Fire and Emergency Response

Fire Response: RACE and PASS

Every healthcare worker must respond to fire the same way, because seconds matter and residents cannot always save themselves. The two acronyms you must know exactly are RACE and PASS.

RACE — What to Do When You Discover a Fire

The order matters: residents come before the alarm, and the alarm comes before any attempt to fight the fire. Smoke and toxic gases kill more people than flames, which is why containing the fire by closing doors is a rescue measure in itself.

PASS — Using a Fire Extinguisher

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

Only attempt to extinguish a small fire, keep your exit behind you, and never let the fire get between you and the door.

Oxygen Safety

Oxygen does not burn, but it supports combustion — it makes other materials ignite faster and burn hotter. When oxygen is in use:

• No smoking anywhere in the area; post "Oxygen in Use" signs
• No open flames, candles, lighters, or matches
• Avoid sparks — use only facility-approved electrical equipment, avoid wool blankets and synthetic fabrics that create static electricity
• Keep oxygen cylinders secured upright in a holder or cart so they cannot fall and become a projectile
• Keep grease and oil away from oxygen connections

Evacuation and Disaster Preparedness

Facilities use a defend-in-place strategy: because moving residents is dangerous, evacuation happens in stages.

1. Horizontal evacuation first — move residents through smoke or fire doors to a safe area on the same floor
2. Vertical evacuation (stairs, never elevators) only if the fire cannot be contained
3. Move order: ambulatory residents first (they can follow instructions quickly), then residents in wheelchairs, then bed-bound residents last using blankets or carries

Before any emergency, know your facility's fire exits, alarm locations, extinguisher locations, and the disaster plan. Facilities hold regular fire drills — take them seriously and know your assigned role. For disasters such as Montana's winter storms, wildfires, or power outages, the facility's emergency plan covers backup power for oxygen and refrigeration, resident identification, and evacuation destinations.

During any evacuation, never use elevators, keep doors closed behind you, stay low if smoke is present, and check doors for heat with the back of your hand before opening them. Bed-bound residents are moved with a blanket drag or carry by enough staff to do it safely — speed matters, but dropping a resident does not save time. Account for every resident at the assembly area using the census list. Facilities also announce emergencies with codes (for example, a fire code); learn your facility's code words and what each one requires of you. Report anything that smells like smoke or looks like faulty electrical equipment — frayed cords and overloaded outlets are common ignition sources, and reporting them is part of the CNA's safety role.

Choking, Cardiac Arrest, and Poisoning

Choking (Foreign-Body Airway Obstruction)

• If the resident can speak, cough, or breathe, encourage coughing and stay with them — do not slap the back or reach into the mouth
• If the resident cannot speak, breathe, or cough (or clutches the throat — the universal choking sign), call for help and give abdominal thrusts (the Heimlich maneuver): stand behind the resident, make a fist just above the navel, and thrust inward and upward until the object is expelled or the resident becomes unresponsive
• For a pregnant or very large resident, use chest thrusts instead
• If the resident becomes unresponsive, lower them to the floor, activate the emergency response, and begin CPR, looking in the mouth before giving breaths

Cardiac Arrest

Call for help first (activate the emergency response or call 911 per facility policy), then begin cardiopulmonary resuscitation (CPR) if it is within your scope and the resident does not have a valid do-not-resuscitate (DNR) order. Push hard and fast in the center of the chest; send someone for the automated external defibrillator (AED). Always check the code status — performing CPR on a resident with a DNR violates their rights.

Poisoning and Chemical Hazards

Under OSHA's Hazard Communication Standard, every facility keeps Safety Data Sheets (SDS) for each chemical — cleaning solutions, disinfectants, and medications you handle. The SDS explains the hazards, safe handling, required protective equipment, and first-aid measures. If a chemical contacts skin or eyes, flush with water and report immediately. For a suspected poisoning, call the Poison Control Center at 1-800-222-1222 and follow the nurse's directions — never induce vomiting unless instructed, because some substances cause more damage coming back up. Store all chemicals in their original labeled containers, never in food or drink containers.