Fire, Oxygen, Chemical & Disaster Safety
Key Takeaways
- RACE sets the order of fire response: Rescue, Alarm, Contain, Extinguish or Evacuate — rescue those in immediate danger first.
- PASS operates the extinguisher: Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side.
- Oxygen does not burn but makes everything else burn faster and hotter, so no smoking, open flame, electric razors, or wool blankets near oxygen in use.
- Rhode Island nursing assistants may not apply oxygen at all — it is an excluded duty under 216-RICR-40-05-22.12.1(C).
- Safety Data Sheets for every hazardous chemical must be accessible to staff at all times, and emergency code colors vary by facility, so learn your own facility's list.
Fire, Oxygen, Chemical & Disaster Safety
A fire in a nursing facility is uniquely dangerous because the occupants cannot self-evacuate. Long-term care fire plans therefore rely on defend in place — containing the fire behind fire doors and moving residents horizontally away from it — rather than emptying the building. Everything below follows from that.
The Fire Triangle
Fire needs three things: fuel, heat, and oxygen. Remove any one and the fire dies. This is why closing doors (removing oxygen) is a required step and why oxygen concentrators dramatically change a fire's behavior.
RACE — the response sequence
| Letter | Action | Detail |
|---|---|---|
| R — Rescue | Move anyone in immediate danger | Only those directly threatened. Do not begin a general evacuation |
| A — Alarm | Pull the nearest manual alarm and call the facility emergency number or 911 | State the exact location of the fire |
| C — Contain | Close all doors and windows | Starves the fire of oxygen and holds smoke behind fire doors. Shut off oxygen only if designated and trained to do so |
| E — Extinguish or Evacuate | Use an extinguisher on a small, contained fire if trained and safe; otherwise evacuate | Move residents horizontally past smoke barrier doors first, then vertically down stairwells. Never use elevators |
Evacuation priority
When evacuation is ordered, the standard priority is: ambulatory residents first (they can be directed to move as a group), then residents needing assistance, then non-ambulatory and bedbound residents. Residents closest to the fire go before those further away within each group.
PASS — operating a fire extinguisher
| Letter | Action |
|---|---|
| P — Pull | Pull the safety pin at the top of the handle to break the tamper seal |
| A — Aim | Aim the nozzle at the base of the fire, where the fuel is, not at the flames |
| S — Squeeze | Squeeze the lever smoothly to discharge the agent |
| S — Sweep | Sweep side to side across the base until the fire is out |
Stand 6 to 8 feet back, keep an exit behind you, and never let a fire come between you and the door. If the extinguisher empties and the fire is not out, leave and close the door.
Oxygen Safety
Oxygen does not burn. It is an oxidizer: it makes other materials ignite more easily and burn far hotter. A cotton gown that would smolder in room air will flash in an oxygen-enriched one.
Rules around oxygen in use
- No smoking by anyone in the room, and post "Oxygen in Use" signage per facility policy.
- No open flame — candles, lighters, matches.
- No electric razors, hair dryers, heating pads, or other spark-producing appliances near the oxygen source.
- No wool or synthetic blankets or clothing that build static; cotton is preferred.
- No petroleum-based products (petroleum jelly on lips or nose) where facility policy prohibits them; use water-soluble lubricant.
- No alcohol-based products or aerosol sprays near the source.
- Keep tubing untangled and off the floor, check that it is not kinked or lying under the resident, and check behind the ears and around the nostrils for pressure sores from the cannula.
- Secure portable cylinders upright in a stand or cart so they cannot fall.
⚠️ A Rhode Island-specific rule you must know. Oxygen application is on the regulation's list of duties excluded from nursing assistant practice (216-RICR-40-05-22.12.1(C)). A Rhode Island nurse aide does not start oxygen, does not change the flow rate, and does not switch a resident from cannula to mask. You may observe the equipment, report a disconnection or empty cylinder, keep the tubing safe, and provide skin and mouth care — the licensed nurse does the rest. Notably, a licensed Medication Aide may apply oxygen, but only under direct supervision of a licensed nurse.
Chemical Safety
- Safety Data Sheets (SDS) — standardized documents giving the hazards, handling, storage, protective equipment, and first-aid measures for every hazardous chemical in the building. They must be accessible to all staff at all times. Know where yours are before you need them.
- Never transfer a chemical into an unlabeled container, and never mix cleaning products. Bleach plus ammonia produces toxic chloramine gas.
- Store chemicals in a locked area away from resident access, especially on units with residents who have dementia.
- Report spills immediately and follow the SDS. Blood and body fluid spills are handled with gloves and the facility's approved disinfectant; "handling of blood/body fluid spills" is an explicitly listed nursing assistant duty in Rhode Island.
Electrical and Equipment Safety
- Report frayed cords, exposed wires, cracked plugs, sparks, a burning smell, or a warm outlet immediately and take the item out of service.
- Pull a plug by the plug, not the cord.
- Do not overload outlets or run cords under carpet or across walkways.
- Do not use electrical equipment near water or with wet hands.
- Report any equipment that is broken, missing parts, or does not lock — beds, wheelchairs, mechanical lifts, side rails.
Emergency Codes and Disaster Plans
Facilities use color codes so staff can be alerted without alarming residents and visitors. Common assignments include:
| Code | Typical meaning |
|---|---|
| Code Red | Fire or smoke |
| Code Blue | Cardiac or respiratory arrest |
| Code Pink | Infant or child abduction |
| Code Purple / Code Yellow | Missing resident (elopement) or disaster, depending on facility |
| Code Gray / Code Black | Severe weather, bomb threat, or structural emergency, depending on facility |
| Code Silver | Weapon or active shooter |
📌 Code colors are not standardized nationally. They vary by facility and even between facilities in the same system. Learn the list posted at your own facility during orientation; an exam item will describe the situation, not rely on your knowing a particular color.
Other disaster responses
- Severe weather / tornado warning: move residents away from windows and exterior glass into interior corridors; close drapes and doors; do not use elevators.
- Elopement (missing resident): report immediately, give a description of clothing and appearance, and search your assigned area as directed. Wandering residents are at risk of traffic, exposure, and dehydration.
- Utility failure: know where emergency lighting and red outlets (emergency generator power) are located; life-support and essential equipment plugs into the red outlets.
A nurse aide discovers a small fire in a resident's wastebasket. The resident is in bed next to it. What is the correct order of actions?
A resident in Rhode Island using a nasal cannula tells the nurse aide he feels short of breath and asks her to "turn the oxygen up a little." What should she do?
Which item poses the greatest fire hazard in the room of a resident receiving oxygen?
When using a fire extinguisher according to the PASS method, where should the Nursing Assistant aim the nozzle?