5.2 Safety & Emergency Response

The CNA's Role in an Emergency

Safety questions appear throughout the New Jersey CNA written exam and underpin the safety points scored in the skills evaluation. In ANY emergency the CNA's job is to stay calm, stay with the resident, call for the nurse, and provide only the care within the CNA scope of practice. The CNA does not diagnose, give medications, or perform procedures reserved for licensed staff; the CNA observes, reports, protects, and assists. Knowing what NOT to do is as testable as knowing what to do.

Fall Prevention

Falls are the leading cause of injury and injury-related death in long-term care. Prevention is proactive, not reactive — you build a safe environment before anything happens.

• Keep the call light within reach and answer it promptly, every time
• Lock the wheels on beds and wheelchairs before any transfer
• Keep the bed in the lowest position with brakes locked when care is finished
• Provide non-skid footwear; clear clutter, electrical cords, and spills immediately
• Ensure adequate lighting, including night lighting, and offer regular toileting
• Use a gait belt for ambulation and stand on the resident's weak (affected) side
• Make sure assistive devices (walker, cane, glasses, hearing aids) are within reach and working

If a resident starts to fall, do not try to catch or hold them upright — you risk injuring yourself and them. Widen your stance, ease them down your body to the floor while protecting the head, then call for help and stay with them until the nurse assesses for injury before anyone moves the resident.

Restraint Alternatives and Safe Use

A restraint is any device, garment, or method that the resident cannot remove that restricts free movement or access to one's own body. Federal OBRA law and New Jersey policy require restraints to be a last resort, used only with a provider's order, for a specified time, in the least restrictive form, and never for staff convenience or discipline.

Restraint risks include strangulation, impaired circulation, pressure injuries, incontinence, depression, agitation, and loss of dignity — which is why alternatives always come first.

Fire Response: RACE and PASS

Two acronyms run the fire response, and the exam loves them. RACE is the overall plan; PASS is only for using an extinguisher on a small, contained fire.

Never use elevators during a fire — use stairs. In oxygen-enriched rooms, fire ignites and spreads fast, so keep oxygen tubing and tanks away from flames, grease, electrical sparks, and frayed cords, and post No Smoking signs on the door and over the bed.

Basic First Aid Within Scope

Notice the pattern: the CNA stabilizes, protects, and summons the nurse — never administers treatment beyond scope.

Incident Reporting and Emergency Codes

Report every fall, medication error, skin tear, injury of unknown origin, or unusual event to the nurse immediately, and complete an incident (occurrence) report with objective facts only — what you saw, heard, said, and did, using the resident's own words in quotes. Never record opinions, blame, or assumptions about cause. Many facilities use color codes; learn yours during orientation (commonly Code Red for fire and Code Blue for cardiac or respiratory arrest), but codes vary by facility, so confirm the exact codes for your workplace.

Choking, Bleeding, and Body Mechanics in Detail

For a conscious choking adult with a complete airway obstruction — they clutch the throat, cannot speak, cough, or breathe — stand behind them, place a fist thumb-side-in just above the navel, and give quick inward-and-upward abdominal thrusts until the object is expelled or the resident becomes unresponsive. If they can still cough forcefully, do not interfere; encourage continued coughing. For severe bleeding, apply firm, continuous direct pressure with the cleanest barrier available, keep the area still, and never lift soaked dressings to peek — doing so disrupts clotting, so layer fresh dressings on top.

Protecting yourself is also tested. Good body mechanics prevent the back injuries that end CNA careers: keep a wide base of support with feet shoulder-width apart, bend at the hips and knees (not the waist), hold the load close to your body, push or pull rather than lift when possible, pivot your whole body instead of twisting your spine, and get help for heavy transfers. Raise the bed to a safe working height before care, then lower it afterward.