As a nursing assistant or CNA you may be the first person to recognize a medical emergency is happening in your unit.
How do you respond to a medical emergency?
Nursing Assistant Skill Scenario: Choking Incident
Our nursing assistant online class instructor give us the following emergency scenario: “Choking Incident” in the dining hall.
Read the scenario below. . .
Mrs. Smith is sitting at the dining room table when you notice her holding her hands to her throat and while appearing to be trying to talk, she is making no sounds.
• What do you think is happening to Mrs. Smith?
• What could you do as a Nursing Assistant to help Mrs. Smith right now? How am I feeling in this situation?
• How are you feeling in this situation?
• What ideas do you have to be able to prevent this from happening in the future?
Response and Scenario Discussion
Here are my responses to the scenario. . .
What could you do as a Nursing Assistant to help Mrs. Smith right now? How am I feeling in this situation?
I know Nursing Assistants (NAs) are not supposed to be guessing the situation of the patient or resident, but I think Mrs. Smith is choking. When people are choking they tend to put their hands to their throats.
What could I do as a Nursing Assistant to help Mrs. Smith right now?
I would call for help immediately. Mrs. Smith should not be left by herself.
Since NAs are not supposed to guess what’s happening with Mrs. Smith, I would ask Mrs. Smith to make it sure that she is choking: “Are you choking? I know what to do. Can I help you?”
If she nods her head yes, this means she has a severe airway obstruction and she needs help immediately.
I would begin giving her an abdominal thrust. Abdominal thrusts should not be given to a person who is not choking. It will cause injury to the ribs and internal organs.
Here’s how I would the abdominal thrust:
• I stand behind Mrs. Smith and bring my arms under her arms.
• I wrap my arms around Mrs. Smith’s waist.
• I will make a fist with one hand. I place the flat, thumb side of the fist against Mrs. Smith’s abdomen (above the navel but below the breastbone.)
• I will grasp the fist with my other hand. Pull both hands toward me and up, quickly and forcefully.
• I will repeat the procedure until the object is pushed out or Mrs. Smith loses consciousness. If Mrs. Smith loses consciousness I will call 911.How am I feeling in this situation?
In this situation I would feel scared, nervous and shaky, but I have to do my very best in this incident to help Mrs. Smith as it is my responsibility to help her.
What ideas do I have to be able to prevent this from happening in the future?
• To prevent this from happening in the future, I will talk to the nurse and the nurse will talk to the dietitian so that Mrs. Smith will be served with a soft diet so that she won’t choke again.
• During meal time Mrs. Smith should be closely watched.
