CNA · Basic Nursing Skills · 6 min read
Emergency Response, Choking and Seizures
- Identify the nurse aide's core responsibilities during general facility emergencies, including maintaining safety and reporting observations.
- Demonstrate the proper sequence of actions for mild and severe airway obstructions, including abdominal and chest thrusts.
- Describe the essential steps to keep a resident safe during and after a seizure without causing secondary injury.
General Emergency Response and Nurse Aide Responsibilities
An emergency is an unexpected situation requiring immediate action to prevent injury or save a life. As a nurse aide, your role is to keep the resident safe and comfortable, assist with basic care needs, observe what happens, and immediately report everything to the licensed nurse. You do not assess, diagnose, prescribe treatments, or adjust care plans. When any emergency strikes, your first duty is to remain calm and call for help immediately.
Whenever possible, stay with the resident during an emergency while calling out for assistance. If you are caring for an acutely injured or unstable resident, remain right by their side while calling for help; if you cannot summon help from the bedside, leave only to get help as quickly as possible and return right away. You must know your facility's specific emergency codes and disaster procedures, as well as the exact locations of emergency equipment such as first aid kits and automated external defibrillators.
To check whether a resident is responsive, gently tap the resident's shoulder and ask loudly if they are okay. If a resident has fallen, do not move the fallen resident until the nurse has checked for injuries, unless there is an immediate danger in the area. Never give a resident food or fluids during a medical emergency unless the nurse directly instructs you to do so. You assist during an emergency by bringing supplies, directing emergency responders to the room, or performing basic life support within the scope of your training.
After the emergency has passed, report all of your observations and actions directly to the nurse. Complete any required documentation as directed by the nurse, ensuring that your records are purely objective, factual, and accurate.
Common mistakes
- Hitting a resident on the back while they are coughing forcefully during a mild airway obstruction, which can lodge the object deeper.
- Attempting to hold down or restrain a resident's limbs during a seizure, risking fractures and muscle tears.
- Inserting a spoon, tongue blade, or fingers into a seizing resident's mouth, which damages teeth and blocks the airway.
- Performing blind finger sweeps in an unresponsive choking resident's mouth when an obstruction is not visible.
Key points
- An emergency is an unexpected event requiring quick action; nurse aides must remain calm, call for help, stay with the resident, and never give food or fluids unless directed by the nurse.
- For a mild choking obstruction with a forceful cough, encourage coughing; for severe choking, alternate five back blows and five abdominal thrusts (or chest thrusts if pregnant or obese).
- If a choking resident becomes unresponsive, lower them to the floor, call for help, begin CPR, look in the mouth before breaths to remove only visible objects, and never do blind finger sweeps.
- During a seizure, protect the resident by guiding them to the floor, clearing furniture, placing a soft item under the head, and turning them on their side when possible.
- Never restrain a seizing resident or place anything in their mouth; time the event and observe eye movements, affected body parts, and loss of bowel or bladder control.
- During the postictal phase, place the resident on their side, provide a calm rest environment, withhold food and fluids until cleared, and report all details immediately to the nurse.
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