FireSafetyIn HealthCare Facilities

A Self-Teaching Fire & Life Safety Program

PortlandFire&Rescue
FirePreventionDivision PublicEducationOffice

Introduction
Goal: Toensurethatemployeesareknowledgeableinfirepreventionandemergencyresponseinhealthcare facilities. Objectives: Employerwill: 1. Developafireandlifesafetyemergencyplan(seePortlandFire&RescuesEmergency OperationsGuide)whichcontainssuggestionstoincreaseeachtenantsopportunityfor survivinganemergencyandhowtoproduceaplanthatcomplieswiththeprovisionsof applicablecodes.http://www.portlandonline.com/fire/index.cfm?c=44518&a=194657 2. Providetrainingforallemployees. Employeeswillbeableto: 1. Describetheemergencyproceduresfortheirfacility,incaseoffire. 2. Identifycommonfirehazardsinhealthcarefacilitiesandhowtopreventthem. 3. Demonstratetheoperationoffireandlifesafetysystems(manualpullalarms,firedoors,calling 911forhelp,etc.). 4. DescribetheRACEresponsesystemusedinhealthcarefacilitiestoensurepatientsafety. 5. Demonstratehowtocorrectlyuseafireextinguisher. Materials: Handouts,obtainedfromPortlandFire&Rescue,suchas:"DevelopingYourOwnFireandLife SafetyEmergencyPlan","10TipsforFireSafety","PortableFireExtinguishers",and"HomeFire SafetyChecklist". Videos(checkedoutforupto3daysavailablethroughthePortlandFire&Rescueorpurchased bythehealthcarefacility),suchas"EmployeeEvacuation:ActionforSurvival"and"Fire ExtinguisherSafety." Thefirerecordforhealthcarefacilitiesisgood;however,thereisthepotentialforlargelossoflife becauseoftheconcentrationoflargenumbersofvulnerableindividualsinoneplace.Itisimportant thatemployeesarewellversedintheFireandLifeSafetyEmergencyPlanfortheirfacility.Whenan emergencyhappens,itwillbetheirquickactionsthatcanmakethedifferenceintheoutcome.

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Lesson Outline

Keepingtheinterestofstaffmembersduringfiresafetytrainingcanbea challengeespeciallywhenyouarereviewinginformationwhichemployees havereceivedinthepast.Involvingemployeesintheprogramisagoodway tomaintaintheirinterest,whileincreasingtheirknowledgelevelonfireand lifesafety.Also,trylimitingtheprogramto60minutesorlessinlength. GettingStarted: Makesureallemployeeshaveacopyofyourfacility'swrittenfireandlifesafetyemergency plan,aswellasacopyof10TipsForFireSafety","PortableFireExtinguishers",and"HomeFire SafetyChecklist".ThesehandoutsareavailablethroughPortlandFire&RescuesPublic EducationOffice. Reviewtheemployee'sobjectives. UnderstandhowimportantitistogettoknowyourFireandLifeSafetyEmergencyPlan. Familiarizeyourselfwiththeemergencyproceduresbeforeyouneedtofollowthem.Beable toreactquicklywheneverafireisdiscoveredorthealarmsounds. Reviewtheactionstobetakenifanemployeediscoversafire.UsetheRACEacronym (RescueAlarmConfineExtinguish)tohelppeopleremembertheresponseprocedureaseasily aspossible. Discussyourfacility'sengineeredfireandlifesafetyemergencysystems.Doeseveryoneknow whatandwheretheyare,andhowtheywork?Whichofthefollowingdoesyourfacilityhave, andwhatistheirimportanceinafire...smokedetectors,manualpullalarms,firedoors,alarm systems,sprinklers,fireextinguishers,etc.? Discusshazardsparticulartoyourfacility.Whatcanyouidentifyandwhatprecautionscanbe taken? USETHEFOLLOWINGSCENARIOSTOSTIMULATEDISCUSSIONON EMERGENCYRESPONSEPROCEDURES 1. Onehourintoyourshift,thefirealarmactivates.Describewhatyoumaybedoingatthattimeand howyouwouldreacttothealarm.Whatwouldbethefirstthingyouwoulddo?Wouldyouinitiate theRACEresponseortrytoevacuate? 2. Youdiscoverafireintheutilityroomthatisalreadytoobigtotryandextinguish.Describewhat yourreactionwouldbe...whatwouldbeyourresponse,andinwhatorder? 3. Aretherespecialsituationsinyourfacilitythatyouneedtobeawareofincaseofafireemergency? Describeanyspecialsituationsthatwouldrequirearesponseotherthanthatgenerallydescribed forstaff(nonambulatoryindividuals,visitorsunfamiliarwithevacuationprocedures,patientswith specialmedicalneeds). PortlandFire&Rescue
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Fire Extinguishers
Holdafiredrillwithinamonthofyourprograminorderforstaffto practicetheFire&LifeSafetyEmergencyPlan.Itisimperativethat everyonehavetheopportunitytophysicallyrunthroughtheRACE procedures.Studiesindicatethatunlessadultsactuallypracticesafety behaviors,theyverywellmaynotbeabletoperformthemcorrectly whentheneedarises. Provideanexampleofeachtypeoffireextinguisherfoundin yourfacility. Distributefireextinguisherhandoutstoeachemployee. Showthevideo"FireExtinguisherSafety"(12minutes). Discussthetypesoffireextinguishersfoundinyourbuilding; theirlocation,howtoaccessthem,andthetypesoffireson whichtheywould(orwouldnot)beused.Identifythepartsof theextinguishers.Passthemaround,sothateveryonecan identifyandfamiliarizethemselveswithhandlingthem.Review thePASSsystemforusingaportablefireextinguisher:Pullthepin AimatthebaseofthefireSqueezethehandleand,Sweep thenozzlebackandforth.PULLAIMSQUEEZESWEEP. ***NOTE:Personalsafetyandthesafetyofothersarethemost importantfactorswhendecidingwhethertofightasmallfire.Before youbegintofightafire,besureofthefollowing:RESCUEALARM CONFINEEXTINGUISH. Thefireisconfinedtoasmallarea,suchasinawastebasketand isnotspreading(gettingbigger).Aportablefireextinguisheris nomatchforalargeorrapidlyadvancingfire. Yourbackistowardsanunobstructedexit,towhichthefirewill notspread.Youmustalwaysassumethatyoumaynotbeableto extinguishthefireyouarefighting.Ifthefiredoesn'tdiminishwithyourfirstattack,orif anythinggoeswrong,leaveimmediatelyanddonotreturn. Theroomisnotfilledwithsmoke.Firefighterswearprotectivebreathingequipmentbecause ofthedangersofsmokeinhalation.Withoutprotection,youmayquicklyfindyourselfunable tobreatheorsee.

Itisrecklesstofightafireinanyothercircumstances.Ifindoubt,leaveimmediately;closeoffthearea toslowthespreadoffireandsmoke.Ifnecessary,evacuateandwaitoutsideatyourdesignated meetingplacefortheFireDepartment. PortlandFire&Rescue

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HandsOnTraining Ifyouhaveextrafireextinguishersavailable[onesnotrequiredforthefacility'sprotection]employees canpracticedischargingtheminanopenoutdoorarea.Agarbagecanmakesagoodtargetandwill helpcontainextinguishingagentifadrychemicalpowderisused.Sincedrychemicalpowdercanbe corrosivetosomemetalswhencombinedwithwater,careshouldbetakennottouseitnearcarsor otherequipment.EachpersonshouldtakeaturnutilizingthePASSmethodofoperation;pullingthe pin,aimingtheextinguisherlowatthebaseofthefire,squeezingthehandle,andapplyingtheagentin asweepingmotion.Justafewsecondsofdischargingtheextinguishergiveseachpersonafeelforthe realthing.Usually,severalpeoplecanuseoneextinguisherbeforeitisfullydischarged. Remember: Evenifyouaresuccessfulinputtingoutthefire,itshouldbeinspected.IT'STHELAW...AIIfiresareto bereported.

Instructor Information

Themajorcausesoffiresinhealthcarefacilitiesare: SmokingMaterials: Carelesshandlingofsmokingmaterialsisthemostcommoncauseoffirein healthcarefacilities.Althoughsmokingisnotallowedinsidefacilities, employeesmustsharetheresponsibilityofrestrictingsmokingto designatedareasoutsidethebuilding.Certainlysmokingshouldneverbe allowed,byeitherstafforpatients,inanyareawhereoxygenisinuseoris stored.Ifasmokingareaisprovidedoutsidethefacility,large,deep,non tipashtraysshouldbeprovided.Cigarettebuttstossedonthegroundcan ignite,particularlyiftheylandingardens,barkdustorothercombustibles. Equipment: Faultyequipmentandtheimproperuseofequipmentareothermajorcauses offireinhealthcarefacilities.Allequipmentshouldbecheckedand maintainedroutinely.Allstaffmemberscanbealertforcracked,split,melted orbrokenelectricalcordsorplugs.Extensioncordsshouldnotreplace permanentwiring. Laundryandcookingequipmentshouldalsobemaintainedonaroutinebasis. Especiallyimportantistocleanlintscreensindryersandgreaseon/oraround stovesandrangehoods,asbothprovideaneasilycombustiblefuelsource. CompressedGas: Storegascylindersinasecurelocationawayfrompatients.Capcylinderswhennot inuse.Allstaffshouldknowhowtoshutoffoxygenandotherpipedgassystems,if instructedtodoso. PortlandFire&Rescue Page5of11
FirePreventionDivision PublicEducationOffice


Priortoyourprogram,becomefamiliarwithyourfacility'sfireandlifesafetyemergency systems.Knowwhichofthefollowingyouhave,aswellastheirlocationanduse: o Manualpullalarms o Smokedetectors o Exitdoors&stairwells o Sprinklers o Fireextinguishers o Firealarmmonitoringservice o Voicealarm o SelfClosingFiredoors Commonfireandlifesafetyhazardstowatchforinhealthcarefacilities: o Missingorbrokenfiresafetyequipment o Blockedfiredoors o Accumulatedtrash o Burnedoutexitlights Itisimportantforeveryhealthcarefacilitytohaveafireandlifesafetyemergencyplan.A wellthoughtoutplanthattakesintoconsiderationtheuniquefeaturesofyourfacilityandits occupants.Thisplanshouldbeinwriting,andeasilyavailabletoallemployees.Thisincludes thosewhoworkweekendsandoffshifts.Theplanshouldbekeptcurrentthroughperiodic updating.Forfurtherinformationindevelopingyourownfireandlifesafetyemergencyplan, contactthePublicEducationOfficeofPortlandFire&Rescue. WheneveryouneedtheassistanceofPolice,Fire,orEmergencyMedicalPersonnel,youonly needtorememberonephonenumber:911.It'simportantforemployeescalling911tobe abletogivethefollowinginformation:Thenatureoftheproblem,address,nearestcrossstreet, anyspecificsknown,suchasnoting"thisisahealthcarefacility,locationinsidefacilityof problem"thirdfloorroom__Westwing."Thecallershouldnothangupuntiltoldtodosoby the911Operator. Itisimperativethateveryalarmistreatedasthroughitisarealemergency,eveniftheinitial sourceisunknown.Ifthealarmsounds,orafireissuspected,call911tonotifytheFire Departmentimmediately.Aftercalling911,ifyoudeterminethatthereisnofire,butrathera malfunctionofyourequipmentorafalsealarm,call911backandrelaythisinformation. NeverwaittoinvestigatethesituationbeforenotifyingtheFireDepartment.Anydelaywill allowafiretogrowandfurtherendangerthebuildingoccupantsandproperty. DONOTsilencethealarmuntilgivenpermissiontodosobyFireDepartmentpersonnelorby theemergencyoperator.DONOTresetthealarmuntiltheFireDepartmentarrivesandhas investigatedthesourceofthealarm.AllfirealarmsaretobeinvestigatedbytheFire Department. Closedoors.Byclosingdoors,youhelpprotectoccupantsfromthespreadofsmokeandfire. Doorsshouldbeclosed,notlocked,byemployeeswhenfollowingtheRACEprocedures. Elevatorsshouldneverbeusedbybuildingoccupantsduringafireemergency.Thereasonsare threefold: 1. Elevatorsoftenfailduringafire,trappingoccupants; 2. Elevatorshaftsmayfillwithsmoke;and 3. Theelevatorneedstobeavailableforfirefightersincaseofemergencyneeds. Page6of11

PortlandFire&Rescue
FirePreventionDivision PublicEducationOffice


MosthealthcarefacilitiesusetheacronymRACEasawayforstafftorememberhowtoreact inafireemergency.RACEstandsfor: o

RescueanyindividualdirectlythreatenedbyfirePatientsafetyistheprimary
consideration,somovepatientswhoareinimmediatedangerawayfromsmokeor flames.Placethepatientinanearbyroom,behindacloseddoor.

o o

Alarm.Activatethefirealarmifyoudiscoverafireorrespondimmediatelytothe
alarmifyouhearitsound.

Confinethefirebyclosingdoorstoslowthespreadofsmokeandflame.Closethe
doorsofpatient'srooms.Ingeneral,residentsaresaferinaclosedroomthanina smokefilledhallway.

Extinguishthefireonlyifthefireissmallandifyouknowhowtooperateafire

extinguisher.BesurepatientshavebeenrescuedandtheFireDepartment(911)is calledbeforeusingthefireextinguisher. FireCoderequirementsspecifythesize,number,andlocationoffireextinguisherswithinyour facility.Theserequirementshelpestablishaprotectionlevelappropriateforthehazardclassof yourbuilding.Makesureyouknowthetypes,sizesandmaintenancerequirementsofyour extinguishers,aswellasthebasicsofextinguisheroperation. ThePublicEducationSectionoftheFirePreventionDivisionprovidesassistanceinFire&Life SafetyEmergencyplanning,aswellasresourcesfortrainingstaffandfacilityresidents.Callthe PublicEducationOfficeduringbusinesshoursat(503)8233700.

Thankyoufortakingresponsibilityforthesafetyofyour facilityanditsresidents!

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FirePreventionDivision PublicEducationOffice

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Discussion Questions
1. Ifafireoccurredinyourworkplacerightnow,whatwouldyoudo? 2. Whatdoyoufeelisthebestfirepreventionactivityyourorganizationconducts?Whatneedsto beimprovedupon? 3. Ifyouneededtohelpafriendwhowasjustburned,wouldyouknowwhattodo? 4. Howhasyourorganizationpreparedtoassistpeoplewithdisabilitiesinafireemergency? 5. Doyoufeelyourfireevacuationplaniswellunderstoodbyeveryoneinyourorganization? Whatwouldhappenifyouheldafireexitdrillunannounced?

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Fire Extinguishers
Fireextinguisherssavelivesandpropertybyputtingoutorcontainingsmallfiresuntilthe firedepartmentarrives.Evenagainstsmallfires,however,extinguishersareusefulonly undercertainconditions... Theoperatormustknowhowtousethem.Thereisnotimetoreadinstructionsduringan emergency. Theymustbewithineasyreach,inworkingorder,andfullycharged. Theyneedtobekeptneartheexit.Theuserneedstohaveanescaperoutethatwillnotbe blockedbyfire. Theyshouldmatchthetypeoffireyouarefighting. Theymustbelargeenoughtoputoutthefire.Mostportableextinguishersdischarge completelyinasfewaseightseconds.

HOWTOOPERATEANEXTINGUISHER
RememberthePASSword! Beforeusingyourextinguisher,makesureyourbackistoanexitandthatyouarestandingsixtoeight feetfromthefire. PULLthepin:Holdtheextinguisherwiththenozzlepointingawayfromyouandpulloutthepin locatedbelowthehandle.Thisunlockstheoperatingleverandallowsyoutodischargethe extinguisher.Ifyoucannotpullthepinyoumightbesqueezingthehandletoohardandbindingthe pin. AIMatthebaseofthefire:Notattheflames.Thisisimportantinordertoputoutthefire, youmustextinguishthefuel. SQUEEZEtheleverslowly:Thiswillreleasetheextinguishingagentintheextinguisher.Ifthe handleisreleased,thedischargewillstop. SWEEPfromsidetoside:Usingasweepingmotion,movethefireextinguisherbackandforth untilthefireiscompletelyout.Operatetheextinguisherfromasafedistance,severalfeetaway,and thenmovetowardsthefireonceitstartstodiminish.Besuretoreadtheinstructionsonyourfire extinguisherdifferentfireextinguishersrecommendoperatingthemfromdifferentdistances. Remember:Aimatthebaseofthefire,notattheflames!!!! Alwaysbesurethefiredepartmentinspectsthefiresite,evenifyouthinkyouveextinguishedthe fire.Ifthefiregetsbigger,getout!Closethedoortoslowthespreadofthefire. PortlandFire&Rescue
FirePreventionDivision PublicEducationOffice

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ABC'sofFIREEXTINGUISHERS
SelectinganExtinguisher: Fireextinguishersarelabeledwithlettersorpictographstoindicatethekindoffireonwhichthe extinguisheriseffective.

OrdinaryCombustibles

Paper,wood,manyplastics,fabric,trash

FlammableLiquids

Gasoline,oil,grease,somepaintsandsolvents

Electrical

Energizedelectricalequipmentincludingappliances,computers,circuit breakers,wiring PortlandFire&Rescue

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FACTSABOUTFIRESPRINKLERS
Automaticfiresprinklersystemshaveexistedformorethan100years.Theyhavebeenprovento significantlyreducelossoflifeandpropertydamage.Still,therearemisconceptionsabouttheir effectivenessandhowtheywork. Myth: Waterdamagefromsprinklersismoreextensivethanfiredamage. Fact: Waterdamagefromasprinklersystemwillbemuchlessseverethanthedamage causedbywaterfromfirefightinghoselinesorfromsmokeandfiredamageifthefire goesunabated. Myth: Whenafireoccurs,everysprinklerheadgoesoff. Fact: Sprinklerheadsareindividuallyactivatedbyheat,and90%ofallfiresarecontrolled withsixorfewerheads. Myth: Sprinklersarecostly. Fact: Thecurrentcostofinstallingasprinklersystemisabout1%ofthetotalcostofnew construction(aslittleas$1.61persquarefoot). Myth: Sprinklersaredesignedtoprotectproperty,notlives. Fact: Theyareextremelyeffectiveinprotectinglives.Therearenoreportedmultiple fatalities(3ormore)intheU.S.fromfiresinsprinklerprotectedfacilities. Myth: Sprinklerscanbeactivatedbysmoke. Fact: Firesprinklersystemsareactivatedonlyfromtheheatofafireatthelocationofthe headusuallywhenthetemperaturereaches165degreesFahrenheit.
F:Belmont/PEO/AtRiskAdults/FireSafetyinHealthCareFacilities1510

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