Disaster Preparedness: Fire
In case of a fire, the ultimate concern is for the safety of
the patients, visitors, employees and professional staff.
The meeting place for this organization is: 130 Ave P
If fire is in your area, follow RACE:
R REMOVE persons who are in immediate danger of
flames and/or smoke. Remain calm. Designated staff
should remain outside to direct emergency personnel
to the location.
A Activate ALARM or otherwise notify others to come
help. Ask front desk staff to call 9-1-1 and
security to alert other occupants of the building.
C CLOSE all doors in your area to confine the spread
of fire and smoke. Turn off all medical gases and
electrical equipment as permitted and leave lights
on. (Decisions regarding the provision of medical
gases to any patient in the midst of surgery are the
responsibility of the attending physician).
E Prepare to EVACUATE in a quick and orderly manner,
using the nearest exit and following evacuation plan.
If it is safe to do so, staff not involved in the evacuation
of patients or visitors, shall report to the location of the
fire, bringing a fire extinguisher with them, consistent with
assigned duties from the fire plan. It is not the duty of
the staff to fight the fire; the responsibility of the staff
is to provide for the safe evacuation of those on site.
If it is possible to evacuate all personnel from the building
and if there is no procedure underway, all personnel will
evacuate; the fire department will then be responsible for
fighting the fire.
Any procedures in progress should be brought to an interim
conclusion as soon as possible; the surgeon should be kept
apprised of the progress of the fire so that an informed
medical decision can be made regarding the disposition of the
patient. If the patient must be evacuated, a sterile
dressing should be placed over the wound and the patient
moved to the nearest exit with necessary support equipment.
The surgeon may administer appropriate reversal agents to
Available clinical staff should assist the physician(s), as
1. Searching for a safe route.
2. Advising on best relocation point.
3. Advising on the availability of equipment and
services for completion of surgery.
Other duties, as assigned, may include:
1. Turn off all electrical equipment.
2. Turn off all fans, air conditioning, exhaust
3. All equipment that might tend to spread the fire
should be shut down at once:
A. Turn off all non-medical equipment, except lights.
B. Turn off steam and water valves on autoclaves
C. Identify medical equipment to be turned off; no such
equipment shall be turned off until consultation
obtained between the surgeon and Fire Department
4. Removal/placing of records in fire safe area.
5. Disconnect all electrical equipment; leave the lights
Additional responsibilities may include:
1. Turning off all gas and electrically operated equipment
2. Turning off all machines and main line switches for all
The senior administrative person on site will oversee the
evacuation of the building and account for all persons who
were in the facility. The senior clinical person on site
will assure that no patient is left unattended.
*Note: Respond to drills in identical manner as actual fires;
do not use elevators.
ACTIONS WHICH MAY PREVENT A FIRE OR MINIMIZE DAMAGE:
1. Portable fire extinguishers must be maintained in a
fully charged and operable condition and kept in their
designated places at all times when they are not being
At regular intervals, not less than annually, or when
specifically indicated by an inspection, extinguishers
must be thoroughly examined and recharged. Repairs or
replacement may be necessary to ensure safety.
If all extinguishers in the facility are removed from
their locations to be recharged, spare extinguishers
must be available during the period they are gone if
the facility is operational.
Each extinguisher must have a durable tag securely
attached to show the maintenance or recharge date and
the initial or signature of the person who performs this
service. Each time the fire extinguisher is checked, a
notation should be made on the appropriate line or space.
2. Extinguishers must be conspicuously located, readily
accessible and immediately available for use.
3. The type of fire extinguisher appropriate to a given
situation has been placed in the corresponding physical
location. Fire extinguishers should be used in the area
in which they are located; the selection of fire
extinguishers for a given situation depends upon the
predicted characteristics of a potential fire, the
construction and occupancy of the individual property,
the hazard to be protected, and other factors.
4. Only employees who have been trained in their proper use
should use fire extinguishers.
5. Any damaged or apparently-used fire protection equipment
must be promptly serviced or repaired.
6. Access to extinguishers, sprinkler risers, switch boxes,
fire alarms, and exits is to be kept clear and
unobstructed at all times.
8. Exits and fire doors must never be blocked and must be
in operating condition at all times. All exit doors
shall be kept unlocked unless security requirements for
protection of life, property, or patient confinement
A. An exit door that must be locked shall open from the
inside without key by use of 'night latch' panic bar
or similar approved device.
B. Exit doors shall open with traffic flow.
C. Exit doors shall be plainly marked by approved signs.
D. Exits shall be maintained unobstructed and lighted;
they will not be blocked shut.
E. Exit doorways, including stairway, enclosure doors,
will not be propped or wedged open.
[NOTE: 'Exits' are all doorways, hallways, stairs,
and designated routes that provide a means of egress
from the interior of a building to the exterior of
the building at ground level.]
9. The effects of smoke upon the human body are very
significant. It is necessary that everyone likely to be
exposed to smoke should be informed of the potential
danger, which will be encountered in the concentrations
of smoke found in fires.
A. Fire emits smoke, heat and toxic gases. Smoke
encountered in a structural fire may be charged with
toxic gases which may prove fatal upon short
exposure. Far more fire fatalities are caused by
smoke inhalation and suffocation than by burns.
B. Most combustible materials contain carbon, which
burns to form carbon dioxide when there is
sufficient air supply, or poisonous carbon monoxide
when the air supply is restricted. Carbon monoxide
cannot be detected by smell and is one of the most
dangerous of all gases.
10. The condition of wall receptacles should be checked and
any defective parts repaired or replaced. Floor and
table lamps are a source of trouble, partly due to
unsuitable design. Insulation on wiring should be
checked to be sure that any broken sections are
discovered before short circuits occur.
Before any new electrical equipment is purchased, the
installer should be responsible for determining whether
or not the equipment is safe and adequate for the
purpose. This opportunity will tell him either to
increase the capacity of existing circuits or to install
a new circuit as needed.
Portable lamps, if unguarded, may ignite paper, cloth,
wood, and other combustibles or cause an explosion in an
atmosphere which is dusty or contains flammable vapors
or gases. Portable lamps should be suitable approved
types with sturdy, heavy duty cords.
HANDLING OF FLAMMABLE/COMBUSTIBLE LIQUIDS AND MATERIALS
Definition: The Interstate Commerce Commission Regulations
define a flammable liquid as 'any liquid which gives off
flammable vapors at or below a temperature of 80 degrees F.
The Commission requires a designated red label on such
liquids when shipped.'
Approved Storage Space: An approved storage space for storing
of flammable liquids located within the work areas consists
of a room or other space made of fire resistant materials and
properly cut off from other sections. This space shall have
appropriate sprinklers, drains and other necessary fire
explosion protective devices.
Guidelines for Storage and Use of Flammable Liquids:
1. Flammable liquids must be used only in small quantities
and in approved (UL or FM), self closing containers.
2. Flammable liquids must not be disposed of by dumping or
pouring into sewers or into conductor pipes leading into
3. Cleaning solvents should be used only when good
ventilation is provided. This precaution will help to
avoid fire, explosion, or injury to health.
Other precautions include:
A. Keep open flames or sparks away from flammable
liquids or their vapors.
B. Avoid breathing vapors. Vapors of chlorinated
solvents are especially toxic.
4. Flammable liquid containers must be clearly labeled and
stored in a protected, separate area.
PROPERTIES OF OXYGEN
There are many ways in which oxygen is utilized in the
medical profession. Properly handled and safeguarded, oxygen
is of great value and presents little hazard.
1. Oxygen does not burn. It does, however, support
2. Oxygen in combination with certain combustible
anesthetic agents may form violently explosive mixtures.
When these combinations are being used, utmost care must
beexercised to prevent ignition. The source of ignition
may be a static spark, a faulty electric cord or
appliance, an unapproved appliance, etc. Proper
maintenance of this equipment and regulation of
personnel can eliminate this hazard almost entirely.
3. Oxygen, under high pressure, if allowed to come in
contact with grease or oil, may cause a violent
explosion. For this reason, oil or grease may not be
used on valves, threads, or parts of oxygen equipment.
For the same reason, persons with oil or grease on their
hands should not handle oxygen equipment.
4. Oxygen cylinders present a serious hazard if not
properly secured against tipping over. If an oxygen
cylinder should fall just right and knock the valve
assembly off, it could become a dangerous projectile
with over 2,000 pounds of pressure for propulsion.
There have been cases in which cylinders so powered have
penetrated solid brick walls. Oxygen cylinders will be
kept on a cart or stand or secured to a wall when not in
use. In the storage room, oxygen cylinders will be
secured against tipping or falling.
Approved By Governing Board