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1. HOSPITAL FIRE SAFETY
Ahmad Thanin

2. OVERVIEW
Healthcare facilities such as hospitals and nursing homes normally see a
continuous flow of people.
Almost all of them operate on a 24×7 basis.
Hospitals are not only required to take care of patients but must ensure that
their safety is prioritized.
Fire accidents at healthcare facilities should not force anyone to run for their
life.

3. DIFFENETION
Fire safety:
• Fire is most dangerous and occurrence accidents, so all staff
must know what is the fire and how preventing and
controlling.
Fire Definition:
• It is the heat and light which are formed by chemical reaction
between vapor of combustible matter with oxygen in suitable
degree of heat.
Definition of Flash Point
• It is a minimum degree of heat at which flammable materials
form vapor combined with oxygen can ignite by any flame.

4. Fire Elements:
Combustible Matter:
• Solid matters like wood, papers, textiles, plastics, metals.
• Liquids like petroleum liquids, Oils, mineral acids and blood.
• Gases like petroleum gases, natural gas.
Oxygen:
• Air contain 21% oxygen and until ratio 16% enough for ignition.
• Oxidizers like H2o2, KMno4.
• Oxygen Cylinders.
Sources of Heat:
• Sun.
• Flame.
• Hot surfaces.
• Spark.
• Friction.
• Electricity.
• Some Chemical reactions.
Chain of Chemical Reaction
• Presence of three elements in equivalent ratio which cause reaction be continuously.

5. Three components interact to create a fire.
Fuel
• is any combustible material that can be used as the source of ignition of
the fire, as well as to keep it burning.
Oxygen
• is an oxidizing agent that reacts with the fuel to start and continue the fire.
• Lower concentrations of oxygen result in slower fuel combustion.
Heat:
• Fires require oxygen and fuel reacting with each other at a temperature
exceeding a threshold temperature, referred to as the “flash point.”
• Different materials and chemicals have different flash points, some at low
temperatures and some high.
• The lower the flash point temperature of a compound, the more easily the
compound ignites.

6. Classes of Fire
Class A:
•Wood, paper, cloth, trash, plastic.
•solids that are not metals.
Class B:
•Flammable liquid gasoline, oil, grease, acetone.
•Includes flammable gases.
Class C:
•Electrical—energized electrical equipment.
•As long as it’s “plugged in.”
Class D:
•Metals—potassium, sodium, aluminum, magnesium. Requires Metal-X, foam, and other special extinguishing agents.
Class K:
•kitchen oils, deep fat fryers, and others.
•Recently recognized by NFPA 10.
•Fires involving combustible vegetable or animal non-saturated cooking fats in commercial cooking equipment.

7. Potential Fire
Hazards in
hospitals
Medical and surgical equipment
Hospital kitchens
Overused sockets and cables
Smoking

8. The Four Principles
of Fire Safety were
created to help
make fire safety in
hospitals simple.
Life Safety
Notification
Extinguish
Relocate/Evacuate

9. Life Safety
As with any emergency, the priority is to protect both ourselves
and those around us.
In the event of a fire, hospital employees should aid patients in
their vicinity.
First, the hospital employee will search for any obstacles, such
as an I.V. or an oxygen tank, that may need to be disconnected
or removed in order to move the patient.
If the patient is ambulatory, they will be guided to a safer
location.
If a patient is unable to move on their own, the employee might
transport their bed or employ an emergency carry.

10. Notification
It is also important to let others know about the emergency.
Effective communication and quick alerts can ultimately save lives and minimize
damage in the hospital.
Notification of the fire situation could take many forms.
The closest fire alarm should be pulled, and the 24-hour hospital emergency telephone
line should be called so that the fire department and first responders are notified.
Additionally, many hospitals rely on a verbal warning called “code red”.
This warns hospital employees in a discreet way so that they can start taking action
before panic spreads among patients and visitors.

11. Extinguish
Whether or not a hospital employee should take steps to
extinguish the fire depends on a few factors, including how
large the fire is and whether they are certified to use a fire
extinguisher.
If the fire is small, if it can be extinguished in a quick and safe
manner, or if a life is in immediate danger, an employee may
try to extinguish it themselves.
However, if the employee is untrained on fire extinguisher use,
if the fire is spreading quickly, or if it is unsafe to remain in the
area due to smoke or heat, it’s best to wait until first
responders arrive.

12. Relocate/Evacuate
Moving to a safer location is also an important component of fire
safety.
Sometimes, this involves evacuating the building completely, while
other times it is best to move to a different wing, floor, or
department.
Ideally, hospital employees should try to move themselves and their
patients through at least one set of fire doors.
To avoid the chaos of overcrowded hallways, hospital employees will
develop an evacuation priority order so that those in immediate
danger can be moved to safety first.

13. Health care
personnel
should be
trained and
drilled in:
Fire prevention.
Location and use of fire alarms.
Location and use of fire extinguishers.
Location of emergency exits.
Evacuation procedures.

14. Health Facilities Fire Protection Systems
Each Health Facility, will have Policies & Procedures at the local level.
• These Policies & Procedures have been developed to guide employee in the event of a workplace hazard occurring.
• It is up to the individual to have knowledge of these local Policies & Procedures;
All Health Facilities will have heat and smoke detectors;
All Health Facilities should have a ‘Break Glass Alarm’ within its environment and an internal alarm system;
Most Health Facilities have fire and/or smoke rated doors;
All Health Facilities will have a selection of fire fighting equipment
• canvas hose reels (for use of Fire Department);
• fire extinguishers;
• fire blankets,
• fire hose reels;
All Health Facilities will have a maintenance system of all its equipment on a annual basis;
All Health Facilities will have a training/education program for their staff.

15. Fixed
Systems

16. Fire Blankets
Fire Blankets are to only used on a small fire.
Protect yourself from the flames by
• shielding your body with the blanket.
• Look over the blanket and
• approach the fire keeping it at arm’s length;
Place (do not throw) the blanket over the container to completely smother the fire.
• Make sure that the blanket has completed a seal around the rim of the container;
Back away from the fire to a safe distance;
Dispose of the blanket after use. DO NOT RE-USE.

17. Fire Hose Reel
Open valve ( ensure that hose reel is turned off at
nozzle)
Run out hose towards scene of fire
Open nozzle and direct stream at base of fire
Usually connected to main water system but not
the canvas reels that are used by the fire brigade

18. Sprinkler System
A high-pressure sprinkler
system can reduce the impact
of a fire — and without
requiring much water.
In fact, they’re reported to
reduce injuries by up to 80%
and reduce property damage
by up to 90%.

20. TYPES OF FIRE
EXTINGUISHERS
Water extinguishers
Foam extinguishers
CO2 extinguishers
Dry Powder extinguishers
Wet Chemical Extinguishers

21. Water Extinguishers
Water extinguishers are very common and should be used on solid materials only.
• This can include paper, wood or any other solid fuel.
Water based extinguishers are essentially filled with water and use compressed air to help this come out.
• Some will also have an additive that will help make them more effective.
• They work to cool the fire, removing heat from the fire triangle and will effectively stop any fire that has started.
Can be used on:
• Solid fuel fires
Not to be used on:
• Flammable liquids
• Flammable gases
• Flammable metal
• Electrical fires
• Cooking oil fires

22. Foam Extinguishers
Foam extinguishers are used on burning liquids such as petrol or diesel fires.
•They can also be used on solid fuel fires in the same way as water extinguishers.
Foam fire extinguishers are actually water based (this is why they can be used on solid fuels) and have a cooling
effect.
•They also contain ‘Aqueous Film Forming Foam’ which smothers the fire and seals in any flammable vapors.
•This will prevent the fire from reigniting and is why they are used to treat flammable liquids.
•Since fire only burns on top of flammable liquids, a foam extinguisher will create a barrier that smothers the flames.
Can be used on:
•Solid fuel fires
•Flammable liquids
Not to be used on:
•Flammable gases
•Flammable metal
•Electrical fires
•Cooking oil fires

23. CO2 Extinguishers
CO2 extinguishers are typically used on electrical equipment.
•They can also be used to extinguish flammable liquids in the same way as foam extinguishers.
Since CO2 extinguishers are perfect for electrical fires,
•they are commonly found in offices or places where there is a lot of electrical devices.
•They work to replace the oxygen in the air with CO2 and will smother the fire in order to put it out.
•CO2 extinguishers are safe to be used on both high and low voltage electricals.
Can be used on:
•Flammable liquids
•Electrical fires
Not to be used on:
•Solid fuel fires
•Flammable gases
•Flammable metal
•Cooking oil fires

24. Dry Powder Extinguishers
Dry Powder extinguishers can be used on most fire types including electrical devices.
Dry Powder fire extinguishers are also known as ABC extinguishers because they can be used on fire types A, B
and C.
Specialist ABC extinguishers can also be used on flammable metals such as magnesium and titanium.
Powder extinguishers work to coat the fuel source and smother the fire.
•They will therefore stop any oxygen from getting to the fuel.
•Dry Powder extinguishers should not be used in confined spaces as particles that are released can be easily inhaled.
Can be used on:
•Solid fuel fires
•Flammable liquids
•Flammable gases
•Flammable metal
•Electrical fires
Not to be used on:
•Cooking oil fires

25. Wet Chemical Extinguishers
Wet Chemical extinguishers are specifically designed to be used on fires that have cooking
oils and fats as their fuel.
• They can also be used on solid fuel fires, but it is more common to use water or foam extinguishers for these.
This type of extinguisher uses a fine mist that cools flames as well as salts that form a layer
on top of cooking oils.
This type of extinguisher both cools and smothers the fire.
Can be used on:
• Solid fuel fires
• Cooking oil fires
Not to be used on:
• Flammable liquids
• Flammable gases
• Flammable metal
• Electrical fires

28. Action in the Event of Fire or Smoke in a
Hospital
•Remove people from the immediate area if safe to do so;
R
•Alert switch (dial emergency no.) or the Fire Brigade (break glass alarm);
A
•Contain if practicable, close the doors & windows; but make sure no one left
behind and DON'T LOCK the door also.
C
•Extinguish use appropriate fire-fighting equipment but do not take risks.
•Evacuate to a safe area if and when directed to do so, ensuring that you can
account for everybody under your care.
E

30. How to use Fire Extinguisher?
•This unlocks the operating lever and allows you to discharge the extinguisher.
•Some extinguishers have other devices that prevent inadvertent operation.
P – PULL the pin out:
•Point the extinguisher nozzle (or hose) at the base of the fire.
A – AIM low:
•This discharges the extinguishing agent.
•Releasing the lever will stop the discharge.
•Some extinguishers have a button that you press.
S – SQUEEZE the lever
below the handle:
•Moving carefully toward the fire, keep the extinguisher aimed at the base of
the fire and sweep back and forth until the flames appear to be out.
•Watch the fire area. If the fire re-ignites, repeat the process.
S – SWEEP from side
to side:

31. Before You
Fight a Fire
Everyone else has left and someone’s calling
the fire department.
The fire is small, confined, and not
spreading.
You have an unobstructed escape route.
Your extinguisher is right for the fire.
You know how to use the extinguisher.

32. Inspection Procedure :
•Make sure the extinguisher is in its proper spot, visible and easy to access.
Ensure easy access.
•Look over the tamper seal and safety seal to make sure they are intact.
Check the seals
•fire extinguishers have a pressure gauge that indicates whether the device is in the proper operating range.
•check to make sure that the gauge’s needle indicates proper pressure.
•If the fire extinguisher has a test indicator, press it to make sure the pressure reading is within the correct range.
Check the pressure.
•Visible signs of damage, such as corrosion, leakage or a clogged nozzle, may mean it’s time to replace the
extinguisher.
Look for physical damage.

33. RULES FOR
FIREFIGHTING
The final rule is to always
position yourself with an exit
or means of escape at your
back before you attempt to
use an extinguisher to put
out a fire.
In case the extinguisher
malfunctions, or something
unexpected happens, you
need to be able to get out
quickly. You don’t want to
become trapped.

34. Action in the
Event of an
Alarm
Check your immediate area for any sign of smoke, fire or a red
light showing on a detector;
If safe to do so, proceed to the Nurses station and place
patient records in a pillowcase but only if safe to do so.
• Check for smoke or fire as you proceed and make sure that fire doors and
windows are closed;
Listen for any messages over the PA (Public Address) system;
If directed to evacuate
• Evacuate to a safe area when directed to do so ensuring that you can
account for everybody under your care and if possible, take records with
you;
Remember the R.A.C.E format if you discover fire or smoke

35. Emergency Codes
Medical Emergency Code Blue
Bomb Threat Code Purple
Internal Emergency or Rapid Response Team Code Yellow
Personal threat Code Black
External Emergency Code Brown
Evacuation Code Orange
Fire/Smoke Code Red

36. Fire &
Smoke
CODE RED
The presence of smoke or fire is a CODE
RED.
If you discover a CODE RED you should:
• Remain calm;
• Dial the hospital emergency number and state:
• ‘there is a CODE RED’,
• The exact location
• Your name & title
In the event of a fire in a hospital you are
to follow R.A.C.E

37. Evacuation CODE ORANGE
Stage 1:
•Remove people from the immediate danger, outside the room, or into an
adjoining room and for example in the case of a fire, isolating the fire by
closing the door.
Stage 2:
•Remove people from outside the involved room into another safe
adjoining fire compartment, either horizontally away from the fire
through the smoke/fire doors, or vertically to another level/floor below
the fire.
Stage 3:
•Remove people from the building to a pre-determined safe assembly area
dependent on the size of the facility.

38. Priority of Evacuation
•Who can evacuate themselves and can be directed to a safe area.
•Can also assist semi- ambulant patients;
First Ambulant Patients and Visitors:
•who may be suffering ailments, which cause them to be slow movers; they must be assisted out of danger;
Second – semi ambulant patients:
•who are totally reliant upon rescuers to remove them from danger;
Third – non ambulant patients
•These are the type who may put the rescuer at risk.
Fourth – violent aggressive or resistive patients.

39. Mandatory for all employee to know
RACE and PASS
procedures.
Location of
closed Fire
Extinguisher.
Location of
closed Fire call
point.
Location of
closed Assembly
point.
Location of
closed Fire Exit
door.
Location of
closed Fire
Blanket.
Location of
closed
Evacuation Map.
Location of
Closed Medical
Gas Valves

40. The Control Room staff shall:
Announce on the hospital wide paging system "Code Red" and the location of the fire.
•This shall be repeated three times.
Page the fire and rescue team through phones or pagers and will notify civil defense, if necessary, by hospital
management .
The security Officer and Safety Officer will take control of the situation and report to the site.
An evacuation plan (within the hospital to the safe areas or outside the hospital at the assembly points) might
be activated.
•There are assembly points designated with signage.
Order partial or full evacuation by announcing code orange by call center through Executive Dir.

41. What is a fire exit?
Lead directly as possible to a safe place, such as outside or into a protected stairwell.
Be quick and easy to open and never locked or fastened in a way that prevents an
immediate evacuation.
Open in the direction of escape.
Not be a sliding or revolving door.
Be clearly labelled with fire safety signs.
Be kept clear of obstructions and flammable materials.

42. Fire Exit Door
A fire escape door is usually installed in the
emergency exits of buildings to reduce the
spread of fire and smoke between separate
compartments.
The emergency fire exit door will remain
closed or automatically close in an
emergency upon the sounding of a fire
alarm that would protect people from
smokes.

43. Fire Safety Signs for
Assembly Points
A fire assembly point is a location
where staff and visitors can gather in
the event of a fire to ensure everyone
is in a designated safe area.
Fire assembly point signs help you
make sure that people will know
where to gather following an
emergency evacuation.

45. REMEMBER

46. The Important Fire Safety Measures in the
Hospitals
Fire safety is an important norm that needs to be considered during the construction of a hospital.
•Compared to the general buildings, it is a tough task to evacuate the people from the hospitals.
•It is unfortunate there are still a few hospitals in which the fire safety is still the words written on the water surface.
The hospital training and learning arm to blame that most of the hospital staff do not have awareness of
fire safety and the steps that need to be employed in the face of calamity.
•the highly dependent and immovable patients make it a difficult task to evacuate the hospital building in a rush.
Hospitals and other healthcare facilities need to focus more on the easy and safe evacuation methods.
•The healthcare practices are responsible for the safety and security of the people inside the hospital, and they are expected to
adhere to the legally approved fire safety measures.
The Emergency Management Plan (EMP) should be kept current so that it stands the unexpected
occurrence of a fire in a hospital

47. A few fire safety measures of a hospital that
are proven to be effective
A Detailed Action Plan
• The fire accidents leave no room for thinking.
• With a detailed action plan that has answers to all questions and needs will save time for thinking and help you to react
instantly in the right way.
• Involve all the departments of the hospital in the brief of this action plan.
Establish the Incident Command Structure
• Communication has vital importance in reducing the damage caused by a fire accident.
• Establish a functional incident command structure that has groups and subgroups.
• These groups and subgroups form a tree of communication and follow the instruction of the group leader.
Instructions for a Fire Safety Management Team
• Involving the Fire Safety Management team in the hospital planning and opening the gates of communication with this
team well advance will reduce the damage caused by the fire accident.
• Keep the communication loop always open with the Fire Safety Management team will keep the damage to a minimum.

48. A few fire safety measures of a hospital that
are proven to be effective
Fire Safety Evacuation Aids
• Hospital evacuation is a challenging task, and the fire safety evacuation aids will help you in this regard.
• There are many types of evacuation aids available in today’s market.
• Equip your hospital with evacuation mats and sheet that could hold the patient firmly while sliding to a safer location.
Fire Fighting Equipment in Check
• The firefighting equipment that includes smoke detectors, fire alarms, emergency exit signals, fire extinguishers and
other fire fighting equipment should always be in check.
• Conduct a performance check while doing the fire drills to ensure the responsive in the face of a danger.
Mock Drills and Fire Safety Training
• This aspect has vital importance in reducing the damage and saving lives during a fire accident.
• Ensure all your staff members are undergoing the fire safety training programs and participating in the mock drills.
• This not only creates a responsive and reliable team in case of a fire but also establishes a safe and secured atmosphere
that prevents fire accidents.

49. THANK YOU