2.3 First Aid, Choking, Rapid Response & Emergency Codes

First Aid, Choking, Rapid Response & Emergency Codes

NCCT's test plan asks PCTs to perform first aid, BLS, and rapid response procedures and to respond to work setting emergency situations such as fire and biological hazards. Section 2.2 covers fire response and adult BLS. This section covers the rest: recognizing deterioration early, summoning the right team, and giving first aid within the PCT role until licensed help arrives.

Rapid Response vs. Code Blue

Each hospital sets its own RRT criteria. The Institute for Healthcare Improvement's widely used example list includes:

• Heart rate below 40 or above 130 beats per minute
• Systolic blood pressure below 90 mm Hg
• Respiratory rate below 8 or above 28 breaths per minute
• SpO2 below 90% despite oxygen
• An acute change in level of consciousness
• Urine output below 50 mL over 4 hours
• A staff member who is worried about the patient

That last criterion matters for PCTs. You do not need to know the diagnosis; if something is wrong, stay with the patient, call for the nurse, and activate the RRT according to policy.

Stroke: Think BE-FAST

• Balance: sudden loss of balance or coordination
• Eyes: sudden vision loss or double vision
• Face: one side of the face droops
• Arms: one arm drifts down or is weak
• Speech: slurred or confused speech
• Time: note the time the patient was last known well and call for help immediately

Stroke treatments depend on how much time has passed, so the exact time you last saw the patient normal is valuable information for the nurse.

Choking (Foreign-Body Airway Obstruction)

The 2025 American Heart Association (AHA) Guidelines simplified choking care:

Earlier guidance taught abdominal thrusts alone for adults; the 2025 guidelines begin with back blows. If the person becomes unresponsive, lower them to the floor, call a code, and start CPR. Each time you open the airway to give breaths, look in the mouth and remove an object only if you can see it. Never perform a blind finger sweep.

Bleeding

1. Put on gloves and apply firm, direct pressure with gauze or a clean cloth.
2. If blood soaks through, add more layers on top without lifting the first dressing, which would pull away the forming clot.
3. Call for help. For life-threatening bleeding from an arm or leg that pressure cannot control, trained staff may apply a tourniquet above the wound; note the time it was applied.
4. Watch for signs of shock: pale, cool, clammy skin; fast, weak pulse; falling blood pressure; confusion.

Seizures

• Stay with the patient, call for help, and note the start time.
• Lower the bed and pad or clear the area; protect the head.
• Do not restrain movements and never put anything in the mouth.
• Loosen tight clothing, and when the jerking stops, turn the patient onto their side (recovery position) to drain secretions. Keep suction ready.
• A seizure lasting longer than 5 minutes, or repeated seizures without recovery between them, is an emergency (status epilepticus).
• Afterward, report and document what you saw: duration, body parts involved, incontinence, injuries, and how the patient woke.

Fainting, Low Blood Sugar, and Burns

• Fainting (syncope): guide the patient down safely, keep them lying flat, raise the legs if there is no injury, check breathing and pulse, and report. Section 9.2 covers fainting during blood draws.
• Low blood sugar (hypoglycemia): shakiness, sweating, confusion, headache, fast pulse, or sudden behavior change. Check a point-of-care glucose if you are trained and it is ordered, and notify the nurse. For an alert patient who can swallow, protocols often use the "15-15 rule" (15 grams of fast-acting carbohydrate, then recheck in 15 minutes), but the PCT gives food or juice only as the nurse or protocol directs.
• Burns: stop the burning, cool the area right away with cool (not icy) running water, remove jewelry near the burn before swelling starts, and cover loosely with a clean dressing. Never apply ice, butter, or ointments, and never break blisters.

Workplace Emergencies: Codes, Spills, and Biological Hazards

Hospitals announce emergencies with codes, and the names vary by facility and state. Many facilities are moving to plain-language alerts (for example, "Medical emergency, Room 412"). Commonly used examples:

• Chemical spills: a small, known spill may be cleaned with the spill kit following the Safety Data Sheet and the correct PPE. For a large, unknown, or fuming spill, move people away, close the door, keep others out, and notify according to the hazardous materials procedure.
• Biological hazards: for a patient suspected of a highly infectious disease, or a suspicious powder or package, keep people away, don the ordered PPE, isolate the area or patient, and notify the charge nurse and infection prevention. Follow the facility's incident command instructions rather than acting alone.
• Know your unit before an emergency happens: exits, fire alarm pull stations, extinguishers, oxygen shut-off valves, eyewash stations, spill kits, the crash cart, and the AED.