What should you do If you Detect Fire-Emergency in a Hospital? (Tips to Handle Emergency)

1. Minor Fire:

a. The information of fire may reach the security control room through:

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i. The individual who first detects the fire

ii. Through the fire indication detected at the ‘fire control panel’ located at the central control room

iii. Through the automatic fire alarm.

b. The individual discovering the fire will take the following actions:

i. Inform the security control room giving the type and location of fire and his own name and department

ii. Starts immediate action to fight the fire with the assistance of colleagues in the close vicinity and using the fire extinguishers available at the nearest fire point.

c. Staff on duty at Fire Control Room will immediately flash a message, giving location of the fire, on walkie-talkie to:

i. Fire safety supervisor

ii. The security supervisor/security officer

iii. The AMS/DMS

iv. Engineering maintenance supervisor/CME.

d. Engineering supervisor/CME will ensure adequate water supply and also alert the engineering control room in case the oxygen/electric supply is to be switched off.

It is important to remember that the security supervisor should carry a torch (during night hours) as well as the master keys of all the floors. Similarly, the engineering supervisor must carry the emergency elevator key with him.

When the fire is extinguished the AMS/Security Officer and the CME will assess the damage and submit a preliminary report to the MS.

2. Major Fire (Without Evacuation):

After the quick initial assessment, the team of AMS/DMS, Security officer and the CME, (or the senior most official present on the spot) should be able to decide the extent of fire.

If it appears to be a major fire, they should inform the control room and the telephone operator to:

i. Send more staff available on duty

ii. Activate the full fire plan by flashing Code Red and calling staff off duty

iii. Informing the MS, and the NS

iv. Calling the Fire Brigade as well as police for help.

All the staff responding to the emergency code will report to the Control room and will be organized into four groups:

i. Fire fighting party

ii. Cordon party

iii. Rescue party

iv. Salvage party.

In case, the fire is in the patient care areas, a decision will have to be taken whether evacuation, partial or full, should be carried out. Even, if the fire is containable/being contained, the evacuation may be necessary because of excessive smoke, heat and disruption of power supply air conditioning services.

Evacuation may be required in case the fire is a major one, getting out of control spreading to other floors also and life of the patients/staff on the floors is in danger because of fire, smoke and disruption of essential services.

Depending on the extent of spread of fire/ smoke, it may be full evacuation (evacuation of all the floors in the block or even beyond) or it may be a partial evacuation (up to 02 floors above and 01 floor below the floor of fire) it would involve:

i. Safe evacuation of patients along with their treatment records and belongings

ii. Preparing the records of new location of the patients transferred

iii. Informing the relatives of the patients evacuated and the concerned staff.

After the fire is extinguished and patient treatment restored to normal, attention is paid towards assessment of the damage done by the fire and investigating the cause and mode of fire.

3. Role of various officials/services in a Fire Emergency:

a. Role of Fire safety Supervisor/Officer:

i. A member of Initial Response Team

ii. Rush to the location of fire on receiving the message of fire

iii. Coordinate, supervise, guide and participate in all fire fighting activities.

b. Role of Security Officer/Security Staff:

i. Prevent the panic and supervise fire-fighting team to fight the fire, effectively

ii. Clear the approach and entrance to facilitate easy movement of fire tenders

iii. Arrange to rescue the trapped persons from place of fire with the help of rescue and salvage teams

iv. Call the local police for assistance

v. Deploy the security staff to cordon the area and prohibit the entry of unauthorized persons into hospital

vi. Guard all the floors to prevent the theft of patients’ valuables and pilferage/theft of hospital property

vii. Guide the Fire Tenders to Location of fire

viii.Deny entry to other vehicles in the affected areas.

c. Front Office:

i. Informing all the staff (especially off duty staff) in the shortest possible time about the fire alert.

ii. Act as information center by obtaining latest information from the fire fighting team and inform all concerned.

iii. Keep the patients’ attendants and public informed (after clearance from the control room) and pacified.

iv. Handling all the telephonic queries

v. On receiving the directions for evacuation, to announce on public address system, the under mentioned message in English and Hindi (If possible, the message may be recorded on audio CD/cassette):

“All patients, public and staff are hereby informed that there is an accidental fire on the floor of block of the hospital.

All necessary measures to fight and control the fire are being taken and fire will be brought under control soon.

All are advised to evacuate from that area by the nearest staircase. Please do not use the lifts. Please follow all the instructions by the security, staff and the fire wardens and cooperate fully. We shall try to keep you informed. Thank you.”

In case of mock fire drill for staff, the following announcement should be made: “All patients, public and staff are hereby informed that a mock fire drill is being conducted in area of the hospital.

All staff not directly committed to patient care is requested to proceed to the assembly area. Please do not use the elevators. Thank you.”

i. Keep an up-to-date correct information about all the admitted patients such as:

ii. Whether affected by the fire or not

iii. Patients’ condition

iv. Evacuated to some other area/hospital or not and if so, the new location of the patient.

d. Chief Engineer/Shift Engineer/Engineering Staff:

Implements the following actions as indicated.

i. Cut off power to the affected area

ii. Switch off the A/C supply to the area

iii. Shut off the main LPG line

iv. Ensure availability of sufficient water supply to the concerned floor

v. Take part in fighting and control of fire

vi. Opening the windows/doors and switching on the AHU’S, fresh air units, exhaust fans when situation has been controlled to clear off the smoke and the odor

vii. Coordinate with the Fire Service to fight and effectively control the fire

viii.Ensure water and emergency power is in a ready state to cater for emergency.

e. Role of HK Manager:

i. Rendering all required / possible assistance in control of fire and evacuation of patients, reassurance to patients and their relatives

ii. Escorting the patients to the new location safely, as per the directions

iii. Ensuring that the patients’ property is safely escorted with the patients’ to the new location

iv. Thorough search of the affected floors to locate any victims of fire/patients’ that might be lying unconscious

v. Ensure, that doors of all rooms are locked after evacuation,

vi. Supervise removal of property from location of fire

vii. Preparing a detailed report of the extent of damage to property (patients’/hospitals) on each floor for submission to the MS office for subsequent processing of Insurance claim.

f. Nursing Service:

i. Ensuring smooth evacuation of the patients, whenever the decision is taken

ii. Inform patients and attendants about the fire incident and the need for evacuation without causing any panic

iii. Reassurance to all the patients and attendants

iv. Ensuring that the patients’ treatment is not disrupted due to the fire incident, in any way

v. Direct patients’ attendants to the assembly area so as to help in control of fire.

g. Role of HR Department:

i. Recording the details of employees responding to the coded message along with the response time

ii. Noting down the details of employees who failed to respond

iii. Ascertaining reasons (subsequently) for their absence and instituting necessary actions to ensure speedy response of all the staff in such emergencies.

h. Role of the Medical Superintendent:

i. Take over the command and control of the situation immediately on receiving the information

ii. Reach the hospital at the earliest to personally direct and supervise all activities

iii. Set up an Emergency Control Center (ECC) at the security control room or any other suitable place as per the plans

iv. Take major decisions such as calling the fire brigade/informing the police, evacuation— full or partial

v. Liaison with other hospitals for shifting the patients temporarily in case the extent of evacuation is beyond the capacity of the hospital

vi. Continuous monitoring and review of the situation and issue directions in case the plans need to be changed

vii. Issue of press briefings

viii.Submission of reports to the government offices, fire brigade and police as indicated

ix. Ordering of investigations to find out the cause of fire and implementation of necessary measures to prevent recurrence.

Calamities, like accidental fire, have the potential to do incalculable damage. Especially so in hospitals that are full of fire hazards and have so many vulnerable patients (bedridden, unconscious and helpless to save their lives) responsibility for taking all fire safety precautions and installing an efficient fire fighting mechanism in the hospital should be among the top priorities for the hospital management.

It is imperative that the infrastructure is inspected and approved by the fire service authorities every year and firefighting equipment are maintained in a fully operational state at all times.

What is even more important is a detailed and documented fire safety plan with periodic realistic drills organized at different times in different shifts so that all the staff can be trained, deficiencies corrected and the efficiency and effectiveness of fire safety plans ensured.