Fire Emergency/Safety

According to the National Fire Protection Association more than

8,000 hospital fires are reported yearly

Types of fire extinguishers

A = Ordinary combustibles such as paper products, wood, rags, household garbage B = Flammable liquids such as oil , grease or gasoline C = Electrical fires such as electrical equipment ABC = Use on any type of fire D= Combustible metals

More tips on using a fire extinguisher:

Apply extinguishing agent even after the flames are extinguished. Never leave an extinguished fire unattended. Stay until the fire department arrives. Check your unit to know the type of fire extinguishers are available as well as their location and you know how to use them.

C

Confine the fire

If you must evacuate a non ambulatory patient down a stairway:

Drag the patient headfirst to the stairway. Position yourself several steps lower than the patient, so that his lower body inclines upward. Place your arms under the patient's arms and clasp your hands over his chest. Back down the stairs slowly, maintaining close contact with the patient and keeping one leg against the patients back

E

Extinguish or evacuate

Smoke can kill:

Fire can fill the workplace with a thick, black, blinding smoke. Smoke contains toxic gases that can kill in minutes. Carbon monoxide poisoning causes 75% of all fire deaths. Smoke rises to the ceiling, forming a dense cloud that slowly descends. Beneath it you can still see and breathe

Fire is hot:

Flames are frightening but you may face a greater danger from the fire's intense heat that can sear the lungs and fuse clothes to the skin

When evacuating challenging patients it's important to remember to:

Give directions firmly and calmly and escort patients one- on one to a safe area. If staffing is short, more stable ambulatory patients may help escort challenging patients as long as they are under general supervision of a staff member. Blind patients should be told to get close to the floor and keep in physical contact with a leader. Deaf patients should be directed by gestures and also escorted from the area.

C Confine the fire

Hospital units are separated by heavy fire doors. Once the alarm is sounded, they will close automatically to keep the fire from spreading. To help confine the fire within your unit: Close all windows, doors, and vertical openings like laundry chutes. These are barriers to smoke, heat, and flames. Stuffing damp towels underneath doors can help keep smoke out. Shut off oxygen if you are directed to do so.

E Evacuate

If a fire can't be extinguished and smoke, fumes, or flames threaten patient's safety, you may have to evacuate. If so: Move the patient's HORIZONTALLY. Get patient's out of their rooms, through the next set of doors and into a safe area on the same floor. If you can't move horizontally because of smoke or flames block your way, proceed vertically. Work your way down to a lower level. DON'T move patient's to a higher floor unless ABSOLUTELY necessary. NEVER USE ELEVATORS to escape. Evacuate ambulatory (patient's able to walk) first to reduce confusion and hallway congestion. Stay calm and give clear and exact directions. To move non ambulatory (patient's that can't walk) patients: Be prepared to disconnect respirators and other equipment, remove an IV or perhaps, even cut a patient down from traction if necessary. Use wheelchairs if available. If necessary, you may even push a patient to safety while in bed, although more than one or two beds could cause a dangerous traffic jam in the hallway.

E Extinguish

If a fire is small and confined to the area where it started, you may want to try to extinguish it yourself AFTER patients have been removed from immediate danger, the alarm has been rung and staff members have begun closing doors and windows. If the fire is in a trash can or an ash tray, you can smother it with a pillow, towel, rug, or blanket. if a patient's clothes are on fire, wrap the patient tightly in a large blanket to extinguish the flames. If a piece of equipment is on fire, pull the plug if possible. Shut off oxygen and remove any patient from immediate danger.

Heat rises:

In a fire, temperatures can vary from 90 degrees F near the floor to a lethal 600 degrees at eye level

"Flashover"

Occurs when the air becomes hot enough to ignite every combustible object in a room

Fire is fast:

Only takes about 3 minutes to go from a tiny flame to a raging, all consuming inferno

How to use a fire extinguisher:

P.A.S.S. -Pull the pin -Aim at base of fire -Squeeze the handle -Sweep from side to side

To evacuate infants or small children:

Place as many children as possible in one crib. Pull the crib to a safe area. Or use the blanket drag method to drag more than one infant at a time: Place the blanket or sheet on the floor. Put 2 infants in each bassinet. Pad with diapers or small blankets. Place the bassinet in the middle of the blanket. Fold the blanket over one end, fold the corners in, then roll the sides in, to form a pocket. Grasp the folded blanket corners and pull the infants to safety.

Rescue technique: Swing carry

Requires two people to carry the patient. Rescuer One: Slide an arm around the patient's neck and grasp the patient's far shoulder. With your free hand, grasp the upper part of the patient's other arm. Step toward the bed to bring the patient to a sitting position. Rescuer Two: Grasp the patient's ankles, bringing the legs over to the edge of the bed so they bend at the knees. Both Rescuers: Take one of the patient's wrists and pull it down over your shoulder, while supporting the patient's body. With your arm closest to the patient, reach across the patient's back, placing your hand on your partner's shoulder. Reach under the patient's knees to grasp your partner's hand. Staying close to the patient, stand and remove the patient from the bed and carry him to a safe area. At the safe area, drop on your knee closest to the patient, lean against the patient and rest the patient's buttocks on the floor. Next lower the patient's torso and head to the floor.

R

Rescue the patients

To evacuate a patient with a lower body cast provided the patient can be placed in a sitting position:

Rescuer One: You will handle the upper body. Grasp the patient by his shoulders and pull him to a sitting position. Rescuer Two: You will handle the lower body. Take the patient's ankles and move his legs until one leg just clears the bed. If moved further, it will be difficult for your partner to get a hold on the patient. Rescuer One: Maintain the patient in a sitting position and get behind the patient. Place your arms around the patient beneath his armpits and lock them in front. Rescuer Two: Back in between the patient's legs, far enough to grasp just above his ankles. Both Rescuers: On signal, slide the patient to the edge of the bed, staying close to the patient. Rescuer One should hug the patient's back to their chest and keep their shoulders about even with the patient's. On signal, carry the patient to safety , walking forward. Rescuer Two should keep his arms straight down and thumbs up. At the safe area Rescuer Two stoops and lowers the patient's legs until his buttocks rest on the floor. Rescuer One slides the patient down their body and legs and lowers the patient to his back.

Special Challenges:

Sometimes patients present special evacuation challenges, such as children, psychiatric patients as well as elderly patients may act irrationally by ignoring the fire, becoming transfixes by the fire, or resisting rescue efforts or even hiding in closets or under beds.

A

Sound the alarm

A Sound the alarm

Sounding the alarm immediately after discovering a fire is also vital. If you must rescue a patient in immediate danger, call out you facility's code word for fire so that other staff members can begin sounding the alarm. Rehearse/practice your facility's alarm procedure with your coworkers: Work as a team. One person may pull the alarm while another person calls the switchboard to give the precise location of the fire and any other important information. Never hang up without asking the party on the other end to repeat the message.

Rescue technique for a non ambulatory patient by yourself:

Spread a blanket on the floor beside the bed, with one-third under the bed and about 8 inches extending beyond the patient's head. Grasp the patient's ankles and move his legs until they drop over the edge of the bed at the knee. Slowly pull the patient by his shoulders to a sitting position. From behind, encircle the patient with your arms under his armpits, and clasp your hands together over his chest. Slide the patient slowly to the edge of the bed and gently lower him to the blanket. If the bed is high, slide him down one of your legs. Wrap the blanket around the patient and grasp above his head with both hands. Do not let his head snap back. Pull him to safety

RACE to Safety

What you do in the first 2-3 minutes of the fire is more important than what you do over the next few hours. in order to respond rapidly and effectively, memorize an easy to remember formula like RACE that tells you how to proceed and in what order

Additional tips when evacuating patients:

When you arrive at the safe area :account for all patients to make sure they are all present. Never leave the group unattended. Bring the patients chart if possible because it has essential information you may need later. Know which valves to shut off oxygen or other gases , but never turn them off unless you're specifically instructed to do so. Have a system for tagging the rooms already evacuated to avoid unnecessary backtracking. Direct firefighters to the fire and to any patients still on the unit.

R Rescue the patients

When you discover a fire, rescuing patients in immediate danger is always your top priority. You should always stop and investigate any unusual odor immediately. If you smell smoke behind a closed door you should : feel the door with the back of your hand before opening it. If it's too hot to touch don't open it. If it's touchable, open it slowly. If you must enter the scene to rescue a patient: Stay low, remember that smoke and heat rise to the ceiling. Crawl beneath the smoke and heat.

Who do the patients lives in the hospital or facility depend on in case of a fire?

You and your coworkers

React to the unexpected:

if you should catch on fire: STOP, DROP, AND ROLL. If a coworker or patient catches on fire, smother the flames by grabbing a blanket or rug and wrapping them up in it. That could save them from serious burns or even death.