Page 1 of 5 Fire safety & Evacuation For ICU Scope Fire in the Intensive Care Unit (lcu) requires a rapid response to ensure safety of patients and staff. Staff working in the ICU must be prepared to make an early decision to evacuate. Under such circumstances, their response depends upon their having regular fire training and knowledge of evacuation procedures and escape routes. Life support equipment must be readily available as oxygen and power supply to the ICU may be lost soon after the outbreak of fire. Emergency evacuation will involve triage of patients. If fire spreads quickly and uncontrollably, it may not be appropriate to attempt to evacuate all patients. Regular planning and training, appropriate fire containing measures and readily available life support equipment for evacuation will reduce the risk to life. Responsibilities ICU incharge, nurse incharge, staff and support workers of ICU. It is a statutory requirement to have an evacuation plan for ICU in case of fire. The nurse incharge or consultant cover ICU will take decisions in consultation with fire safety officer during the day time or when they are on duty. During the nights shift incharge nurse will take decisions in consultation with fire safety officer. Procedure The main principles of fire control are Prevention Rapid detection Effective containment and extinction Alarm Evacuation 1
Page 2 of 5 ICU design Provided with 2 doors. Smoke detectors and sprinklers installed. Fire extinguisher installed. Fire in the hospital but outside ICU Following alarm the incharge person should be ready with plan for evacuation as required by fire safety officer. The fire officer will take a call whether we should evacuate or move to other areas of the hospital or we should stand by for evacuation. The advice of fire officer should be followed and his decision will be final. Patient preparation The patients should be clinically prepared for evacuation. Some modification of their ICU management and the collection of additional equipment may be necessary The senior members of the ICU staff already present should establish a rank order of evacuation should it become necessary. Clinical circumstances will determine which patients should be moved first: the principles of triage apply. The possible loss of electrical or gas supply may be important in determining the order of evacuation. Order of evacuation If the fire is likely to be controlled then leaving the most unstable patient, in the hope that the patient will not need evacuating, may be a wise and safe option for both the patient and staff. If the fire is likely to spread rapidly, then the patients nearest the source of the fire should generally be moved first. It is important to emphasize that decisions on which patients to move must be 2
Page 3 of 5 taken at a local level and must be taken by the most senior member of staff already present in the ICU. Valuable time should not be wasted attempting to contact senior staff not present on the ICU: staff must spend their time preparing patients for evacuation. Evacuation of the ICU Choose the evacuation route in consultation with fire officer Evacuation sheets and additional staff, if the patients are to be evacuated down stairwells. The designated fire lifts situated in the C ward can be used if it is safe to do so. All staff should assemble in the designated assembly point for ICU, which is the front of the hospital near Dhanvanthri temple. ( ASSEMBLY POINT- Outside IP Entrance) Fire in the ICU Alert the fire alarm in the corridor if possible. Make a telephone call to fire department 7777 or activate 1000 via switch board Fire officer of the hospital is incharge of plans till fire service personal arrives Attempts should be made to control the fire without endangering hospital staff. Failure to control the fire with the fire extinguishers is an indication for immediate evacuation from the ICU. Plan for evacuation Evacuation route depends on the site of fire. Use the route, which is away from fire source either the stairs or 4 th C fire evacuation lift or Ramp in the 4 th C ward. Staff should not be put at risk The nurse incharge will assign the patients to the available personal and some form of triage will be needed. The unstable patients will go last. The patients 3
Page 4 of 5 not on ventilators will be evacuated with attenders help either in stretcher or bed. Some life saving treatments cannot be continued due to bulk of the machine or power and gas supply (dialysis, balloon pump). These measures have to be switched off and the patients requiring these measures will go last. Use the available attenders to shift the beds in case more help needed Move the patients either via stairs or ramp depends on which is available and this route should be adviced by fire officer. Equipment required Ambu bag or any self inflating bag and face masks All intubated patients should be attached to a closed breathing system like self inflating bag with reservoir, in order to prevent inhalation of the potentially toxic atmosphere. Use the available portable monitors to the unstable patients Disconnect the unwanted syringe pumps use only those with ionotropes. Take the resuscitation bag with emergency drugs and take additional ionotropes Assembly point All ICU staff should assemble at the designated point for the ICU Do not leave your patients and move from one area to other areas with out informing the incharge Incharge staff will make a roll call to make sure all the staff and patients are evacuated Do not re enter the building until it is cleared and the fire officer gives all clear All visitors should be adviced to evacuate the area once the fire alarm went on Further care Continuity of care will be decided on case by case basis either in Ganga or other ICUs and this decision will be taken by the consultant with admission 4
Page 5 of 5 unit Nurse incahrge will make arrangements for additional drugs and equipments till that time Training All ICU staff should undergo mandatory training in hospital fire safety procedures Staff should attend regular fire drill both in the unit and in the hospital All ICU staff should read the SOP and should familiarize with the plans 5