8.2 Fire (RACE/PASS), Oxygen, and Disaster Response
Key Takeaways
- RACE is Rescue, Alarm, Confine, then Extinguish or Evacuate — rescue a person in immediate danger before you fight the fire.
- PASS is Pull the pin, Aim at the base, Squeeze, Sweep — only if you are trained and have a clear exit.
- Never use the elevator in a fire unless the fire department or the written plan directs you; close doors to confine smoke.
- Oxygen safety: no smoking, no petroleum jelly (Vaseline) on the client or your hands near oxygen, no wool blankets that throw static, tanks upright and secured.
- In a tornado, blizzard, or active threat, the CNA stays with clients, keeps them calm, and follows the licensed nurse and the facility plan.
8.2 Fire (RACE/PASS), Oxygen, and Disaster Response
Quick Answer: In a fire, follow RACE: Rescue people in immediate danger, Alarm, Confine the fire by closing doors, then Extinguish or Evacuate. If you are trained and it is safe to use an extinguisher, follow PASS: Pull the pin, Aim at the base, Squeeze, Sweep. Never use the elevator in a fire unless a firefighter or the facility plan directs you. Oxygen is a fire accelerant: no smoking, no petroleum (Vaseline) on the client or your hands near oxygen, no wool blankets that throw static, tanks upright and secured. In a tornado, blizzard, or active threat, stay with clients, keep them calm, and follow the licensed nurse and the written facility plan.
Why this section is on the exam
Safety/Prevention/Emergency (NNAAP I.B.2) is not only falls. Written items ask what you do first when you smell smoke, how you aim an extinguisher, and what you never put on a person who is using oxygen. Colorado 3 CCR 716-1.11 requires safety and emergency procedures, including the Heimlich maneuver, in the first 16 pre-clinical hours. Fire, oxygen, weather, and an active-threat lockdown sit in that same pre-clinical bucket.
RACE — the order that saves people
RACE is the sequence, not a slogan you recite after the room is empty.
- Rescue. Move people in immediate danger first — the client in the smoking room, the person next to the burning wastebasket. You rescue if you can do it without becoming a second victim. Pull the person in the wheelchair, stay low under smoke, and do not go back for purses or phones.
- Alarm. Activate the pull station. Call out "fire" and the location. Dial the facility emergency number. The alarm is not optional because you "already yelled down the hall."
- Confine. Close doors and windows. That slows smoke and starves the fire of oxygen. Do not prop fire doors open with a linen cart. Know how to close the door to the room you just emptied.
- Extinguish or Evacuate. A small, contained fire (wastebasket) may be put out with an extinguisher if you are trained and you have a clear exit behind you. A spreading fire, heavy smoke, or a fire you cannot see the far side of is an evacuate event. Follow the facility exit route to the meeting point. Take the assignment roster if you can do it without delay so the nurse can account for every client.
Rescue comes before the alarm when someone is in the flames. If you are in the hall and you see smoke under a closed door, alarm and confine may come first because there is no one in immediate reach. The exam's favorite first action when a client is still in the burning room is rescue.
Elevators, doors, and the meeting point
- Never use the elevator in a fire unless the fire department or the written plan directs you. Smoke and power failure turn an elevator into a trap.
- Close doors as you leave. An open door is a chimney.
- Know two ways out of your unit and the outdoor or zone meeting point. Do not invent a shortcut through the kitchen if the plan says the courtyard.
- Horizontal evacuation (behind fire doors on the same floor) is common in nursing facilities. Follow the nurse; do not freelance a stairwell carry unless that is the plan.
- Once you reach the meeting point, stay with your clients. The count only works if the aide who knows the assignment is there.
PASS — only if it is safe to fight
PASS is how you hold the extinguisher. It is not a replacement for RACE, and it is not step one when a person is still in the chair beside the wastebasket.
- Pull the pin.
- Aim at the base of the fire, not at the pretty flames at the top.
- Squeeze the handle.
- Sweep from side to side at the base until the fire is out or you must leave.
Stand with your exit behind you. If the fire grows, drop the fight and evacuate. Aiming at the top of the flames is the classic wrong answer. Using PASS while people are still in the room is the other classic wrong answer.
Oxygen safety
Oxygen does not explode by itself. It makes everything else burn hotter and faster. Treat every cannula, concentrator, and tank as a fire hazard.
| Oxygen rule | Why it is on the exam |
|---|---|
| No smoking and no open flame (candles, lighters, gas stove, birthday sparkler) | The most common deadly combination |
| No petroleum products — Vaseline, petroleum lip balm, oil-based lotion — on the client or on your hands near oxygen | Petroleum gels ignite easily in an oxygen-rich field |
| No wool blankets or nylon that throws static | A static spark plus oxygen |
| Cotton bedding and clothing when the care plan specifies them | Cotton holds less static |
| Tanks upright and secured in a stand or cart; never lying loose under a bed or in a wheelchair footwell | A tank is a missile if the valve shears |
| Know how to shut the oxygen off if you are trained and the nurse or the fire plan directs you | You do not invent a shut-off during a drill you were never taught |
| Check tubing for kinks; keep equipment away from heat and from the edge of the overbed table | Delivery and fire risk |
| Post and enforce "oxygen in use" signs with visitors | Families bring candles |
If a visitor lights a cigarette "just outside the door" while a concentrator is running, you stop the smoking, remove the flame, and tell the licensed nurse. You do not laugh it off as a habit the family has had for 40 years.
Colorado expanded scope (3 CCR 716-1.10 I.3) lets a competent CNA apply authorized oxygen on a stable, not high-risk client. That permission is not a license to change the flow rate, to ignore a no-smoking sign, or to coat cracked lips with petroleum jelly "so the cannula does not hurt." Use a water-based product the nurse or the care plan allows.
Disaster response — tornado, blizzard, active threat
Colorado weather is not theoretical. Facilities write plans for tornado, blizzard or winter power loss, wildfire smoke, and active threat (an armed person). The CNA role is the same skeleton in every plan:
- Stay with your assigned clients. Abandonment during a disaster is still abandonment.
- Keep people calm. Short, true sentences. "We are moving to the inner hallway. I am staying with you."
- Follow the licensed nurse and the written facility plan. Do not argue for the basement if the plan says the interior bathroom. Do not post the lockdown on social media.
- For a tornado: move people away from windows, close curtains, and use blankets and pillows as assigned. Interior halls and windowless rooms are the usual shelter.
- For a blizzard or power failure: keep clients warm, watch for shivering and confusion, and conserve flashlight batteries. Report a generator or heat-loss problem up the chain. You do not leave the unit to "check the parking lot."
- For an active threat: follow the facility code — lock or secure, hide, keep clients quiet and away from doors and windows, and do not open the door for an unknown voice. Run only if the plan and the nurse direct an evacuation that is safer than staying.
You are not the incident commander. You are the person who does not leave Mrs. Ortiz alone in a wheelchair by a plate-glass window.
Electrical safety
Water and electricity kill. So do frayed cords.
- Do not use equipment with a frayed cord, a cracked plug, or a missing ground prong. Take it out of service and tell the nurse or maintenance.
- Do not daisy-chain extension cords or stack power strips. Plug facility equipment into the outlet the building provided.
- Keep hair dryers, razors, and chargers away from sinks and wet floors. Do not reach into water to grab a plugged-in device — separate the person from the power without becoming the next conductor, then call for the nurse.
- Oxygen concentrators and beds need clear vents. Do not bury a cord under a wet rug.
- If a person is being shocked, do not grab them with your bare hands. Cut the power or separate them with a dry non-conductor, then start the emergency report.
A tingling bed control, a hot plug, or a concentrator that smells like burning plastic is a take-it-out-of-service event, not a "it still works" event.
Colorado scenario
You are working evenings in a Fort Collins assisted-living memory unit. Mr. Hale uses oxygen by nasal cannula. You smell smoke at the end of the hall. A wool lap blanket is tucked around him. His daughter has just smoothed petroleum jelly on his lips "because the oxygen dries him out." A wastebasket in the next room is burning. The elevator is closer than the stairwell.
Rescue Mr. Hale and anyone in that next doorway first — wheelchair, not elevator. Alarm as soon as people in immediate danger are moving. Confine by closing doors. Do not take the elevator. At the meeting point you stay with your clients, keep them calm, and wait for the nurse's count. Later you report the wool blanket and the petroleum jelly as oxygen hazards, and you do not put the jelly back on "once the fire is out." If the fire had been only a small wastebasket, you had a clear exit, and people were already out of the room, PASS would mean aim at the base, not at the top of the flame.
Exam traps
- Using PASS as the first action when a person is still in the burning room (rescue first).
- Aiming the extinguisher at the top of the flames.
- Taking the elevator "because it is faster."
- Vaseline on oxygen clients, wool blankets, or tanks rolling under the bed.
- Leaving clients to go watch the fire trucks.
- Daisy-chaining extension cords or grabbing a person who is still in contact with a live wire.
- Changing an oxygen flow rate because "he looks short of breath" without the nurse.
You see flames in a client's wastebasket and the client is still in the recliner next to it. What is the RACE sequence?
A client is using oxygen by nasal cannula. Which oxygen-safety rule should the CNA follow?
Smoke is filling the corridor of a Colorado nursing facility. What should the CNA do about evacuation and the elevator?