Contact: Janice Cadywould BCU Critical Care Fire Action Plan Ysbyty Gwynedd For further information contact: Janice Cadywould 1
Fire Evacuation Procedure for ITU & HDU at Ysbyty Gwynedd The following procedure is to outline the fire evacuation procedure for both ICU & HDU at Ysbyty Gwynedd, to detail staff action and identify the location of preferred assembly points. The fire alarm at Ysbyty Gwynedd is of 3 phases; Phase 1 --- Continuous sounding alarm indicating zone of fire alarm activation. Phase 2 --- Intermittent sounding alarm indicating fire alarm activation in neighbouring fire zone. Phase 3 --- Wailing sound indicating general fire alarm in hospital block. Action of Staff to a Fire Alarm Sounding in Main Hospital Switchboard 1.) Call the Fire Service 2.) Activate the Fire Bleeps giving the location of the Fire. Fire Response Team 1. Clinical Site Manager (Bleep 100) will respond to the location of the fire 2. Bleep 021 will respond to the hospital main assembly point located at reception front entrance of hospital on the ground floor. 3. Porters will proceed to the location of fire. 4. Estates Engineer will proceed to location of fire. Fire Panels are located in the following areas: 1) Main Reception of hospital on ground floor 2) Lift foyer on each floor Action of Clinical Site Manager 1. To make contact with nurse in charge 2. Co-ordinate all members of staff present. Give clear instructions of their duties 3. Ensure that the area is thoroughly searched and identify method of triggering the alarm e.g. Smoke Detector or Manual Call point 4. Assist with evacuation of the unit. 5. Maintain radio contact with Bleep 021 at the assembly point; inform them of actions. On Discovery of a Fire on the ICU or HDU Sound the fire alarm, operating the nearest Fire Alarm point. Attack the fire with appropriate fire extinguisher if you feel safe to do so. Report to the nurse in charge N.B. Do not compromise your own safety as an employee/staff member. 2
On Hearing a Continuous Alarm: Fire alarm may be activated manually or automatically Check all the areas within the unit for signs of fire. When fire confirmed alert On Call/Resident ITU Anaesthetist & Consultant Anaesthetist Staff to remain with their patient. Other staff report to the Unit Manager/Senior Nurse Nurse in charge to direct staff Nurse in charge to take a roll call of staff on duty Escort all visitors off the unit to a neighbouring zone and instruct them to make their way to the main entrance. Attack the fire with extinguisher provided but only if it is safe to do so. CLOSE ALL DOORS Prepare for evacuation of the Unit On Hearing an Intermittent Alarm: Check to see that the fire is not affecting the immediate area. If staffing levels permit send one member of staff from ICU or HDU to ground floor main reception Staff to remain with their patient Other staff to report to Unit Manager/Senior Nurse Establish location of fire - Nurse in charge to ascertain if fire is on ICU or HDU (Different zones) Identify location of fire alarm activation On Hearing Wailing Fire Alarm: Nurse in charge send member of staff to main assembly point Lifts Lifts must not be used unless specific instructions are given by a senior Fire Service Officer. It is vital that all Staff know the location of: Fire Alarm Break Glass Points. Location of portable fire extinguishers. Escape routes out of the unit. Location of reception areas for patients should evacuation be necessary HDU Patients to go to; 1) ICU 2) Main Theatres Recovery ITU Patients to go to; 1) Main Theatres Recovery (first instance if capacity and location of fire) Or 3
2) HDU See Diagram Patient Evacuation Plan For ICU or HDU This is a last resort. i.e. there is smoke in the patient area of ICU or HDU In the event of evacuation from HDU the On Call/Resident ITU Anaesthetist and Consultant Anaesthetist will take charge of patients on the HDU. If patient evacuation is necessary: Assess the Fire situation. Decide which is the safest exit route from the unit. Prioritise which patients should be moved first. Prepare the patient for evacuation. Preparation of patients for evacuation: Minimum of two staff required to prepare patient. Place pumps on the bed and disconnect any unnecessary pumps. E.g. feed pumps etc. Place oxygen cylinder in holder on bed frame. Check to ensure sufficient oxygen for transfer is available. Ensure that you have enough drugs for transfer, e.g. sedation, inotropes etc. EVACUATION Nurse in charge to liaise with Consultant Anaesthetist & Clinical Site Manager o Consider equipment needed, drugs, dialysis fluid o Obtain transfer ventilators from ICU, ED, theatres Nurse in charge, with Consultant Anaesthetist, to prioritise patient evacuation. Nurse in charge to select evacuation route ICU patients to be transferred to Main Theatre Recovery as they have facilities to accommodate ventilators. Nurse in Charge to inform Theatre Recovery of the number of patients to expect so that space can be made. Nurse in Charge & Consultant to decide method of ventilation to be used during transfer e.g. ambu-bag or transport ventilator Ventilators to be transferred to recovery a.s.a.p. A minimum of two staff to move one patient. The transferring critical care nurse to remain with the patient, with the assisting nurse returning to the ICU or HDU when the transferring nurse is happy for them to do so. Senior Clinician in discussion with the fire officer makes decision about which Isolation Valves to turn off. N.B. Be mindful of patients still on the unit who require oxygen. 4
EVACUATION ROUTES FROM ICU: Remember that the hospital is compartmentalised into zones. Each zone is protected for a minimum of 60 minutes. Route A Preferred route via theatre corridor to Main Theatre Recovery Route B Alternative route out of ICU main doors and left along corridor to Theatre Recovery Route C Consider option of moving patients to HDU depending on capacity EVACUATION ROUTES FROM HDU: 2 preferred routes; Across main corridor to ICU Or Along main corridor to Theatre Recovery Alternative route to Theatre Recovery via Enlli Ward and Anaesthetics Department 5
HOW TO OPERATE THE EXTINGUISHER STAND APPROXIMATELY 2METRES AWAY FROM THE FIRE WITH THE EXTINGUISHER. P PULL THE PLASTIC CLIP FROM BETWEEN THE HANDLE. A ALIGN THE NOZZLE AT THE BASE OF THE FIRE. S SQUEEZE THE HANDLE. S SWEEP ACROSS THE TOP OF THE FIRE. WHEN TO CONSIDER FIRE EXTINGUISHERS OR USING FIRE BLANKETS WHEN FIRES ARE SMALL. WHEN THE USER IS NOT AT RISK. WHEN THERE IS A SAFE ROUTE TO ESCAPE FROM THE FIRE SHOULD THE FIRE START TO ENDANGER THE USER. WHEN THE USER FEELS CONFIDENT TO USE THE EQUIPMENT. MULTI-PURPOSE AFFF-FOAM EXTINGUISHER THE MULTIPURPOSE AFFF-FOAM EXTINGUISHER HAS BEEN INSTALLED IN ICU AND CAN BE USED ON ALL CLASSES OF FIRES. IT IS COLOURED RED TO CONFORM TO THE NEW EC REGULATIONS OF THE COLOUR CODING OF FIRE EXTINGUISHERS. THINGS TO CONSIDER BEFORE USING THE FIRE EXTINGUISHER NEVER USE A FIRE EXTINGUISHER BEFORE RAISING THE ALARM. CHECKING TO SEE THAT YOU HAVE A SAFE ROUTE AWAY FROM THE FIRE. The above picture shows the CO 2 and AFFF Foam extinguishers present on the unit. 6