CHAPTER 3 2 - S AF E T Y

Selected Safety Hazards throughout the life span:

- Developing fetus: exposure to maternal smoking, alcohol consumption, addictive drugs, x-rays (first
trimester), certain pesticides

- Newborns and infants: falling, suffocation in crib, placement in the prone position, suffocation when
entangled in cords, choking from aspirated milk or ingested objects, burns from hot water or other spilled hot
liquids, automobile crashes, crib or playpen injuries, electric shock, poisoning

- Toddlers: physical trauma from falling, running into objects, aspiration of small toys, getting cut by sharp
objects; automobile crashes; burns; poisoning; drowning; and electric shock

- Preschoolers: injury from traffic, playground equipment, and other objects; choking, suffocation, and
obstruction of airway or ear canal by foreign objects; poisoning; drowning; fire and burns; harm from other
people or animals

- Adolescents: vehicular (automobile, bicycle) crashes, recreational injuries, firearms, substance abuse

- Older adults: falling, burns, and pedestrian and automobile crashes

Bioterrorism - deliberate release of viruses, bacteria or other germs (agents) used to cause illness or death in
people

Category A agents have the highest risk because they:

• Can be easily spread or transmitted from person to person.

• Result in high death rates and have the potential for major public health impact.

• Might cause public panic and social disruption.

• Require special action for public health preparedness

Category B agents are the second highest priority because they:

• Are moderately easy to spread.

• Result in moderate illness rates and low death rates.

• Require specific enhancements of CDC’s laboratory capacity and enhanced disease monitoring.

Category C agents include emerging pathogens that could be engineered for mass spread in the future
because they:

• Are easily available.

• Are easily produced and spread.

• Have the potential for high morbidity and mortality rates and major health impact.

Nursing Management:
Assessment:

Assessing clients at risk for injury involves:

- noting pertinent indicators in the nursing history and physical examination

- using specifically developed risk assessment tools

- evaluating the client’s home environment

Seizure - single temporary event that consists of uncontrolled electrical neuronal discharge of the brain that
interrupts normal brain function

Partial seizure - also called focal; involve electrical discharges from one area of the brain

Generalized seizure - affect the whole brain

Seizure precautions - safety measures taken by the nurse to protect the clients from injury should they have a
seizure

Scald - burn from a hot liquid or vapor, such as steam

Burn - results from excessive exposure to thermal, chemical, electric, or radioactive agents

Fires:

RACE protocol:

Rescue - if area is safe to enter, protect and evacuate clients who are in immediate danger

Alarm - pull fire alarm and report fire details and location

Confine - contain fire by closing the doors to all rooms and fire doors at each entrance to the unit

Extinguish - use appropriate type of fire extinguisher

Or Evacuate - evacuate area if the fire is too large for fire extinguisher

Three categories of fire (classified accdg to type of material that is burning):

- Class A - paper, upholstery, rags, ordinary rubbish

- Class B - flammable liquids and gases

- Class C - electrical

Use PASS when using fire extinguisher:

Pull out extinguisher’s safety pin

Aim hose at base of fire

Squeeze or press handle to discharge material onto the fire

 Sweep hose from side to side across the base of fire until fire appears to be out

Carbon monoxide - odorless, colorless, tasteless gas that is very toxic

- exposure to Co cause symptoms that include headaches, dizziness, weakness, nausea, vomiting, or loss of
muscle control

- prolonged exposure can lead to unconsciousness, brain damage, or death

Asphyxiation or suffocating - lack of oxygen due to interrupted breathing

Heimlich maneuver or abdominal thrust - emergency response which can dislodge the foreign object and
reestablish an airway

Excessive noise - health hazard that can cause hearing loss, depending on the overall level of noise, frequency
range of the noise and duration of exposure and individual susceptibility

Electric shock - occurs when a current travels through the body to the ground rather than through electric wiring
or from static electricity that builds up on the body

Restraints - devices used to limit the physical activity of a client or a part of the body

Physical restraints - include any manual method, physical or mechanical device, material or equipment that
immobilizes or reduces ability of a patient to move his or her arms, legs, body or head freely

Chemical restraints - involve using medication to control behavior or to restrict client’s freedom of movement and
is not a standard treatment for the client’s medical or psychological condition

Seclusion - involuntary confinement of a client alone in a room or area from which the client is physically prevented
from leaving