Meagan Ray, RN Safety Director
A fire can be a great hazard in a patient care setting. The 4 most common hospital fires include clothing, wastebasket, burning liquid or gas, and electrical fires. Follow these basic rules for fire prevention within the hospital setting: The hospital has a smoking policy that all employees must know and follow. Visitors and patients must be notified of the smoking policy through instruction given by the staff. Check electrical cords before plugging them into electrical outlets. Do not use worn, frayed, or damaged cords. All equipment must be maintained in safe working order, issues identified must be reported immediately to the Director of Plant Operations/Safety Officer/Designee or your Supervisor. Avoid the use of extension cords, multiple plug adapters, or personal appliances at work. Always store flammable materials in a cool, uncluttered, locked place. Never permit smoking or lit matches or lighters around flammable materials. Combustible materials will be kept to a minimum and removed when no longer needed. Grease and chemically soiled rags should be disposed of and not retained or laundered. Heated or hot electrical cords, electrical outlets, or walls means that there is something wrong with the wiring or electrical equipment. Unplug the equipment and notify your supervisor immediately. Do not store anything on window sills, on top of or above air conditioner/heating units or on electrical equipment.
Be prepared before fire strikes and catches you unaware. It is important to know the following: Memorize all exit and emergency routes in your area Know the location of all fire alarms Know which fire extinguisher to use and how to use it Report all known, suspected, or non-locatable fires or smoke immediately
The types of fire extinguishers are identified below and are represented by a letter. Some extinguishers are single and some are multiple rated. In addition, extinguishers are rated by size. A Wood, paper, cloth, trash B Gasoline, oil, paint and other flammable liquids C Live electrical fires without danger to the operator D Combustible metals and metal alloys Hold the extinguisher upright and pull the ring, breaking the safety pin. Stand back from the fire and aim at the base of the fire nearest you. Squeeze the handles together to discharge and sweep from side to side at the base of the fire. Move closer as the fire is extinguished, but watch for possible re-ignition. Evacuate the area immediately after use, as the fumes and smoke may be deadly. In house staff should perform inspection monthly, but a licensed professional must perform a more thorough annual maintenance. Every 6 years, class A extinguishers must have a hydro test. All extinguishers must be recharged after use.
If you should discover smoke or fire, DO NOT shout FIRE! Remain calm. Employees who first smell smoke or see flames should remember the acronym RACE, and immediately: Rescue: Remove anyone from immediate danger. This means remove patients and visitors from the immediate vicinity of the fire. Shut the door or windows of the room once it has been evacuated. Alarm: Notify the rest of the hospital and the fire department. Activate the manual pull station nearest the fire. A verbal CODE RED will be announced overhead 3 times. The alarm system will automatically notify the fire department when either the pull station is activated or the smoke detector initiates the alarm. Contain: Because fire and smoke can quickly travel throughout a building, it must be contained by closing doors and windows. The corridor smoke compartment doors are activated by automatic closers and will close on their own if the system has been alarmed (Nothing should obstruct fire doors). Extinguish: The first 3 responses save lives. This last one saves the building. Extinguish the fire using an appropriate extinguisher (ABC).
Close the door to the room of the smoke or fire Activate the fire alarm system and/or have someone call the Fire Department with the exact location of the smoke or fire Close the doors to all rooms and hallways in the building Get your self and the patients down low if there is smoke Test doors by feeling if they are hot before opening them (use the back of your hand) Use the proper fire extinguisher only if your are knowledgeable of its operation
If the alarm activates before the fire has been discovered: Locate the fire by looking on the annunciator LED readout on the fire alarm panel at the Nurses station. Follow the RACE procedure The alarm may be silenced only after the cause and location of the fire has been determined. Silencing the chimes is accomplished at the annunciator panel by pushing Signal Silence. Authorization to silence chimes may only be given by the CEO, DOPO/Designee, or in their absence, the CCO or Charge Nurse.
When the receptionist becomes aware of the fire, either through a call received, direct notification, or upon hearing the fire alarm, the following procedure will be implemented: Page 3 times overhead at 5-second intervals, CODE RED (location) If CEO, Director of Plant Ops, or Designee is out of the building, page them on their phones. Stay at the phone to give further pages or phone calls if needed If phone service is affected, notify staff using runners Keep unnecessary calls to a minimum Be prepared to announce Code Red All Clear overhead 3 times when instructed
The CCO or Charge Nurse will direct all nursing staff and any physician to respond immediately Secure all the doors, including those in unaffected areas Locate extinguishers and be ready to bring to point of fire Reassure and comfort patients and visitors Control traffic in corridor, keeping visitors in rooms Evacuate patients who could be in immediate danger Be prepared to evacuate patients if evacuation plan is activated Keep track of patients locations throughout facility Get charts ready for evacuation with assistance from Medical Records Upon hearing all clear, account for all patients
Upon hearing Code Red be prepared to shut down piped oxygen system Get patients ready for possible evacuation with portable oxygen system Help with securing all doors to contain smoke When alarm is clear account for all respiratory patients. If oxygen was shut off, reestablish connection to patients
Account for all patients in gym and report names to Charge Nurse Secure patients in gym or prepare to evacuate per plan Determine location of wheel chairs to be used for possible evacuation Any unassigned employees should report to the nurses station for assistance One unassigned employee should report to the fire site with an extinguisher When All Clear is announced, return patients to their rooms and assist nurses with fire health status checks
Medical records will secure charts and assist nurses preparing for open chart evacuation Meet arriving fire department personnel to direct them to the scene of the fire Controls visitors attempting to enter the building by keeping them in the lobby Assist with directing visitors out of the building or into the lobby
The AA will secure important records and prepare to evacuate them Additional office staff will assist receptionist with calls and communications
Remain in department to provide food or drinks if required Additional employees may respond to the fire with an extinguisher
Report to the receptionist to assist as needed When all clear is given, help nursing services return patents back to their rooms.
Employees will report to the fire with extinguisher Fight fire under the direction of Director of Plant Ops/designee
Direct the fire response at the scene of the fire Stay in contact with CEO to help assess the situation Make a determination with the fire department officers on whether or not to shut off utilities Have floor plans or keys ready for fire department officers Makes decision with CEO to call off fire department response Determines when fire is All Clear Evaluate drill or fire response Make sure fire doors and HVAC shutdown work properly
When a fire is announced over the paging system, the CEO or designee will do the following: Designate and establish a control center Direct all operations in cooperation with fire department officials Assist facility departments in shutting off utilities if needed Issue evacuation orders if necessary (evacuation orders may only be initiated by the CEO, the Fire Chief or the Charge Nurse in the absence of the CEO and CCO) Authorize Code Red All Clear when appropriate to cancel fire response. The alarm must be reset by pushing the Acknowledge button and then the System Rest button. It is important to note that the alarm is not ready to detect another fire situation unless it has been reset! Recall of the fire department will be accomplished when it has been determined that a false alarm is responsible for the alarm. This is done by calling the alarm monitoring company and authorizing them to try to recover the trucks and crews
Always assess the impact of the utility failure on the patients FIRST! Attempt to mitigate the effect on the patients as quickly as possible. Partial Failure: - The panel exhibits trouble - The panel will not reset following an alarm - The alarm keeps going off at short intervals Catastrophic Failure: - The panel is non-functioning - The smoke detectors are inactive - A functional check of the alarm system will not activate an alarm
Partial Failure: Assess patients, inform visitors of cause for frequent alarms Inform all facility personnel Notify the CEO Notify the Fire Department Catastrophic Failure: Assess patients, inform visitors of system being down and ask for cooperation in being observant for smoke/fire signs Inform Director of Plant Operations/Safety Officer/Designee If the system will be down for more than 24 hours, contact the property insurer through the Corporate Offices.
System Type Service Frequency Performed By Fire Extinguishers Inspection Monthly Maintenance Dept. Fire Extinguishers Inspection Annually Contract Vendor Fire Alarm System Inspection Monthly Maintenance Dept. Fire Alarm System Inspection Quarterly Contract Vendor Sprinkler System Inspection Quarterly Contract Vendor Smoke Detectors Inspection Every two years Contract Vendor
RACE: R-Rescue anyone in danger from the smoke or fire A-Alarm (pull nearest fire alarm and call 0 for the operator C-Contain fire by closing doors and windows E-Extinguish the fire using the proper fire extinguisher (ABC) PASS: P-Pull pin A-Aim the nozzle at the base of the fire S-Squeeze the trigger S-Sweep the nozzle from side to side