HCA - Health Care Assistant Safety and Emergency Procedures Questions and Answers 2 — Questions and Answers
Question 1: What is the correct sequence for responding to a fire in a long-term care facility according to RACE and PASS protocols?
- RACE: Rescue, Alarm, Confine, Extinguish/Evacuate; PASS: Pull, Aim, Squeeze, Sweep (Correct answer)
- RACE: Run, Alert, Call, Escape; PASS: Push, Aim, Spray, Sweep
- RACE: React, Alarm, Call, Escape; PASS: Pull, Activate, Spray, Squeeze
- RACE: Rescue, Alert, Contain, Extinguish; PASS: Prime, Aim, Squeeze, Spray
Correct answer: RACE: Rescue, Alarm, Confine, Extinguish/Evacuate; PASS: Pull, Aim, Squeeze, Sweep
RACE (Rescue, Alarm, Confine, Extinguish/Evacuate) and PASS (Pull pin, Aim at base, Squeeze handle, Sweep side to side) are the standard fire emergency mnemonics used in Canadian facilities.
RACE is the standard fire response framework in Canadian long-term care: Rescue anyone in immediate danger first, Alarm by pulling the nearest pull station and calling 911, Confine the fire by closing doors (smoke control), Extinguish/Evacuate based on training level and fire size. PASS guides safe fire extinguisher use: Pull the safety pin, Aim the nozzle at the base of the flames, Squeeze the handle, Sweep from side to side. HCAs should know evacuation routes, assembly points, and resident mobility categories from the facility's fire safety plan.
Question 2: A resident is found unresponsive and not breathing normally. What is the HCA's immediate action?
- Call for help immediately, activate the emergency response system, and begin CPR if trained and it is consistent with the resident's resuscitation status (Correct answer)
- Wait for a nurse to arrive before beginning any intervention
- Perform CPR on all unresponsive residents regardless of their DNR status
- Administer oxygen from the nearest supply tank independently
Correct answer: Call for help immediately, activate the emergency response system, and begin CPR if trained and it is consistent with the resident's resuscitation status
Immediate call for help and CPR (if appropriate per DNR status) are the correct initial actions; resuscitation status must always be checked first.
The immediate actions for an unresponsive, non-breathing resident are: call for help/activate the code system, check the care record or armband for DNR (Do Not Resuscitate) or DNAR (Do Not Attempt Resuscitation) status, and initiate CPR only if resuscitation is indicated. Performing CPR on a resident with a valid DNR order violates their advance directive and legal rights. HCAs certified in CPR should proceed only within their training level and the resident's documented wishes. AED use follows facility protocol.
Question 3: Which of the following actions is correct when a resident is experiencing a hypoglycaemic episode (blood sugar too low)?
- If the resident is conscious and able to swallow, administer 15 grams of fast-acting carbohydrate (e.g., glucose tablets, orange juice) per the care plan and notify the nurse immediately (Correct answer)
- Administer insulin to stabilize the blood sugar quickly
- Keep the resident lying flat and do nothing until the nurse arrives
- Give the resident a full meal with protein and fat to raise blood sugar
Correct answer: If the resident is conscious and able to swallow, administer 15 grams of fast-acting carbohydrate (e.g., glucose tablets, orange juice) per the care plan and notify the nurse immediately
Conscious hypoglycaemic residents need 15 grams of fast-acting carbohydrates; insulin would worsen the hypoglycaemia.
Hypoglycaemia (blood glucose <4.0 mmol/L in most Canadian guidelines) requires immediate treatment with fast-acting glucose. The '15-15 rule': give 15 grams of rapid carbohydrate (3-4 glucose tablets, 125 mL orange juice, or 125 mL regular soft drink), wait 15 minutes, recheck blood glucose. Insulin during hypoglycaemia would cause dangerous further glucose drop. A full meal with fat and protein is absorbed too slowly for acute treatment. Nursing notification is immediate and mandatory regardless of response to treatment.
Question 4: A resident is found on the floor after a fall. What should the HCA assess BEFORE attempting to help the resident up?
- Consciousness level, obvious injuries, pain complaints, and any inability to move extremities — do not move the resident if spinal injury is suspected until assessed by a nurse (Correct answer)
- Whether the resident can stand independently without assistance
- How long the resident has been on the floor and if they are upset
- Whether a second staff member is available before any assessment occurs
Correct answer: Consciousness level, obvious injuries, pain complaints, and any inability to move extremities — do not move the resident if spinal injury is suspected until assessed by a nurse
A systematic post-fall assessment for injury (especially spinal) must precede any movement; moving an unstable fracture or spinal injury can cause permanent harm.
Post-fall assessment is a critical safety procedure. Before attempting to assist the resident to stand, the HCA must assess: responsiveness/level of consciousness, any obvious injuries (deformity, swelling, asymmetry), complaints of pain especially neck or back, ability to move extremities. If any concern for spinal injury exists, the resident must not be moved until a nurse completes a spinal precautions assessment. A second staff member is recommended for the eventual assisted stand, but their absence does not delay the safety assessment.
Question 5: What is 'workplace violence prevention' and how does it apply to HCAs caring for residents with challenging behaviours?
- Recognizing triggers, using de-escalation techniques, following the care plan for responsive behaviours, and reporting incidents — never accepting violence as 'part of the job' (Correct answer)
- Physically restraining residents who display aggressive behaviour to protect other residents
- Avoiding all interaction with behaviourally challenging residents to minimize risk
- Documenting assaults only when injuries require medical treatment
Correct answer: Recognizing triggers, using de-escalation techniques, following the care plan for responsive behaviours, and reporting incidents — never accepting violence as 'part of the job'
Violence prevention includes proactive de-escalation, care plan adherence, and consistent incident reporting; accepting violence normalizes harm.
WorkSafeBC and Ontario's Occupational Health and Safety Act both require employers to develop workplace violence prevention programs for health care settings, and HCAs have rights and responsibilities within these programs. This includes: identifying and reducing environmental triggers per behaviour care plans, using trained de-escalation techniques, not working alone with high-risk residents when preventable, using breakaway techniques if trained, and reporting every incident of resident aggression regardless of injury severity. Under-reporting perpetuates under-staffing and inadequate care-plan updates.
Question 6: What should an HCA do if a resident is found to have swallowed a non-food substance (e.g., cleaning product)?
- Call Poison Control (1-800-268-9017 in Ontario or 1-800-567-8911 in BC), notify the nurse immediately, and do not induce vomiting unless specifically directed to do so by Poison Control (Correct answer)
- Immediately induce vomiting to remove the substance from the stomach
- Give the resident large amounts of milk or water and wait to see if symptoms develop
- Document the incident and wait for the nurse to notice during rounds
Correct answer: Call Poison Control (1-800-268-9017 in Ontario or 1-800-567-8911 in BC), notify the nurse immediately, and do not induce vomiting unless specifically directed to do so by Poison Control
Poison Control provides immediate expert guidance; inducing vomiting can worsen injuries from caustic substances.
Inducing vomiting after ingestion of caustic substances (bleach, lye, acids) causes additional chemical burns to the esophagus on the way back up. Current Poison Control guidance recommends against routine vomiting induction for most ingestions. Poison Control Canada provides 24-hour expert toxicological guidance and should be contacted immediately alongside nursing notification. The HCA should stay with the resident, note the time and substance ingested (bring the container if possible), monitor vital signs, and follow Poison Control and nursing instructions.
HCA - Health Care Assistant Safety and Emergency Procedures Questions and Answers 2
What is the correct sequence for responding to a fire in a long-term care facility according to RACE and PASS protocols?