5.5 Emergency Response Procedures

The CNA Role in an Emergency

The CNA does not provide advanced treatment, but is usually the first person at the bedside, so the exam tests rapid recognition and the right first moves. For any emergency the order is the same: stay calm, call for help (activate the emergency or code team), stay with the resident, and provide basic care within your training. Never leave a resident in distress to go searching for the nurse - use the call light or shout.

Cardiac Arrest and CPR

If a resident is unresponsive and not breathing normally (or only gasping), check responsiveness, call for help and the automated external defibrillator (AED), and begin cardiopulmonary resuscitation (CPR) if certified. The current American Heart Association (AHA) 2025 adult standards are tested precisely:

Note that the depth ceiling of 2.4 inches is a recent AHA refinement of the older "at least 2 inches" wording - deeper compressions raise injury risk without benefit. Untrained or unwilling rescuers perform hands-only CPR (continuous compressions, no breaths).

Choking

A conscious adult who can still cough or speak has a partial obstruction - encourage forceful coughing and do not interfere. If the person cannot cough, speak, or breathe, the airway is fully blocked: give abdominal thrusts (the Heimlich maneuver).

1. Stand behind the person and wrap your arms around the waist.
2. Make a fist, thumb-side in, just above the navel and below the breastbone.
3. Grasp the fist with the other hand and give quick inward and upward thrusts.
4. Continue until the object comes out or the person becomes unresponsive; then lower them and begin CPR, checking the mouth before any breaths.

Stroke: BE FAST

Time is brain. Memorize BE FAST:

Keep the resident calm and safe, give nothing by mouth (swallowing may be impaired), and report the exact time symptoms began, because clot-busting treatment is time-limited.

Seizures

Do not restrain the resident and never place anything in the mouth - both cause injury. Instead, ease them to the floor, cushion and turn the head to the side to protect the airway, clear nearby hazards, loosen tight clothing, and time the seizure. Afterward keep them on their side in the recovery position, check breathing, stay with them, and report duration and what you observed.

Bleeding and Anaphylaxis

For severe bleeding, apply firm direct pressure with a clean cloth and do not lift it to peek - add more cloths on top if it soaks through. For a severe allergic reaction (anaphylaxis) with facial swelling and breathing difficulty, call for help immediately, keep the airway open, and assist with the resident's prescribed epinephrine auto-injector only if trained and permitted.

Recognizing the Emergency Early

Fast recognition is what the CNA is actually graded on, because the aide is usually first at the bedside. Memorize the system-by-system danger signs: no breathing or only gasping; no pulse, crushing chest pain, or uncontrolled bleeding; sudden unresponsiveness, new confusion, or a seizure; a blue or gray (cyanotic) or sweaty, ashen appearance; and the BE FAST stroke signs. Any one of these triggers an immediate call for help and the emergency team rather than waiting to "see if it passes."

Fainting (Syncope) and Positioning

If a resident says they feel faint, help them sit or lie down before they collapse; for a seated resident, having them lower the head toward the knees and loosening tight clothing restores blood flow to the brain. If a resident does faint, guide them to the floor rather than catching them, position them on the back, and elevate the legs to return blood to the heart and brain. Check breathing, call for help, and give nothing by mouth until the resident is fully alert and the nurse has assessed them.

The Recovery Position and Aspiration Risk

For any unresponsive resident who is breathing - after a seizure, a faint, or once choking resolves - the side-lying recovery position protects the airway by letting secretions or vomit drain out of the mouth instead of into the lungs. Aspiration is a leading complication the exam wants you to prevent, which is why nothing is given by mouth and the head is turned to the side during and after these events.

Staying Within Scope

The CNA's lane in an emergency is recognition, summoning help, basic care, and clear reporting - not diagnosis or medication. You report exactly what you saw and did to the arriving team, including times. Acting beyond your training, or leaving the resident to find someone, are the two most common wrong answers on emergency items.

Worked Scenario

A resident at lunch suddenly clutches the throat, turns dusky, and cannot make a sound. This is a complete obstruction, so the CNA delivers abdominal thrusts at once while someone calls for help. If instead the resident is coughing loudly and can gasp "I'm choking," the airway is only partially blocked and the correct action is to encourage continued coughing - intervening with thrusts on someone still moving air can convert a partial block into a complete one.