The presentation provides an outline about the fire control system and how to act in case of a fire disaster.

1. FIRE SAFETY
MANAGEMENT
DR. N. C. DAS

2. WHY FIRE SAFETY
The hospital, as an Institution is prone to fire because of:-
 Having many heat-dissipating equipments,
 Combustible gasses /fuel, chemicals, used in different
areas.
A lot of electrical wiring, high voltage connections.
Fire prone articles like gauze, cotton, linen, books and
registrars.
Heavy Equipments and electrical gadgets.
that are inflammable and prone to hazardous incidents.
proper precautions has to be taken while planning
the infrastructure.
Adequate measures need to be considered, designed and
practised to ensure safety to all.
 Indicators like architectural designs, interior designs,
electrical wiring, appropriate equipment planning and
proper waste management are considered while planning
such safety measures.

3. STEPS OF EMERGENCY MANAGEMENT
Mitigation
Mitigation
Mitigation
Recovery Recovery Preparedness Preparedness
Response
Response

4. MITIGATION
• Planning
• Analysis of weaknesses and identifying
gaps
• Testing and Practices
• Learn from mistakes and make
improvements
• Institute practices and policies
• Collaboration

5. PREPAREDNESS
• Exercise
• Training
• Resource management
• Planning

6. RESPONSE
• Supplies
• Staff
• Procedures
• Relationship cooperation
• Unified management of disasters

7. RECOVERY AND RESILIENCY
• Internal effort within an organization to
ensure that all critical business and service
functions are resistant to disruption by fire i,e.
• Business Continuity
• Recovery Plans
• Insurance Coverage
• Continuity of operations
• Continuity of services

8. 4 phases of a
SOP TEMPLATE comprehensive
emergency management
approach
• Mitigation/Preparedness activities of the threat/event.
State several objectives/strategies for:
- Hazard reduction and resource issues
- Preparedness and resource issues
• Response/Recovery from the threat/event.
State several objectives/strategies for:
- Hazard control and resource issues
- Hazard monitoring
- Recovery

9. SOP TEMPLATE
• Notification procedures
- Within facility, system
- Other - (gov, external etc.)
• Specialized staff training, references and further
assistance
- Texts and manuals on specific issues and
procedures
• Review date

10. 9 STEPS PROCESS FOR FIRE SAFETY
1 2 3 4
Develop Hazard Develop
Standard Implement
Form Vulnerability
Operating Mitigation and
Emergency Analysis &
Procedures Preparedness
Management Complete
Activities
Operating Unit Develop Strategies
Committee for Mitigation, Take Actions to
Templates
Establish Roles, Preparedness, Reduce Impacts,
Assign Determine Threats Response & Build Capacity
Responsibilities and Impacts Recovery
5
Report Results of Mitigation and Preparedness to
Emergency Management Committee
On-going Monitoring
6 7 8 9
Develop Implement Annual
Emergency Conduct Staff Emergency Evaluation
Operations Education & Operations & Corrective
Plan Training Plan, Conduct Actions
Organizational Understand Roles, Critique Review and Refine the
Concept of Build Competencies Emergency
and Confidence Rehearsal or
Operations Actual Event Management
Program

11. PLANING AND MANAGEMENT
INFRASTRUCTURE ELECTRICAL SYSTEM
INTERIOR DEGINING
PLANNING PLANNING
FIRE SAFETY TRAINING FIRE SAFETY EQUIPMENT/SERVICES
AND PRATICES PLANING
SAFETY/ SECURITY FIREPROTECTION FIRE PRTECTION
EQUIPMENTS EQIPMENTS SYSTEM

12. INFRASTRUCTURE PLANNING
Architectural designs, interior designs,
electrical wiring,
Appropriate equipment planning and
proper waste management are taken in to
consideration at the stage of planning for
fire safety.

13. ARCHITECT & LAYOUT PLANNING
Following points must be kept in mind during
building planning.
There is sufficient open space around the
building
Sufficient open space between two buildings so
as to minimize fire spread possibilities from or to
neighboring structures.
Also there should be enough space for
movement and parking of fire fighting vehicles,
ambulances, etc in the premises and wide road
approach to the building.
Considering the size & number of occupancy,
lobbies, staircases, ramps, etc should be
sufficiently wide to ensure easy movement of
traffic and quick evacuation during emergencies.

14. ARCHITECT & LAYOUT PLANNING
The design of the building structure should be so planned that
it allows pressurised exclusion of smoke in case of fire or any
smoke leak.
 Must have enough doors and windows for proper ventilation.
Adequate emergency rescue aids and suitable refuge area
should be incorporated in the design.
Ideally, a heavy-duty elevator especially for use of fire fighting
personnel only and used in case of emergency only should be
incorporated.
The building should be so designed that it can resist damages
due to earthquakes to a fair extent.
Safe and easy means of access should be provided to and in
every place of work /in patient area.
This should enable access to all including the disabled to move
easily.
In case of an emergency, safe and rapid exit should be
provided for all occupants.
Each building must have separate fire exit, staircase with
proper signage.

15. INTERIOR DESIGNING
The critical areas like Labs X-Ray, OT, ICU etc where
heavy equipments are installed should be well protected and
extra precautionary measures should be implemented in
such critical areas,
 Interior should have fire proof doors, windows, walls and
roof covered with fire proof materials.
The floor should be so designed that they are free from
obstructions, are slip-resistant & even.
Openings in floors should be securely fenced or covered.
Staircases, ramps should be provided with substantial
handrails and other suitable support means to prevent
slipping, wherever necessary.
Easy access for the servicing and maintenance of plant,
machinery and buildings should also be incorporated in a
design.
The building should be so designed that it can resist
damages due to earthquakes to a fair extent

16. INTERIOR DESIGNING
The interior designer also needs to incorporate the
environment safety measures such as:-
Adequate natural light, fresh air and colour therapy on
walls and lights.
The designs should be such that there is minimal use of
combustible materials like gases, petrol or kerosene.
The designs should use plenty of good quality fire
retardant material for interior furnishing and decoration
purposes.
Appropriate waste management systems also need to
be designed to prevent accidents due to hazardous
waste.
The gas and oxygen pipelines must be made of copper.

17. ELECTRICAL ENGINEERING
For electrical wiring designs and AC plant:-
•The electrical wiring could be enclosed in metal/ heavy gauge
screwed conduits.
•The cable passing from one floor to the other should be
suggestively sealed off effectively to minimize fire-spread
possibilities.
•Good quality copper cables well covered, switches , plugs and
sockets to be used for good conduction and heat resistance.
•There should not be any loose wire hanging.
•A master control switch for each floor should be located at the
ground floor for easy switching off of systems in case of
emergency.
•It is highly advisable to use individual air- conditioning or
space heating systems for each floor in large buildings.
•However in case of centralized systems that is generally
preferred in hospital infrastructures; care should be taken
to provide appropriate automatic fire dampers for each floor in
the common ducting system.

18. MACHINERY DESIGNS
•Proper cooling facilities to dissipate heat should be
provided for equipments/plants/machinery generating
heat.
•Boilers, plant rooms, freezers, manholes and similar
confined spaces should have effective means to ensure
safe access & exits.
•All equipments should be earthed properly to dissipate
the static charges to the earth.
•Incorporate totally enclosed switchgear systems/
miniature circuit breakers instead of ordinary fuses.
•Always emergency power supply arrangements need to
be designed & incorporated in case of total system switch-
offs during emergency.
•Appropriate fire fighting equipments, fire detection,
smoke and heat detection alarms should be incorporated
in the design.
•The fire-fighting equipment as per quality standards and
norms should be used..

19. FIRE PROTECTION SYSTEMS
SYSTEM
CENTRAL LOCAL
Fire Water Hydrant System Fire Extinguishers
Fire Protection System Fire Fighting
Fire Detection System Equipments.

20. FIRE TETRAHEDRON
The four Elements which required fire to spread is called “FIRE
Tetrahedron”

21. CLASSIFICATION OF FIRE
TYPE A TYPE B
wood and paper. liquids and gases.
FIRE
TYPE C
TYPE K TYPE D
Energized
Oils & Fats Combustible Metals
electricity.

22. WATER – HYDRANT SYSTEM
There is a separate water tank under/over ground to be exclusively used for
Fire hydrants.
Each building has got a fire hydrant connected to the tank by steel water pipes.
The hydrants have hose pipes and various nozzles to be fitted in to hose on
one side and the other side is attached to hydrant.
Fire Hydrant Hose Pipe Nozzles

23. PROTECTION SYSTEM
1.Protection System mainly contains dry chemicals and acids,
Coming on contract it releases Foam which covers the flame
there by cutting down the Oxygen supply.
The type of foam used are, CO2, Foam Chemicals.
2.Sprinkler system
"Sprinkler system" means a system of piping designed in accordance
with fire protection engineering standards and installed to control or
extinguish fires.
The system includes an adequate and reliable water supply, and a
network of specially sized piping and sprinklers which are
interconnected.
The system also includes a control valve and a device for actuating an
alarm when the system is in operation.
The sprinklers are fitted on the roof of the building
SPRINKLERS
Sprinkler on roof

24. FIRE DETECTION SYSTEM

25. LOCAL PROTECTION
LOCAL
EQUIPMENT
FIRE FIGHTING
FIRE EXTINGUISHER
EQUIPMENTS
(Fire Hose Box, Fire Man Axe, Fire
Beater, Fire Hook, Fire Bucket,)

26. TYPE OF EXTINGUISHER
Class A – ordinary combustibles (wood, cloth,
paper)
Class B – flammable liquids, gases, greases
Class C – energized electrical equipment
Class D – combustible metals
B C D
A

27. TYPE OF EXTINGUISHER
The National Fire Prtection Association (NFPA) classifies fires
into five general categories (U.S.):
Class A fires are ordinary materials like burning paper,,
cardboard, plastics etc.
Class B fires involve flammble or combustible liquids such as
gasoline, kerosene, and common organic solvents used in the
laboratory.
Class C fires involve energized electrical equipment, such as
appliances, switches, panel boxes, power tools, hot plates and
stirrers. Water can be a dangerous extinguishing medium for
class C fires because of the risk of electrical shock unless a
specialized water mist extinguisher is used.
Class D fires involve combustible metals, such as magnesium,
titanium, potassium and sodium as well as reagents such as
alkyllithiums, Grignards and diethylzinc. These materials burn
at high temperatures and will react violently with water, air,
and/or other chemicals.
Class K fires are kitchen fires ie. Ghee and oils..

28. BASIC TYPES OF EXTINGUISHERS
The two most common types of
extinguishers in laboratories are
pressurized dry chemical (Type BC
or ABC, left) and Carbon dioxide.

29. INSTALLATION AND
General Requirements
Wall Mounted, easy to locate and visible from
a distance so that they are readily accessible.
Only approved extinguishers shall be used (ISI)
Fire Fighting equipments in the vicinity.
Inspect Extinguishers once a month.
The pressure is at the recommended level in
the gauge in green zone
The extinguisher is not blocked by objects that
could interfere with access in an emergency.
The pin and tamper seal (if it has one) are
GAUGE
intact.
There are no dents, leaks, rust, chemical
deposits and other signs of abuse/wear and tear.

30. MAINTENANCE
Maintain extinguishers in a fully charged
and operable condition
Visually inspected monthly
Maintained annually
Hydrostatically tested periodically to ensure
that the cylinder is safe to use.
If the extinguisher is damaged or needs
recharging, get it replaced immediately.
Recharge all extinguishers same time after
use regardless of how much they were used.

31. FIRE SAFETY RULES
The “National Building Code of India”, 1980,
issued by the Indian Standards Institution,
serves as excellent references to safety
management for infrastructures.
The Tariff Advisory Committee of the General
Insurance Industry and the Metropolitan City has
their own requirement.
 Government Authorities recognize fire hazards
with large buildings and have developed rules
and regulations for fire protection and fire
fighting requirements in large buildings.
Fire Clarence is not given by the authority if
these rules are not complied with by the owner
as it is mandatory under Law..

32. TRAINNING IN USE OF EXTINGUISHERS
Employees designated to use fire fighting
equipment should be trained in:-
i)Use of extinguishers
ii) Associated Hazards Initially and Annually
iii) General principles of fire extinguisher use
iv)Where portable fire extinguishers have been
provided for employee use in the workplace,
employees must be provided with an
educational program.
v)Employees designated to use extinguishers
must receive instruction and hands-on practice
in the operation of equipment

33. FIRE FIGHTING EQUIPMENT
MANAGEMENT
The employer should ensure
maintenance and inspection of
fire fighting equipment at least
annually, Ensure safe
operational condition of the
equipment.
Training of employees in use of
fire extinguishers.
Portable fire extinguishers to be
inspected at least monthly
Respirators shall be inspected
at least monthly

34. PERSONAL PROTECTION EQUIPMENTS
The personal protection equipments include
Gloves, Canister Gas Mask, Breathing Apparatus Set,
Resuscitator, Aluminized Suit, Helmet, Goggle, Shower
& Fountain, Emergency Kit, Safety Torch, Siren, Wind
Sock, Stretcher, Gum Boot, Face Shield, Ear Muff, Ear
Plug, Apron, Blanket, PVC Suit, Plus Pressure Suit,
Safety Belt, Safety Net, Rope Ladder, Traffic Control &
Road Safety Devices, Safety Sign & Posters.
These are only used by trained “Fire Fighters” of Fire
Department.

35. SECURITY EQUIPMENT
These are used by ‘FIRE MEN’ only
and includes:-
Hand Held Metal Detectors
Door Frame Metal Detectors
CCTV
Alarm Systems
Access Control system

36. INTERNAL EMP SHOULD BE:
• For All-hazards
• Comprehensive Emergency Management
• Dynamic and continuously updated
• Compatible with standard EM concepts,
yet unique to the particular facility
• Include involvement with community and
external entities
• Fully supported by management

37. EM PROGRAM GOALS
– Continuity of care.
– Safety of patients, families and staff.
– Support to community (and Nation).
– Preservation of vital records and
property.

38. INTERNAL DISASTER ACTION PLAN
It is activated when the hospital buildings are effected in disaster.
Action plan should clearly mention:
• Alternate site (dharmashala,Temple,Schools,Playground nearby)
• Folding tents, cots, trolleys for temporary shelters
• Identify a nearby tent house to provide beds,blankets
• TPT for transportation of cases to alternate sites or hospital
• First aid and drug kits, potable lights.
• Portable communication system.
• Identify local voluntary organization, who can provide services of
care,food and water.

39. STEPS OF FIRE MANAGEMENT
RAISE RUN RESCUE

40. ACTIONS FOR MINOR FIRE
The building is being evacuated (fire alarm is
pulled)
The fire department is called (dial 101).
The fire is small, contained and not spreading
beyond its starting point.
The exit is clear, and you can fight the fire with your
back to the exit.
You can bend down to avoid smoke.
The proper extinguisher is immediately available at
hand.
Aware of the instructions and know how to use the
extinguisher.
 In major fire start Evacuation.

41. EVACUATION
Planning evacuation:
Emergency Preparedness Committees and integration with region or
operational area plans
Identification of alternative locations
Communications
Transport options
Cache of supplies or resources
Employee safety and well-being
Intense focus on facilities’ ability to respond
Evacuation must be done in partnership
Personnel were sent with NICU, ICU, and psychiatric patients, stable
patients were not accompanied
Patients moved using backboards, walking, wheelchairs, blankets,
sheets.
Stairs only to be used
No special equipment used

42. Increased need for wheelchairs, walkers, adult diapers, colostomy
supplies and personal hygiene items, soft foods, clothing changes,
portable oxygen and medicines.
Evacuation requires a command structure to best manage the situation
Safety of the patients, visitors and staff - All are at risk!
Coordination and tracking are needed
Staff health and safety while meeting the hospital’s medical mission are
the highest priorities in responding to any type of incident.
Evacuation can be coordinated by a central Emergency Operations
Center (EOC) or independently by the affected facility and had equal
success
Should have a secondary evacuation plan in the absence of area EOC
Evacuation from any cause requires accountability for patients and for
staff
Family members who are with patients or staff in a crisis situation
Priority for relocation will depend on the stability of the patients and the
resources available

43. OPTIONS IN EVACUATIONS
1. Shelter in place
2. Horizontal or lateral movement
3. Vertical evacuation
4. Complete facility evacuation
5. The situation may require all methods
1.Shelter-in-Place
Stay in the facility but minimize the hazardous impact
Example: distance from a hazardous spill, isolated fires, security breach
Fire location
2. Horizontal or Lateral Evacuations
Moving to other wings in the facility, beyond fire doors, into a safety zone
Easier movement of beds and equipment
Faster in initial phases
Further evacuation may not be necessary or shelter-in-place option may
be ordered

44. 3. Vertical Evacuations
•Complex
•Cumbersome
•Increased physical risks
•Depending on cause for the evacuation, elevators and
escalators may be prohibited or out of operation
4. Who is Evacuated First
Green - Walking
Yellow - Chair assist
Red - Full assist in stretcher and accompany
The basic concept of triage in a disaster circumstance is to do
the greatest good for the greatest number

45. FACILITY AND UTILITY
CONSIDERATIONS
4. Evacuation devices (evacuation chairs and sleds) or
manual carries may be required
•Most evacuations can be controlled .
•In a controlled evacuation, exit at direction of Incident
Command Center, Fire or Police or authority in charge
•Lateral / horizontal first
•Vertical second
•Evacuees can be staged in outside areas to facilitate
transport
Evacuations may require rapid shut down of ventilation
systems, power, water, gas and other infrastructure controls
for the protection of everyone
Risks include: explosion, flooding, electrocution, toxic gases

46. AREAS OFTEN NEED A SPECIFIC PLAN
The nature of the patients or residents of the
facility may require more specific plans and
techniques
Examples:
•Sensory impaired (sight, hearing)
•Specialty units: dialysis, operating rooms, ICUs,
psychiatric care, hyperbaric oxygen chambers
•Pediatrics facilities, NICU
•Extended care units

47. EVACUATION FROM THE OPERATING
ROOM
Cancellation of OR cases
In evacuation procedures:
•Stabilization and premature closure of case
•Airway management with alternative means
•Life support mechanisms
•Transport options from OR
•Management in alternative environment
•Transfer to stable environment
Know the routes and clear the corridor
Gather transport stretchers & devices
Conclude procedure as soon as possible
Maintain life supports
Maintain anesthetic state

48. Take necessary meds with patient to continue
anesthesia during transport
Control bleeding
Sterile towels/covers over surgical sites
Remove intravenous solutions from poles - place
in transport with the patient
Disconnect unnecessary leads, lines or other
equipment
If time permits:
•Gather minimal number of instruments for
transport
•Take additional intravenous solutions
•Secure equipment for transport
•Don’t delay

49. COMMUNICATION AND
TRANSPORTATION OF PATIENTS
•Private cars
•Public buses
•Hospital vans
•Ambulances
Communications intermittent but all evacuations
relied on functioning communications
Pay phones, cell phones, intermittent landlines, ham
radios, ambulance radios, hand-held radios

50. SECURITY CHALLENGES IN
EVACUATIONS
Security staff in most hospitals are:
•Private guards (hospital or contract)
•Unarmed and have no powers of arrest
•Expected to restrain violent patients or visitors or act
as deterrents
Trend of minimal staffing and inadequate coverage with
a dependency on local law enforcement
Facilities may need to make do with on site security
Law enforcement agencies may be overrun with urgent
requests for multiple types of assistance and no
prioritization
Training must include exercises and realistic planning
and models

51. SUMMARY
Evacuation requires planning
Most evacuations are controlled
Multiple resources are required
Specific needs must be considered
Departmental plans should be specific
Employee and patient safety requires training
Evacuations may need to include families and visitors
Accountability is important in considering the safety for
all involved
Security will have to be managed internally at least in
initial phases

52. hospiad
Hospital Administration Made Easy
http//hospiad.blogspot.com
An effort solely to help students and aspirants
in their attempt to become a successful
Hospital Administrator.
DR. N. C. DAS
Based on Extracts from Internet.