Disaster Preparedness: Fire


 
POLICY:
 
In case of a fire, the ultimate concern is for the safety of 
the patients, visitors, employees and professional staff.  
 
PROCEDURE:
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 
expedite evacuation.
 
Available clinical staff should assist the physician(s), as 
possible, by:
 
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 
    fans, etc.
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 
        and distillers.
    C.  Identify medical equipment to be turned off; no such 
        equipment shall be turned off until consultation
        obtained between the surgeon and Fire Department
        personnel.
4.  Removal/placing of records in fire safe area.
5.  Disconnect all electrical equipment; leave the lights 
    on.
 
Additional responsibilities may include:
 
1.  Turning off all gas and electrically operated equipment 
    and valves.
2.  Turning off all machines and main line switches for all 
    equipment.
 
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 
    used.
  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 
    otherwise dictate:
 
    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
    sewers.
 
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 
    combustion.
 
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    
DP.4    
Control #238.5
GUPTA GASTRO