Section 1, Unit 4

1. Section 1, Unit 4 Emergency Measures

2. General Measures • Stay with the resident and call for help • Be sure the * is notified • Do not move the resident unless there is immediate danger. • Remain calm and reassure the resident. • Start emergency measures that you are * while waiting for help to arrive according to facility policy. • Know the facility procedures and phone numbers for reporting emergencies. • Know where emergency equipment and supplies are located.

3. Procedural Guideline #1 – Fainting and Falls • Purpose • *. • Emergency Guidelines • Stay with resident and call for help. Be sure nurse is notified. • Lower the resident's * to increase blood supply to brain: • If resident is standing, assist to lie down or to sit in chair. • If resident is sitting, assist to lie down or assist to bend forward and put head down between knees if able.

4. Procedural Guideline #1 – Fainting and Falls • How to Assist a Resident After Fainting/Falling • Stay with resident and call for help. Be sure * is notified. • Wear gloves and follow Standard Precautions (Procedural Guideline #7) if contact with blood or body fluids is likely. • Keep the resident as *. Do not attempt to move the resident or to straighten the injured area. • Do not attempt to move the resident until the nurse examines the resident, assesses the risk of fracture, and gives instructions. • Then, follow the directions of the nurse for moving the resident. • Check vital signs and provide other care as requested by nurse. • * . Wait until the nurse arrives.

5. Procedural Guideline #1 – Fainting and Falls • Observe For and Report to Nurse: • *. • Cause of the fall such as wet floors, ill-fitting shoes or condition of resident. (Do not speculate on the cause of the fall. Report only what you know to be a fact). • Measures taken to break the fall and assist the resident. • * to the fall. • Additional information needed by the nurse to complete the incident report. • Other *. • Examples: siderails, alarms, signal/call light, bed low

6. Procedural Guideline #2 – Seizures • Purpose: *. • Emergency Guidelines • Stay with the resident and call for help; *. Be sure the nurse is notified. • Wear gloves and follow Standard Precautions (Procedural Guideline #7) if contact with blood or body fluids is likely. • If the resident is in bed, * if present, turn head to side or place in side-lying position and remove pillow. • If the resident is out of bed, gently lower the resident to floor, turn head to side or place in side-lying position to open airway and promote drainage of secretions, and *, padding or hold head in your lap.

7. Procedural Guideline #2 – Seizures (cont.) • Emergency Guidelines (cont.) • Move hard objects out of the way as appropriate, or pad around the bed and/or objects that might cause injury during seizure. • * by asking onlookers to leave and closing doors and/or curtains. • Do not attempt to restrain the resident. • Do not attempt to place any object into the resident’s mouth during seizure. • When the seizure passes, leave the resident in a position of comfort and safety with * within easy reach and lower bed. • If used, remove and discard gloves following facility policy. Wash hands.

8. Procedural Guideline #2 – Seizures (cont.) • Observe For and Report to Nurse: • Changes in the resident * such as visual or auditory aura, confusion, staggering or behavioral changes. • Time the seizure started and stopped and duration of the seizure. • Description of body parts involved and * of convulsive movements. • Presence of an aura, incontinence, unconsciousness, eyes rolled upward, frothing of the mouth, biting of the tongue or *. • Condition of the resident after seizure such as disorientation or sleepiness. • Other significant observations.

9. Procedural Guideline #3 – Clearing the Obstructed Airway • Purpose: To clear the obstructed airway of adults using the Heimlich Maneuver. • Guidelines and Precautions • Choking is a true * that requires immediate action. • Choking is the sign of airway obstruction. The universal distress signal for choking is *. • Choking usually occurs when eating large and poorly chewed pieces of meat or other foods. Associated factors are *, laughing and talking while eating. The airway can also be obstructed by blood, vomitus, foreign bodies, or the tongue.

10. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Guidelines and Precautions • Measures to help prevent choking: • Assure that meat and other foods are cut into *. • Encourage residents to chew foods slowly and adequately. • Discourage laughing and talking while chewing and swallowing. • Assure residents receive correct diets that contain only allowed foods. Peanut butter, nuts, popcorn and beans can cause choking in some residents. • This procedure is limited to use of the * on adults. Specialized and advanced procedures and training are available from the American Red Cross and the American Heart Association. • * practice forceful abdominal thrusts on human subjects as part of training.

11. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Determine if resident can *. • Stay with the resident and call for help. Be sure the * is notified immediately. • Wear gloves and follow Standard Precautions (Procedural Guideline #7) if contact with blood or body fluid is likely. • Observe the resident for coughing, breathing and speech. Ask the resident “*?” • If the resident is able to cough, breathe or speak (Partial Airway Obstruction), stand by and encourage coughing to clear the airway. • If the resident is unable or becomes unable to cough, breathe or speak (Complete Airway Obstruction), perform the Heimlich Maneuver following step D below as appropriate.

12. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Perform the Heimlich Maneuver (Abdominal Thrusts) • With resident standing or sitting: • Stand behind the resident. • Wrap your arms around the resident's *. • Make a fist and place the thumb-side of the fist at the midline of the abdomen, just above the navel and well below the breastbone. • Grasp fist with free hand and press * with a quick upward thrust. Avoid pressure on the ribs and breastbone.

13. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Perform the Heimlich Maneuver (Abdominal Thrusts) • With resident lying down: • Place the resident in the * position on the floor. • Kneel down and straddle the residents' hips. • Position the heel of one hand at the midline of abdomen, just above the navel and well below the breastbone. • Place your free hand over the other hand and press inward with a *. Avoid pressure on the ribs and breastbone. • Repeat abdominal thrusts (as separate and distinct movements) until the * (usually 5 to 10 thrusts). • Assist the nurse and/or EMS as appropriate. • If used, remove and discard gloves following facility policy. Wash hands.

14. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Observe For and Report to Nurse: • Exact * choking and unconsciousness started and stopped. • Procedures done and time procedure started and stopped. • *. • Factors related to cause of choking. • Other significant observations.

15. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Measures to be followed for any Resident who has vomiting, bleeding near the mouth, excess secretions or is unable to swallow: • Notify the nurse immediately if: • Resident is choking or is not able to swallow. • Resident is not able to spit out vomitus, secretions or blood. • Wear gloves and follow Standard Precautions (Procedural Guideline #7) if contact with blood or body fluids is likely. • Keep the resident's head * as allowed. • Keep the resident turned on his/her side or with head turned well to one side, if possible, to allow fluids to *. • Provide * for the resident who is vomiting. • Nurse may provide suctioning and/or notify the physician. • Leave the resident in a position of comfort and safety with the call signal within easy reach. • If used, remove and discard gloves following facility policy. Wash hands.

16. Procedural Guideline #3 – Clearing the Obstructed Airway (cont.) • Observe For and Report to Nurse: • Immediately report difficulty swallowing, bleeding, vomiting, and choking or aspiration. • * discard vomitus or blood until it is seen by the nurse and a specimen is obtained if needed. • Other significant observations.