Fire & Safety in Long Term Care

Fire & Safety in Long Term Care Preparing your staff for a fire emergency Stephen Woodin, EMT-P

Safety Services (813) 855-1225 Fax (813) 818-0019 P.O. Box 471 Oldsmar, FL 34677 www.ceuworks.com READ the module, take and return the test on the final page of this packet. This course counts as 3 hours of continuing education for CNAs. INTRODUCTION Chances are, you are here, reading this book, for one of a number of reasons: YOUR success is OUR success! 1. You are e mployed by a facility and are in need of continuing Second Edition education. This course will Copyright 2005 by Safety Services update/renew your training for the P.O. Box 471 subject you need. Oldsmar, FL 34677 2. You are wanting to improve your www.ceuworks.com educational training information, All rights reserved. No part of this and are taking this course for publication may be reproduced, stored in professional development. a retrieval system, or transmitted in any 3. You desire to start working in the form, by any means, electronic, medical field. You have a burning mechanical, photocopying, recording, or desire to work with and help otherwise, without prior written people, to improve the quality of permission from the publisher. life of the aged population. Printed in the United States of America Keeping your continuing education up to date in todays busy lifestyle is a challenge for even the most organized individual. This course will help you meet the training requirements for continuing education. This content contained herein is reviewed periodically This module is designed to be sent to you via fax. We will wait up to 90 days for you to read the material then complete the test at the end of the course. When you fax your answers back to us, we will score your course, then fax your course completion certificate to you free of charge. and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for continuing professional education or hands on training. Although some of the information contained in this publication relates to medical topics and issues, no information in the publication should be construed as medical advice. Use of AEDs requires medical direction from a qualified physician. The publisher does not guarantee the accuracy of the information and assumes no risk or liability as a result of any reliance on it. Page 1

ABOUT THE AUTHOR Stephen Woodin, EMT-P Stephen Woodin, a Florida certified Firefighter & Paramedic has be involved in EMS and safety/medical related education since 1989. He has written and developed over 30 training courses including CPR, First aid, HIV/Infection Control, and various continuing education courses for licensed professionals. Steve has an extensive background in course development, digital media, including internet webmaster, digital video editing, printing, and graphic arts. Stephen is currently the President of Safety Services International, Inc. SSI, Inc. has been in business since 1994 and currently has 260 instructors nationwide. SSI, Inc. creates and markets instructor products and materials to instructors that need high quality training materials for their training curriculums. Please feel free to contact Stephen by phone at (813) 855-1225, if you have any questions about this or any other course that we offer. You can also do training online from our website at: www.ceuworks.com. The use of this book thanks to our printer who without fail comes through for us everytime. The use of this book is authorized by Safety Services International, Inc and its authorized training partners. Only instructors authorized by Safety Services International, Inc. with the accompanying instructor manual may use this book and its contents for training sessions. Unauthorized use of this book by companies or individuals for training sessions will be prosecuted to the fullest extent of the law. If you would like to use this book for your training sessions, please feel free to contact Safety Services International, Inc. for licensing information. We have wholesale prices available for groups. Safety Services International, Inc. can be contacted during business hours M-F 8:00am-5:00pm EST. (813) 855-1225. Upon completion of this course, the student will have met the requirements for issuance of the course certificate. We can Fax your certificate to you at no additional cost. Additional copies of your certificate or wallet cards can be purchased from our website at www.ceuworks.com. We welcome your comments, and hope that you get from this material all that is available from this course. Please submit your comments to us via fax at (813) 818-0019 or from our website. This book is a culmination of intense reasearch, organization, and the help of many, many individuals & company friends. Of those individuals, this author would like to thank those who helped make this book a reality. Much Page 1

OVERVIEW PURPOSE To provide a safe environment for staff and residents. COURSE OBJECTIVES Upon completion of this course participants should be able to maintain proper functioning of fire extinguishers and smoke detectors. Demonstrate the use of fire extinguishers and smoke detectors. List three methods of fire prevention. Conduct a fire drill, using emergency evacuation procedure. Maintain proper storage of combustible liquids and hazardous materials and maintain a clean and comfortable environment. CONTENT OVERVIEW Pretest Vocabulary Classification of fires Alarm goes off! How to operate the extinguishers In case of fire... Evacuation plan Proper maintenance of fire extinguishers The fire triangle Safety Guard against fire and burns Evacuation plan Post Test PRETEST Read each statement below and choose the best response by circling the letter beside the desired response. 1. There are two types of fire extinguishers, type A for paper, and type B for combustible metals. 2. If there is a small fire, and you feel that you are able to extinguish it, you can get the extinguisher, put the fire out, and notify your supervisor. 3. Overloaded circuits are not dangerous as long as none of the electrical cords are frayed. 4. As long as you participate in a fire drill, you are prepared for a real fire. 5. Fire extinguishers need to be next to the stove, as this is the most likely place a fire will start. 6. Proper maintenance of the fire extinguishers is the job of the maintenance department and the nursing staff just needs to know how to evacuate in case of fire. 7. A resident has a right to have flammable materials in their room if they are keeping them in containers under their sink. Answers: 1. B, 2. A, 3. B, 4. B, 5. B, 6. B, 7. B DO NOT SUBMIT THE ANSWERS TO THIS PRETEST TO US FOR SCORING. THESE ARE HERE TO TEST YOUR PREVIOUS KNOWLEDGE OF THIS COURSE INFORMATION. Page 2

FIRE SAFETY VOCABULARY LIST Alarm- a signal, call or warning. Con fine - to hold within one area, such a fire. Extinguish- to cause or cease or stop burning. Evacuation- to remove from one area. Fir e extinguisher- piece of equipment us ed to extinguish a fire. Rescue - to save, to free or to recover. Safety- freedom from danger, risk, or injury. CLASSIFICATION OF FIRE: Know your extinguishers, know the type, name plate tells fire classes and may also show the quick identification symbols. Know how to operate. Nameplates give instructions. Class A fire: Has a green triangle with an A in the center of the triangle. This extinguisher is for ordinary combustible material (wood, paper, textiles, etc.) requires cooling- quenching. Class B fire: Has a red square with a B in the center. This extinguisher is for flammable liquids, greases (gasoline, oil, paints, etc.) requires smothering. Class C fire: Has a blue circle with a C in the center. Electrical equipment (motors, switches, etc.) requires a conducting agent capable of extinguishing a fire in materials that may be present. Class D fire: Has a yellow star with a D in the center. Combustible metals (magnesiu m, titanium, sodium, potassium, etc.) requires special extinguishing agents or techniques. There are many different types of extinguishers, but the most common, and the one used in facilities are the Multipurpose dry chemical, which is dry chemical expel by air-gas pressure. This is the type that we will be talking about. The reason for this, is that this extinguisher is good for type A, B & C. And this is the only extinguisher good for all three types of fires. LEARN HOW TO USE A FIRE EXTINGUISHER BEFORE THERE IS A FIRE, IN AN EMERGENCY, THERE IS NO TIME TO READ INSTRUCTIONS AND FIGURE OUT HOW TO USE IT, EVERY SECOND COUNTS. Read the label and information in the owners manual. OSHA CFR 1910.157(g)(1-2) requires staff training with fire extinguishers at the time of hire then annually thereafter. Contact a qualified training company to bring your facility into compliance! It may be contrary to their health, residents have the right to smoke in the appropriate areas in/around the facility. Residents with impaired judgment can make them unaware of the danger of burns to clothing, ashtray fires, or lighting the cigarettes of friends who are themselves Page 3

unsafe smokers. It is important to take every reasonable effort to prevent injury & death while smoking. The following tips can help you prevent injuries to a smoking resident: Use large ashtrays that are solid and untippable. Limit smoking to a well-protected & well-ventilated area. Take seriously the smoker s emotional need to smoke. Suggest the creation of a reward system to encourage them to quit. Have smokers bound to wheelchairs wear a smoker s apron Install extra smoke detectors in/near the smoking areas. Even though every effort is made to prevent a fire, unfortunately once in a while they do occur in health care facilities. It is imperative that you know what to do during such situations. You must know the location of fire alarms, emergency exits and fire extinguishers. Defective electrical equipment and wiring, overloaded electrical circuits, and smoking are major causes of fire. Smoking is not allowed in any area where oxygen is in use or being stored. Residents and staff who smoke can only do so in designated areas. Residents must be supervised while smoking. ALARM GOES OFF! If the fire alarm goes off, remain calm. Remember the meaning of the acronym R.A.C.E. as to the critical steps to follow in case of a fire emergency: R- Remove residents Rescue whoever is in immediate danger. Move residents in the immediate area of the fire to a safe place. Do not use elevators. A- Activate Alarm Alert the entire facility by pulling the nearest alarm. C- Confine Fire Close all doors and windows. Clear hallways and emergency exits of all equipment. Turn off oxygen and electrical equipment being used in the area of the fire. E- Extinguish the Fire Use a fire extinguisher on a small fire that has not spread. Remove the safety pin, push down on the top handle and aim the hose at the base of the fire. Fires can be very dangerous and you should always be certain that you will not endanger yourself or others when attempting to put out a fire. For this reason, when a fire is discovered: Page 4

Assist any person in immediate danger to safety, if this can be accomplished without risk of harm to yourself. Activate the building fire alarm system or notify the fire department by dialing 911 (or designating someone else to notify them for you). When you activate the building fire alarm system, it should automatically notify the fire department and get help on the way. It will also sound the building alarms to notify other occupants, and it will shut down the air handling units to prevent the spread of smoke throughout the building. Only after having done these two things, if the fire is small, you may attempt to use an extinguisher to put it out. Before deciding to fight the fire, keep these rules in mind: NEVER FIGHT A FIRE IF: 1. You don't know what is burning. If you don't know what is burning, you don't know what type of extinguisher to use. Even if you have an ABC extinguisher, there may be something in the fire which is going to explode or produce highly toxic smoke. Chances are, you will know what's burning, or at least have a pretty good idea, but if you don't, let the fire department handle it. 2. The fire is spreading rapidly beyond the spot where it started. The time to use an extinguisher is in the incipient, or beginning, stages of a fire. If the fire is already spreading quickly, it is best to simple evacuate the building, closing doors and windows behind you as you leave. Do Not Fight the Fire If: 1. 2. You don't have adequate or appropriate equipment. If you don't have the correct type or large enough extinguisher, it is best not to try to fight the fire. Quickly leave the area, making sure to close all doors behind you to contain the spread of the fire. You might inhale toxic smoke. If the fire is producing large amounts of smoke that you would have to breathe in order to fight it, it is best not to try. Any sort of combustion will produce some amount of carbon monoxide, but when synthetic materials such as the nylon in carpeting or foam padding in a sofa burn, they can produce highly toxic gases such as hydrogen cyanide, acrolein, and ammonia in addition to carbon monoxide. These gases can be fatal in very small amounts. 3. Your instincts tell you not to. If you are uncomfortable with the situation for any reason, just let the fire department do their job. The final rule is to always position yourself with an exit or means of escape at your back before you attempt to use an extinguisher to put out a fire. In case the extinguisher malfunctions, or something unexpected happens, you need to be able to get out quickly, and you don't want to become trapped. Just remember, always keep an exit at your back. If you choose to fight the fire, get the nearest extinguisher, and remember the acronym P.A.S.S. Page 5

P- Pull the pin S- Sweep the nozzle side to side discharged. To prevent the extinguisher from being discharged in a non-emergency setting, the extinguisher has a pin in place for safety. Pull the pin, this will allow the extinguisher to be REMEMBER: Move the nozzle of the extinguisher in a side to side motion. This will apply the extinguishing agent to the fuel so the fire will go out. A- Aim Aim the nozzle of the extinguishe r at the BASE of the fire. The base of the fire is the material that is burning. DO NOT AIM AT THE FLAMES! S- Squeeze the handle Squeeze the top handle or lever on the extinguisher. This depresses a button that releases the extinguishing agent in the extinguisher. A fire extinguisher is only designed to put out small (incipient) fires. If there is a room on fire, the fire extinguisher in your facility WILL NOT PUT IT OUT! The extinguisher is meant to be used on small trash can sized fires. If the fire is larger than that, leave the room, close the door, and call the fire department. Page 7 PROPER LOCATIO N OF FIRE EXTINGUISHERS Fire extinguishers should be put in the right places, they should be throughout the facility you work in, near exits, along traffic paths, upstairs in halls, along escape routes. Also they should be located near hazard areas ( such as stoves) but not so close that extinguishers could be blocked by fire. Walk through your facility and see where the extinguishers are, and become familiar with them. They should all be mounted on brackets, and in clear view. Page 6

Fire extinguishers should be checked regularly according to manufacturer s instructions. There should be a record tag on the extinguishers showing dates of each inspection, recharge, and/or repair. So, when you walk around the building, check these and see that the gauge is full, that there is a tag on each extinguisher, that the wall bracket is in good repair. And remember, after any extinguisher is used, it must be refilled as soon as possible after use. If any of the contents have been expelled, it must be refilled right away. The fire triangle is made up of Heat, Fuel, Fire and Oxygen, without these four things, there will be no fire. This is why it is so important not to open a door if there is a fire behind it, feel the door, if it is hot, do not open. If the door is opened, this lets in oxygen, and may cause the fire to increase in size. EVACUATION PLAN An evacuation plan is very important, and may make the difference between life and death. Check your fire and evacuation plan, pay attention when you have a fire drill, as the next one could be a real one. The next time you go to work, just take a short inventory of the rooms, are they cluttered, and hard to get around? Would this be difficult if there was a fire? Which residents would need help evacuating the building? Do you know where the exit doors are to each unit? Everyone in the building should be oriented to the fire and evacuation plan. SAFETY There are many things you can check to keep a facility safe. Some of them are: In residents rooms and common areas, make sure that electrical circuits are not overloaded. There should be no frayed electrical cords. Remove all scatter rugs. Make sure the areas are not cluttered, and it is easy to maneuver around the room. When you walk by a stairwell, or exit, just check to see that it is not cluttered, and if there were a fire, could people get out without difficulty? In bathrooms, a night light helps prevent accidents. Bathtubs should be equipped with nonskid mats, grab bars, shower chairs (for those who need them). Doors should be provided with special locks which permit emergency opening from the outside. Don t leave any electrical appliances (radio, hair dryer) near sink or bathtub where a wet hand and might be tempted to reach for them. Residents rooms should have a light switch within reach of the bed. Closet shelves should be organized so that things will not topple down if you reach for an item. Smoke detectors need to be checked monthly. Cleaning supplies, poisons and insecticides are stored in labeled containers. No flammable containers should be in residents rooms. Falls are the most common cause of fatal injury for older people. Make sure that the grab bars are in place in the bathroom, and in convenient places to help a resident maneuver around the bathroom safely. Page 7

POST TEST To access the post course test, close this window, and choose the Take Test link. The online test will score and send you a course completion certificate to your email address within 24 hours. Page 8