Written Fire Safety Plans 2012 LSC KATHARINE ACHOR SEPTEMBER 2016 NFPA Standard: 2012 NFPA 101, 19.1.1.3.1 All health care facilities shall be designed, constructed, maintained, and operated to minimize the possibility of a fire emergency requiring the evacuation of occupants. Greenwood Health Center Fire Hartford, CT February 26, 2003 16 deaths
NFPA Standard: 2012 NFPA 101, 19.1.1.3.2 Because the safety of health care occupants cannot be ensured adequately by dependence on evacuation of the building, their protection from fire shall be provided by appropriate arrangement of facilities; adequate, trained staff; and development of operating and maintenance procedures composed of the following: (1) Design, construction, and compartmentation (2) Provision for detection, alarm, and extinguishment (3) Fire prevention procedures and planning, training, and drilling programs for the isolation of fire, transfer of occupants to areas of refuge, or evacuation of the building Staff should understand basic features of the building Building materials and construction design Doors in facilities Exiting components/locking devices Smoke compartments Location and use of equipment for transporting patients between compartments Sprinkler systems Fire alarm system and smoke detection fire/smoke NFPA Standard: 2012 NFPA 101, 19.7.1.1 The administration of every health care occupancy shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of fire, for their evacuation to areas of refuge, and for their evacuation from the building when necessary. NFPA Standard: 2012 NFPA 101, 19.7.1.2 All employees shall be periodically instructed and kept informed with respect to their duties under the plan required by 19.7.1.1.
NFPA Standard: 2012 NFPA 101, 19.7.1.3 A copy of the plan required by 19.7.1.1 shall be readily available at all times in the telephone operator s location or at the security center. Should be located at nurse s station/central location if no telephone operator s location or security center responsible staff should know where the plan is located There is no requirement for a map/evacuation plan to be posted within the facility NFPA Standard: 2012 NFPA 101, 19.7.2.1.1 For health care occupancies, the proper protection of patients shall require the prompt and effective response of health care personnel. NFPA Standard: 2012 NFPA 101, 19.7.2.1.2 The basic response required of staff shall include the following:(1) Removal of all occupants directly involved with the fire emergency (2) Transmission of an appropriate fire alarm signal to warn other building occupants and summon staff (3) Confinement of the effects of the fire by closing doors to isolate the fire area (4) Relocation of patients as detailed in the health care occupancy s fire safety plan
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Employees are required to know and follow the fire response plan/procedures and follow the fire response plan and any instructions that are announced over the fire alarm and PA systems occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Employees are required to know the locations of all manual pull stations in their work area This includes how to activate the range hood The activation of the alarm is required no matter the size of the fire There should not be a different plan for the discovery of a minor fire vs. a major fire
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Individual responsible needs to be designated in the fire plan A redundancy in case the fire alarm does not transmit Gives the fire department additional information such as location, size, type, etc. occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire R.A.C.E: An acronym that hospital personnel use to remember their duties in case of fire. It stands for RESCUE, ALARM, CONFINE, ETINGUISH/EVACUATE Rescue all patients, visitors, employees, staff and volunteers from immediate danger Alarm by pulling the closest fire pull-station and by dialing 911 Confine the area by closing all doors and windows Extinguish the fire if the fire is small. Evacuate patients from the area A larger facility may also designate duties of staff by department
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Confine the area by closing the windows and the door to the room of origin There should be a method for identifying all rooms that have been evacuated Close and mark doors of evacuated rooms (using tape, chalk, door hangars, magnets, etc.) Placing items at the base of the doors in the corridor (trash cans, pillows, etc.) is not the best practice occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Rescue all patients, visitors, employees, staff and volunteers from immediate danger/room of origin Preventing the spread of fire and smoke beyond the point of origin is the first and best line of defense Determine safety of exit routes: primary and alternate exits and fire/smoke compartments to be used in event one is untenable
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Begin with evacuation of the triangle of rooms surrounding the room of origin the rooms on either side and directly across the hall Systematically remove the remaining occupants within the smoke compartment (fire doors to fire doors or fire doors to exit) Moving away from the proximity to the fire (not by ambulation status) Trying not to cross the line of fire with the residents Adjacent smoke compartments should be ready to accept patients from the fire s point of origin
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Keep fire doors closed except when passing through them in order to avoid the spread of smoke/fire Keep patients and visitors in rooms if possible until directed to do otherwise Clear corridors of equipment Do not use elevators At this point evacuation by ambulation status (ambulatory, walkers, wheelchairs, bedridden) would be prudent In multi-story buildings evacuate the floors above and below the compartment of origin In larger buildings, there may be plans for evacuation of the adjacent smoke compartment to another smoke compartment (two compartments away from the compartment of origin).
occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire Partial Evacuation - Partial evacuation or relocation to other areas of the building may be used depending on the particular emergency and the level of danger that it poses. When partial evacuation is indicated, horizontal followed by vertical evacuation will be used Horizontal Evacuation - Horizontal evacuation is preferred over vertical. As directed, patients will be moved typically to an adjacent smoke compartment on the same floor, away from the fire s point of origin Vertical Evacuation - If necessary and as directed, patients may be moved to another floor - typically the floor below. If it becomes necessary to evacuate patients to a lower floor, stairwells should be used Complete Patient Evacuation - Should the emergency condition persist or be of a severity such that the building is endangered, a complete evacuation of the building shall be initiated Patient Removal - Patients are to be removed horizontally by stretcher, wheelchair, blankets, or other method of transportation to an adjacent fire/smoke compartment. Patients in immediate danger shall be removed first - including those who might be subject to danger should the fire spread into their area Ambulatory patients should be accompanied or directed to an appropriate fire/smoke compartment, depending on the situation. Non-Ambulatory patients should be moved using wheelchairs or stretchers when available to an appropriate fire/smoke compartment. Patients being evacuated should be wrapped in blankets before placing in wheelchairs occupancy fire safety plan shall provide for all of the following: (1) Use of alarms (2) Transmission of alarms to fire department (3) Emergency phone call to fire department (4) Response to alarms (5) Isolation of fire (6) Evacuation of immediate area (7) Evacuation of smoke compartment (8) Preparation of floors and building for evacuation (9) Extinguishment of fire P.A.S.S: Duties for discharging a fire extinguisher - stands for PULL, AIM, SQUEEZE, SWEEP Do not attempt to fight a fire that is spreading beyond the immediate area where it started, is already a large fire or is overhead The fire could potentially spread and block your escape You are not trained or feel comfortable operating a fire extinguisher You are in doubt about whether the extinguisher is designed for the type of fire at hand or if it is large enough to fight the fire Staff should be aware of the types of fire extinguishers in the building and what they are used for This includes the K extinguisher in the kitchen - intended for use on cooking oil fires, such as deep fat fryers
Bariatric Units NFPA Standard: 2012 NFPA 101, 19.7.1.1 The administration of every health care occupancy shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of fire, for their evacuation to areas of refuge, and for their evacuation from the building when necessary. Bariatric Units A-0701 482.41(a) Standard: Buildings The condition of the physical plant and the overall hospital environment must be developed and maintained in such a manner that the safety and well-being of patients are assured.
Bariatric Units A701 - Interpretive Guidelines 482.41(a) Assuring the safety and well-being of patients would include developing and implementing appropriate emergency preparedness plans and capabilities. The hospital must develop and implement a comprehensive plan to ensure that the safety and well-being of patients are assured during emergency situations. The hospital must coordinate with Federal, State, and local emergency preparedness and health authorities to identify likely risks for their area (e.g., natural disasters, bioterrorism threats, disruption of utilities such as water, sewer, electrical communications, fuel; nuclear accidents, industrial accidents, and other likely mass casualties, etc.) and to develop appropriate responses that will assure the safety and well-being of patients. The following issues should be considered when developing the comprehensive emergency plans(s): The special needs of patient populations treated at the hospital (e.g., patients with psychiatric diagnosis, patients on special diets, newborns, etc.); Verify that the hospital has developed and implemented a comprehensive plan to ensure that the safety and well-being of patients are assured during emergency situations. Other Considerations: Anything that makes the area unique from a life safety standpoint (chemicals, flammable liquids, special patient s needs) Local fire department review of the plan so the evacuation staging area is not where they want to set up command Phone numbers up-to-date Accurate facility layout with barriers located Memorandums of Understanding or Mutual Aid Agreements are current Fire safety and evacuation plans are reviewed or updated periodically and as necessitated by changes in staff assignments, occupancy, or the physical arrangement of the building Medications, medical supplies, food, water (potable and non-potable), linens, medical records, transportation, identification, patient tracking Procedures for accounting for employees and occupants after evacuation When looking for a fire when the door is closed - feel for heat with back of hand on door, brace shoulder against door and slowly open
NHC Nashville Healthcare Center Nashville, TN September 25, 2003 15 Deaths Fire Watch Plans Fire Alarm Systems NFPA Standard: 2012 NFPA 101, 9.6.1.6 Where a required fire alarm is out of service for more than 4 hours in a 24-hour period, the authority having jurisdiction shall be notified, and the building shall be evacuated, or an approved fire watch shall be provided for all parties left unprotected by the shutdown until the fire alarm system has been returned to service. Pre-planned or emergency Shall be dedicated Shall be trained in fire prevention Shall have means to notify the fire department Occupants notified Local fire department, Department of Health, Fire Marshal shall be notified No propping open of the fire doors Documentation maintained for one year
Fire Watch Plans Sprinkler Systems NFPA Standard: 2012 NFPA 101, 9.7.6 Sprinkler impairment procedures shall comply with NFPA 25. NFPA Standard: 2011 NFPA 25, 4.1.9.1 Where an impairment to a waterbased fire protection occurs, the procedures outlined in Chapter 15 of this standard shall be followed, including the attachment of a tag to the impaired system. NFPA Standard: 2011 NFPA 25, 4.1.9.2 Where a water based fire protection system is returned to service following an impairment, the system shall be verified to be in working properly by means of an appropriate inspection or test. Assignment of an impairment coordinator The system shall be tagged to indicate the system has been removed from service at each FD connection, system control valve, and any other locations deemed by the AHJ Fire Watch Plans Sprinkler Systems Preplanned Impairments BEFORE authorization by impairment coordinator Extent and duration determined and involved areas inspected for increased risks determined Recommendations submitted to property owner or representative More than 10 hours in a 24 hour period impairment coordinator shall arrange for one of the following: Evacuate Implement an approved fire watch Establish a temporary water supply Establish/implement an approved program to eliminate potential ignition sources and limit the amount of fuel available
Fire Watch Plans Sprinkler Systems Preplanned Impairments (Continued) More than 10 hours in a 24 hour period impairment coordinator shall arrange for one of the following: Notify fire department, insurance carrier, alarm company, property owner, AHJ s (Department of Health, Fire Marshal), supervisors of affected area/occupants Tag impairment All tools and materials have been assembled on the impairment site Fire Watch Plans Sprinkler Systems Emergency Impairments Emergency Action shall be taken to minimize injury and damage Implement all of the actions required under 15.5 Return to Service Impairment coordinator shall verify the following: Necessary inspection and testing have been conducted to verify system is operational Occupants/supervisors of affected area informed the system is restored Fire department, property owner/designee, insurance carrier, alarm company, Department of Health, Fire Marshal and any other AHJ have been notified the system is restored Impairment tag is removed
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