3.4 Emergency and Fire Response

Fire Response: RACE and PASS

Fire safety is almost always tested with two acronyms. The first, RACE, tells you what to do when a fire is discovered:

The exam stresses that you rescue people and sound the alarm before ever attempting to fight a fire. If the fire is large or spreading, you evacuate rather than extinguish.

The second acronym, PASS, tells you how to use a fire extinguisher:

• P — Pull the safety pin.
• A — Aim the nozzle at the base of the fire, not the flames.
• S — Squeeze the handle to release the agent.
• S — Sweep the nozzle from side to side across the base of the fire.

During a fire, also turn off oxygen sources, never use elevators, and feel doors for heat before opening them.

Choking, First Aid, and Common Emergencies

Choking (Airway Obstruction)

If a resident clutches the throat (the universal choking sign), is conscious and cannot speak, cough, or breathe, perform abdominal thrusts (the Heimlich maneuver): stand behind the person, place a fist above the navel, and give quick inward and upward thrusts until the object comes out or the person becomes unresponsive. If a resident is coughing forcefully and can still breathe, encourage them to keep coughing and do not interfere. If the person becomes unresponsive, lower them to the floor, call for help, and begin the facility's emergency protocol.

Bleeding and Other First Aid

For severe bleeding, apply firm direct pressure with a clean cloth and call for the nurse; do not remove soaked dressings — add more on top. For burns, cool a minor burn with cool (not ice-cold) water. Always wear gloves when blood is present.

Falls, Seizures, and Syncope

• Falls: If a resident falls, do not move them. Stay with the resident, call for the nurse, and let the nurse assess for injury before any repositioning. Never lift a resident who may be hurt.
• Seizures: Protect the head, lower the resident to the floor, move furniture away, and turn them on their side if possible. Never restrain the resident and never put anything in the mouth. Time the seizure and report it.
• Syncope (fainting): If a resident feels faint, help them sit or lie down to prevent a fall. If lying down, you may elevate the legs. Stay with them and call for the nurse.

Calling for Help and the CNA's Role

In any emergency, the CNA's first duties are to stay calm, ensure safety, and call for help immediately using the call light, calling out, or activating an emergency code. Do not leave a resident in distress alone unless you must get help and no one responds to your call.

The CNA's role and limits in an emergency:

• Work within your scope of practice — a CNA does not diagnose, give medications, or perform procedures reserved for nurses.
• Report what you observe accurately to the nurse: what happened, when, and the resident's condition.
• Perform only the care you are trained and certified to do, such as basic first aid and CPR if you are certified.
• After the event, document objectively and complete an incident report describing the facts.

Recognizing an Emergency

Know the warning signs that require immediate help: chest pain, difficulty breathing, sudden weakness or facial drooping (signs of stroke), uncontrolled bleeding, loss of consciousness, or choking. When in doubt, call for the nurse. A calm, prompt CNA who summons the right help quickly is exactly what the exam — and real residents — need.

Disasters, Codes, and Staying Within Your Role

Facilities run regular drills for fires and other disasters, and CNAs are expected to know their part. In an evacuation, follow the facility plan, move residents who can walk first, use wheelchairs or evacuation devices for those who cannot, never use elevators, and account for every assigned resident at the gathering point. During a power outage, oxygen concentrators may stop working, so report immediately so the nurse can switch residents to backup tanks.

Common Emergency Codes

Many facilities use color codes you should recognize:

Whatever the emergency, the CNA's value lies in early recognition and fast, accurate reporting. You are often the staff member closest to the resident, so noticing a sudden change — new confusion, chest pain, trouble breathing, a fall, or unresponsiveness — and calling for the nurse immediately can save a life. Then assist only within your trained scope: comfort the resident, gather supplies, clear the area, and follow the nurse's direction. Knowing exactly what to do, and what NOT to do, is the heart of emergency competence on the California CNA exam.