5.2 Fire & Environmental Safety

The Fire Triangle and Prevention

Fire needs three elements, known as the fire triangle: fuel (paper, linens, clothing, alcohol-based hand rub), heat/spark (a flame, cigarette, frayed cord, or faulty outlet), and oxygen. Remove any one side and the fire cannot continue — this is why the CNA closes doors (cuts oxygen and confines the fire) and smothers small fires (cuts oxygen). Prevention means keeping these three from meeting: enforce smoking only in designated areas, keep heat sources away from linens and curtains, report frayed or damaged electrical cords, never overload outlets, and store flammable cleaning agents properly.

Electrical safety is part of this domain. Grasp the plug, not the cord, when unplugging; tag and remove any equipment with a frayed cord, exposed wire, or that sparks or shocks; keep cords out of walkways; and never run a cord under a rug where it can overheat. Electrical equipment should not be used near water (e.g., in a bathroom while a resident bathes).

RACE — Responding to a Fire

Every healthcare worker memorizes RACE, the order of fire response. Resident safety always comes before fighting the fire.

The order matters on the exam: you rescue first, then sound the alarm, then confine, then decide to extinguish or evacuate. A CNA only attempts to extinguish a small, contained fire after residents are safe and an alarm is sounded — never a large or spreading fire.

PASS — Using a Fire Extinguisher

When using a portable extinguisher on a small fire, follow PASS:

• P — Pull the safety pin.
• A — Aim the nozzle at the base of the fire (aiming at the flames wastes the agent).
• S — Squeeze the handle to discharge.
• S — Sweep side to side across the base until the fire is out.

Stand 6–8 feet back, keep your back to an exit so you can escape, and if the extinguisher empties or the fire grows, get out and close the door. Most facilities use a multipurpose ABC extinguisher: Class A (paper, cloth, wood), Class B (flammable liquids and grease), Class C (energized electrical equipment). Using the wrong class — for example water on an electrical or grease fire — can spread the fire or shock the user, which is why the all-purpose ABC unit is standard in care settings.

Knowing PASS in the correct order — pin, aim at base, squeeze, sweep — and that you fight only a small, contained fire after residents are safe and the alarm is sounded, are common written-exam items.

A CNA never delays evacuation to fight a fire that is large, spreading, blocking the exit, or producing heavy smoke. If you cannot put a small fire out within seconds, drop the extinguisher, get out, and close the door behind you to confine it.

Oxygen Safety and Evacuation Priorities

Oxygen does not burn by itself, but it makes everything around it ignite faster and burn hotter, so it is a major fire hazard in long-term care. Around oxygen in use: post 'Oxygen in Use' signs, allow no smoking, no open flames, no candles, and no sparking or electrical devices (electric razors, certain call bells). Avoid wool and synthetic blankets that build static, and keep oxygen tubing away from heat. Petroleum products (Vaseline) are avoided on the face of a resident on oxygen — water-based lubricant is used instead.

Evacuation order

If evacuation is ordered, the priority is to move residents in the most immediate danger first, then by mobility:

1. Ambulatory residents who can walk out (often directed/escorted).
2. Wheelchair residents.
3. Bed-bound / non-ambulatory residents last, who need the most help.

Use horizontal evacuation first — move residents through fire/smoke doors to a safe compartment on the same floor — before vertical evacuation down stairs. Never use elevators during a fire; they can fail, lose power, or open onto the fire floor. Stay low under smoke (cleaner air is near the floor), feel doors with the back of your hand before opening — if a door is hot, do not open it and use another route — and account for every resident at the designated assembly point using the unit roster.

Other environmental and chemical safety

The Promotion of Safety domain also covers everyday hazards. Scald prevention: check bath and shower water with a thermometer or your inner wrist — water for resident bathing should be comfortably warm (around 105°F, never hot) to prevent burns, especially in residents with reduced sensation. Poison/chemical safety: keep cleaning agents, sanitizers, and personal products in locked storage away from confused residents; know that a Safety Data Sheet (SDS) is available for every chemical and report spills. Sharps and equipment: dispose of sharps only in the puncture-proof biohazard container, and report any malfunctioning bed, lift, or call system rather than using it. These small habits prevent the burns, poisonings, and equipment injuries that the exam groups under resident safety.