors are Be sure residents or visitors are paying attention when giving paying attention when giving instructionsinstructions

Move families and visitors to a calm Move families and visitors to a calm environment when help arrivesenvironment when help arrives

Keep family and visitors informed of Keep family and visitors informed of resident’s conditionresident’s condition

Common Emergency Codes Common Emergency Codes for facilityfor facility

FireFire

Cardiac arrestCardiac arrest

International hospital codesInternational hospital codes

Disaster codesDisaster codes

Common Emergency Codes #2 Common Emergency Codes #2 Use of emergency call systemUse of emergency call system

Remain calm, do not shout “fire” or Remain calm, do not shout “fire” or “cardiac arrest”“cardiac arrest”

STAT” means respond at once or STAT” means respond at once or immediatelyimmediately

Activate the emergency medical Activate the emergency medical system by calling “911”system by calling “911”

Common Emergency Codes #3Common Emergency Codes #3

Local CodesLocal Codes

– Red = FireRed = Fire– Blue = EmergencyBlue = Emergency– Brown = DisasterBrown = Disaster– Yellow = Security/ManpowerYellow = Security/Manpower– Orange = Hazardous SpillOrange = Hazardous Spill

Major Causes Of FireMajor Causes Of Fire

SmokingSmoking

Sparks from faulty electrical Sparks from faulty electrical equipmentequipment

Heating systemsHeating systems

Spontaneous ignitionSpontaneous ignition

Improper disposal of rubbishImproper disposal of rubbish

Fire PreventionFire PreventionReport frayed electrical cords, smoke Report frayed electrical cords, smoke or burning smellsor burning smellsRefrain from using too many Refrain from using too many electrical devices on one wall socketelectrical devices on one wall socketUse 3-prong grounded plugsUse 3-prong grounded plugsEmpty waste paperEmpty waste paperSupervise residents when smokingSupervise residents when smokingMake sure material in ash trays are Make sure material in ash trays are completely extinguishedcompletely extinguished