CNA Safety and Emergency Procedures 1 2 — Questions and Answers

Question 1: When performing the Heimlich maneuver (abdominal thrusts) on a conscious adult who is choking, the CNA should position their hands:

With both hands over the center of the breastbone
With one hand in a fist placed just above the navel and below the sternum, covered by the other hand (Correct answer)
With both hands around the throat to clear the airway
With hands on the lower abdomen, below the navel

Correct answer: With one hand in a fist placed just above the navel and below the sternum, covered by the other hand

For the Heimlich maneuver, the fist is placed just above the navel and well below the sternum, then covered with the other hand to deliver firm inward and upward thrusts.

To perform the Heimlich maneuver on a conscious adult: (1) Stand behind the choking person and wrap your arms around their waist. (2) Make a fist with one hand and place the thumb side against the abdomen, midline, just above the navel and well below the xiphoid process (bottom of the sternum). (3) Grasp the fist firmly with the other hand. (4) Deliver sharp inward and upward thrusts, repeating until the object is expelled or the person becomes unconscious. If the person becomes unconscious, lower them to the floor, call for help, begin CPR, and each time you open the airway for rescue breaths, look for the object and remove it if visible. Special considerations: for pregnant or obese individuals, use chest thrusts instead of abdominal thrusts.

Question 2: The PASS technique is used when operating a fire extinguisher. What does PASS stand for?

Prepare, Aim, Squeeze, Sweep
Pull pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side (Correct answer)
Push, Activate, Stop, Spray
Point, Assess, Set, Smother

Correct answer: Pull pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side

PASS = Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side. This is the standard technique for using a portable fire extinguisher.

The PASS technique for fire extinguishers: (P) Pull the safety pin from the handle. (A) Aim the nozzle at the BASE of the fire, not at the flames — the fire is fed from the base where the fuel is. (S) Squeeze the handle to release the extinguishing agent. (S) Sweep the nozzle from side to side at the base of the fire until it is extinguished. CNAs should also know the RACE protocol for fire emergencies in healthcare: (R) Rescue — remove residents in immediate danger. (A) Alarm — activate the fire alarm and call 911. (C) Contain — close all doors and windows to slow fire spread. (E) Extinguish/Evacuate — extinguish small fires if safe, or evacuate. Resident safety through evacuation always takes priority over extinguishing the fire.

Question 3: Which of the following is the correct procedure when a resident falls?

Immediately lift the resident off the floor to prevent embarrassment
Stay with the resident, call for help, do not move the resident, and assess for injury before the nurse arrives (Correct answer)
Complete an incident report before providing any care
Tell the resident to get up slowly and offer reassurance

Correct answer: Stay with the resident, call for help, do not move the resident, and assess for injury before the nurse arrives

After a fall, stay with the resident, call for help, and do not move the resident until the nurse has assessed for injuries — moving may worsen a fracture or spinal injury.

When a resident falls: (1) Do not leave the resident alone — stay with them. (2) Call for the nurse/charge nurse immediately. (3) Do not move the resident until the nurse has assessed for injury — moving someone with a hip fracture, spinal injury, or head injury without proper assessment and technique can cause additional harm. (4) Speak calmly to the resident while waiting for the nurse. (5) After the nurse assesses and clears the resident for movement, assist the nurse to help the resident up using safe lifting techniques. (6) After the incident, complete the required fall documentation and incident report as directed by the nurse. The incident report is a quality improvement tool, not a disciplinary document, but it must be completed accurately and promptly. Falls are the most common accident in nursing homes.

Question 4: What type of fire extinguisher should be used on an electrical fire?

Class A (water) extinguisher
Class C extinguisher, which is designed for electrical fires (Correct answer)
Class B extinguisher designed for flammable liquids
Any class of extinguisher is equally safe for electrical fires

Correct answer: Class C extinguisher, which is designed for electrical fires

Class C fire extinguishers use non-conductive agents safe for electrical fires. Water (Class A) extinguishers conduct electricity and can cause electrocution if used on electrical fires.

Fire extinguishers are classified by the type of fire they are designed to fight: Class A — ordinary combustibles (wood, paper, cloth) — water or dry chemical. Class B — flammable liquids (grease, oil, gasoline) — CO2 or dry chemical. Class C — electrical fires — CO2 or dry powder (non-conductive). Class D — combustible metals. Class K — cooking oils and fats (commercial kitchens). Using a water-based (Class A) extinguisher on an electrical fire is extremely dangerous because water conducts electricity, potentially causing electrocution or spreading the fire. Most modern facilities use ABC or BC dry chemical extinguishers that are effective on multiple fire types. CNAs should know the location of all fire extinguishers in their work area and how to use them.

Question 5: What does the acronym 'SDS' (Safety Data Sheet) refer to, and why is it important?

A form documenting a resident's social history and discharge summary
A document that provides information about chemical hazards, safe handling, storage, first aid, and emergency procedures for chemical products (Correct answer)
A schedule of daily safety checks for equipment
A summary of a resident's daily functional status

Correct answer: A document that provides information about chemical hazards, safe handling, storage, first aid, and emergency procedures for chemical products

An SDS (Safety Data Sheet) is required by OSHA for all hazardous chemical products and provides essential information on safe handling, exposure risks, and emergency procedures.

Safety Data Sheets (SDS), formerly called Material Safety Data Sheets (MSDS), are required by OSHA's Hazard Communication Standard (HazCom) for all chemical products that may pose health or physical hazards in the workplace. Each SDS contains 16 standardized sections covering: product identification, hazard identification, chemical composition, first-aid measures, fire-fighting measures, accidental release measures, handling and storage, exposure controls and personal protective equipment, physical and chemical properties, toxicology, ecological information, disposal considerations, regulatory information, and emergency procedures. CNAs may encounter hazardous chemicals (cleaning agents, disinfectants, floor strippers) and must know how to access SDS information in case of accidental exposure. SDS files must be readily accessible to all employees at all times.

Question 6: A resident is found unresponsive and not breathing normally. After calling for help, the CNA's next action in a facility with no AED immediately available should be:

Wait for the emergency medical team to arrive before doing anything
Begin CPR immediately, starting with chest compressions at a rate of 100-120 per minute (Correct answer)
Position the resident in the recovery position and monitor their breathing
Check the resident's vital signs before beginning any intervention

Correct answer: Begin CPR immediately, starting with chest compressions at a rate of 100-120 per minute

For an unresponsive adult who is not breathing normally, CPR should be started immediately with chest compressions at 100-120 per minute while help is summoned.

When a resident is found unresponsive and not breathing normally (or only gasping): (1) Call for help — activate the emergency response system, call 911 if in a home setting. (2) Begin CPR — start with 30 chest compressions: place hands on the center of the chest (lower half of the sternum), compress at least 2 inches deep at a rate of 100-120 per minute, allow full chest recoil. (3) If trained and willing, give 2 rescue breaths after 30 compressions. (4) Use an AED as soon as it is available and follow its prompts. (5) Continue CPR until the AED is ready, emergency medical personnel arrive, the resident begins to show signs of life, or you are physically unable to continue. Note: a valid DNR order means CPR should NOT be initiated. Always verify DNR status.

CNA Safety and Emergency Procedures 1 2

When performing the Heimlich maneuver (abdominal thrusts) on a conscious adult who is choking, the CNA should position their hands: