Module 05

Emergency &
Safety Procedures

Responding to Emergencies, Incident Reporting & Fall Prevention

What You'll Learn

Learning Objectives

Describe the correct sequence of actions in a medical emergency
Identify at least five triggers that require immediate supervisor notification
Complete an incident report with all required elements
Explain the home environmental safety assessment process
Describe actions to take during a weather emergency or power outage at a patient's home

The Reality

"In a home care emergency, you are the first responder. Your actions save lives."

There is no crash cart. No code team down the hall. It's you, the patient, and your training.

Medical Emergency Response

The 5-Step Sequence

Memorize this sequence. Every second matters.

Ensure safety — Is the environment safe for you to approach? (Fire, gas leak, aggressive person)
Call 911 for any life-threatening emergency: difficulty breathing, chest pain, unresponsiveness, seizure, severe bleeding, suspected stroke
Stay with the patient until EMS arrives — do not leave them alone
Call your supervisor immediately — do not wait until EMS leaves
Document everything in the incident report before end of shift

Never Wait and See

Call 911 Immediately For

These symptoms are potentially life-threatening. Do not wait to see if they improve.

Chest pain or pressure — any complaint of chest discomfort
Difficulty breathing or sudden shortness of breath
Sudden confusion or change in mental status
Falls with head injury or inability to get up
Uncontrolled bleeding
Suspected stroke — remember FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911
Seizures in a non-seizure-disorder patient

Stroke Recognition

Remember FAST

Every minute counts during a stroke. Brain tissue dies rapidly without blood flow.

F

Face Drooping

Ask the person to smile. Does one side of the face droop or feel numb?

A

Arm Weakness

Ask the person to raise both arms. Does one arm drift downward?

S

Speech Difficulty

Ask the person to repeat a simple sentence. Is speech slurred or strange?

T

Time to Call 911

If any of these signs are present, call 911 immediately. Note the time symptoms began.

Urgent — Not 911

When to Call Your Supervisor

These situations are not 911 emergencies but require immediate supervisor notification.

Repeated care refusal — patient refuses all care for the second consecutive day
Medication error — patient took wrong dose or wrong medication
New skin breakdown or pressure injury observed
Increased confusion — patient appears significantly more confused than usual
Signs of possible abuse or neglect
Significant vital sign changes (if you are authorized to take them)
Equipment failure — oxygen concentrator, hospital bed, etc.
You feel unsafe in the patient's home

Decision Guide

911 vs. Supervisor — Know the Difference

Call 911 First

Chest pain or difficulty breathing
Unresponsive or unconscious
Severe bleeding
Fall with inability to stand
Suspected stroke or seizure

Call Supervisor First

Care refusal (2+ days)
New skin breakdown
Medication error discovered
Equipment malfunction
Feeling unsafe in the home

When in doubt, call 911 first. You will never be disciplined for calling 911 in good faith.

Documentation

Incident Reports

An incident report must be completed for ANY unexpected event that affects patient safety — including near-misses.

Date, time, and exact location of the incident
What happened — factual, objective description. No opinions.
Patient condition before and after the incident
Witnesses — who else was present
Your response — what you did immediately
Notification — whether supervisor and/or family were notified, and when

Incident reports are internal documents and are NOT placed in the patient's medical record.

Getting It Right

Incident Report — Standards

Write This

"Patient fell from standing position at 10:15 AM in the bathroom"
"Patient states 'my hip hurts' and is unable to bear weight"
"Called 911 at 10:17 AM, supervisor notified at 10:20 AM"
"Patient conscious and alert throughout"

Never Write This

"Patient probably tripped on the rug"
"I think he may have broken his hip"
"He should have been using his walker"
"The family should have had someone watching him"

Rule: Document facts. Document what you observed and what you did. Leave opinions, interpretations, and blame out.

Prevention

Fall Prevention — Every Visit

Falls are the leading cause of injury in home care patients. Prevention is part of every single visit.

Clear pathways — ensure routes to bathroom and commonly used areas are free of clutter
Adequate lighting — check that all hallways and rooms have working lights
Assistive devices — confirm walker, cane, or wheelchair is within reach
Remind patients to call for assistance before getting up
Check footwear — no slippery socks, no loose slippers
Report hazards — loose rugs, wet floors, broken steps to your supervisor

Your environmental scan at every visit is the most powerful fall prevention tool there is.

When a Fall Happens

Post-Fall Protocol

Even with the best prevention, falls happen. Here is what you do.

DO NOT attempt to lift the patient — moving someone with a possible fracture can cause serious additional injury
Make the patient comfortable — pillow under head, blanket if cold
If they report pain or cannot bear weight — call 911
Call your supervisor immediately
Stay with the patient and reassure them until help arrives
Complete an incident report before end of shift

Ohio Weather

Weather & Power Emergencies

Ohio weather emergencies include tornadoes, ice storms, and prolonged power outages. If a weather emergency develops during your shift:

Tornado Warning

Do not leave the patient alone during an active threat
Move patient to an interior room on the lowest floor
Stay away from windows
Call your supervisor to report the situation

Power Outage

Check on oxygen-dependent patients first
Document battery backup status
Ensure patient warmth in winter / cooling in summer
Call supervisor for guidance and document

Environmental Safety

Home Safety Checklist

Conduct a quick visual safety scan at the start of every visit. Report any new hazards to your supervisor.

Check Every Visit

Walkways clear of tripping hazards
Adequate lighting in all areas
Grab bars and handrails secure
Assistive devices within reach
Smoke detectors present

Report Immediately

Loose rugs or damaged flooring
Broken steps or handrails
Expired or absent fire extinguisher
Pest infestation or unsanitary conditions
Exposed wiring or utility hazards

Caregiver Safety

Protecting Yourself

You cannot help your patient if you are injured. Your safety matters too.

If you feel unsafe — leave the home and call your supervisor immediately
Use proper body mechanics for transfers — never lift alone beyond your capacity
Aggressive behavior — do not engage, create distance, call the office
Pets — request animals be secured if they interfere with care
Infection control — use PPE as directed. Hand hygiene every visit.
Document everything — safety concerns protect you and the patient

Emergency Contacts

Numbers You Need

Keep these numbers saved in your phone at all times.

Life-Threatening Emergency

911

Always call first for any life-threatening situation

NobleCare 24/7 On-Call

(740) 262-9845

hello@noblecareohio.com

Ohio Department of Health: 1-800-342-0553 | Mandatory Reporting: ORC § 5101.61

What Would You Do?

Scenario

Situation

Kevin is a companion aide. During a visit, his patient Mr. H stands up from the couch too quickly, becomes dizzy, and falls to the floor. Mr. H is conscious but says his hip hurts and cannot get up.

A) Help Mr. H up off the floor — he shouldn't stay on the cold ground
B) Ask a neighbor to help lift Mr. H back to the couch
C) Keep Mr. H comfortable on the floor, call 911, then call supervisor
D) Wait 15 minutes to see if Mr. H can stand on his own

Correct Answer: C

Do Not Move — Call 911 — Call Supervisor

Why the Others Are Wrong

A — Lifting him could worsen a possible hip fracture and cause serious additional injury
B — A neighbor is not trained. Two untrained people lifting = double the risk
D — Waiting delays critical evaluation. Hip pain + inability to bear weight = call 911

Correct Sequence

Make Mr. H comfortable (pillow, blanket)
Call 911 — report fall and hip pain
Call supervisor: (740) 262-9845
Stay with Mr. H and reassure him
Complete incident report before end of shift

What Would You Do?

Scenario

Situation

During your afternoon shift, a tornado warning is issued for your area. Your patient is an elderly woman who uses oxygen and has limited mobility. The power goes out.

A) Leave immediately to get yourself to safety
B) Continue the visit normally — tornado warnings rarely result in actual tornadoes
C) Move patient to an interior room on the lowest floor, check oxygen backup, and call supervisor
D) Drive the patient to a public shelter

Correct Answer: C

Shelter in Place, Check Equipment, Call Supervisor

Why the Others Are Wrong

A — Leaving abandons a vulnerable, oxygen-dependent patient during an active threat
B — Ignoring the warning puts both of you at lethal risk. Warnings are issued for a reason.
D — Driving a limited-mobility patient during an active tornado warning increases danger

Correct Actions

Move patient to interior room, lowest floor, no windows
Check oxygen — verify battery backup status
Call supervisor: (740) 262-9845
Stay with patient until all-clear is given
Document everything after the event

Review

Knowledge Check

1. Patient has difficulty breathing and chest pain. Your first action?

Call 911, then call your supervisor. Never transport a patient yourself.

2. A patient falls and cannot stand. What do you NOT do?

Never attempt to lift them. Call 911 for anyone who cannot bear weight after a fall.

3. When must an incident report be completed?

For any unexpected event affecting patient safety, including near-misses.

4. Tornado warning during your shift. What is your first priority?

Move patient to interior room on lowest floor away from windows. Never leave them alone.

5. What belongs in an incident report?

Objective facts: what happened, when, patient condition, your response, and who was notified.

Module 05 Complete