5.4 Medical Emergencies
Key Takeaways
- Conscious choking adult who cannot cough, speak, or breathe: give abdominal thrusts (Heimlich) just above the navel until the object clears or the person becomes unresponsive — then lower them and begin CPR.
- During a seizure: protect from injury, clear hazards, never restrain or put anything in the mouth, time it, and turn the resident on their side when safe.
- For severe bleeding: apply firm direct pressure with a clean cloth, add more cloths without removing the first, and call the nurse immediately.
- Florida mandatory reporters must report known or suspected abuse, neglect, or exploitation of a vulnerable adult to the Florida Abuse Hotline at 1-800-962-2873 (1-800-96-ABUSE) immediately.
- Call the nurse for changes; call 911 / activate the code for unresponsiveness, no breathing, severe bleeding, choking that does not clear, or suspected stroke or cardiac event.
- Document every emergency as a factual incident report — what was observed, what was done, and who was notified.
The CNA's Role and Calling for Help
In an emergency the CNA's job is to recognize the problem, stay with the resident, call for help, and provide care within their training and scope until the nurse or EMS arrives. CNAs do not diagnose or prescribe; they observe and act. Knowing who to call is itself tested:
| Situation | Action |
|---|---|
| Change in condition (new pain, slight bleeding, mild distress) | Call the nurse |
| Unresponsive, not breathing, severe bleeding, choking that won't clear, suspected stroke or heart attack | Activate the emergency code / call 911 |
For any unresponsive resident, call for help / activate the code immediately, do not leave the resident, and report exactly what you found. If trained and certified in CPR, begin chest compressions for a resident with no pulse and no breathing. The Florida competency exam expects CNAs to stay calm, not move the resident unnecessarily, and report the time and findings to the nurse.
Choking, Syncope, Seizures
** If a conscious adult can cough or speak, encourage coughing and stay with them. If they cannot cough, speak, or breathe — often clutching the throat (the universal choking sign) — act at once: stand behind, place a fist just above the navel and below the ribs, and give quick inward-and-upward abdominal thrusts (Heimlich) until the object is expelled or the person becomes unresponsive.
If they become unresponsive, lower them to the floor, call for help/911, and begin CPR; check the mouth for the object before breaths and remove it only if you can see it (never a blind finger sweep, which can push it deeper).
Syncope (fainting). Warning signs include pallor, sweating, dizziness, and 'feeling faint.' If a resident feels faint, help them sit or lie down before they fall and elevate the legs if lying. If standing, ease them to the floor to prevent injury, then call the nurse. Keep them lying flat and monitor; fainting can signal low blood pressure, low blood sugar, or a cardiac problem.
Seizures. Protect the resident from injury: lower them to the floor, clear nearby hazards, cushion the head, and loosen tight clothing. Do not restrain the resident and do not put anything in the mouth (you can break teeth or block the airway). Time the seizure, note what you see, and when movements stop, turn the resident on their side (recovery position) to keep the airway clear and let secretions drain. Stay with them and call the nurse; prolonged or repeated seizures are an emergency.
Bleeding and Shock
Severe bleeding (hemorrhage). Apply firm direct pressure over the wound with a clean cloth or gauze; wear gloves if available (Standard Precautions). If blood soaks through, add more cloths on top — do not remove the first, because lifting it disrupts the forming clot. Raise the bleeding part if no fracture is suspected, keep the resident still, and call the nurse / activate help immediately. Note the amount and source for reporting.
Shock. Heavy bleeding, severe burns, or sudden illness can cause shock — inadequate blood flow to the body's tissues. Recognize the signs:
- Pale, cool, clammy (moist) skin
- Rapid, weak pulse and rapid, shallow breathing
- Low blood pressure, restlessness, anxiety, confusion
- Thirst, weakness, possible loss of consciousness
The CNA response: call for help/911, keep the resident lying down, control any bleeding, keep them warm (cover with a blanket) but do not overheat, do nothing by mouth, and stay with them. Do not move a resident in shock more than necessary, and report vital signs and observations to the nurse and EMS.
Abuse / Neglect Recognition & Florida Mandatory Reporting
Protecting residents includes recognizing abuse (physical, sexual, emotional/verbal, or financial exploitation) and neglect (failure to provide needed care) and self-neglect. Warning signs the CNA reports include unexplained bruises, burns, or injuries (especially in patterns), fear of a particular caregiver, withdrawal, or sudden behavior change, poor hygiene, weight loss, dehydration, or untreated pressure injuries, and missing money or belongings. Always treat a resident's report of mistreatment seriously.
Florida's mandatory-reporting duty
Under Florida Statute Chapter 415, anyone who knows or has reasonable cause to suspect that a vulnerable adult (elderly or disabled) has been or is being abused, neglected, or exploited must immediately report it. Nurses, nurse aides, and other health professionals and facility staff are mandatory reporters and can face criminal liability for failing to report. Reports go to the Florida Abuse Hotline at 1-800-962-2873 (1-800-96-ABUSE), operated by the Department of Children and Families; reports may be made anonymously, and the reporter is protected. If a vulnerable adult is in immediate danger, call 911 first, then the Hotline.
Key CNA points: you report on suspicion — you do not need proof, and you do not investigate yourself. You report up the chain to your nurse/supervisor and you (as a citizen and professional) retain the duty to ensure a Hotline report is made. Never confront a suspected abuser; preserve evidence and report promptly.
Incident reporting
Every emergency, injury, error (wrong tray, fall, skin tear), or unusual occurrence is documented in an incident report with facts only — time, what happened, what was observed, what was done, and who was notified — never opinions or blame. Like the post-fall report, it is an internal risk-management record, not part of the medical chart, but the care given is also charted in the resident's record.
A conscious resident in the dining room suddenly cannot speak, cough, or breathe and is clutching the throat. What should the CNA do?
A resident begins having a seizure. The correct CNA response is to:
Which set of findings best indicates a resident may be going into shock?
A Florida CNA suspects that a resident is being abused by a caregiver. Under Florida law, the CNA must: