Fire In ICU
Reviewed and revised 19 February 2015
OVERVIEW
Approach to Fire in ICU has 3 key goals:
- protect patients and staff
- manage fire hazard
- identify cause and prevention
Following a fire conduct a review of incident and response to identify cause of fire and any issues with management with subsequent review of fire policy and implementation of staff education and simulation exercises
MANAGEMENT OF FIRE HAZARD
RACER
Rescue
- Remove all patients and staff from immediate danger area with safe disconnection of lines, monitoring and equipment and manual ventilation of patients, if safe to do so
Alert
- activate fire alarm
- notify switchboard (e.g. “respond red confirmed”), stating exact location and nature of fire
- Activate unit fire drill
- take instructions from the designated area fire warden
Contain
- shut all doors and windows
- turn off oxygen outlets
Extinguish
- If fire is smaller than a waste basket attempt to extinguish, if trained and safe to do so
- use appropriate extinguishers (CO2 and dry powder) and fire blankets
Relocate
- if fire uncontrolled evacuate patients via fire exits
- Evacuate visitors, then the most stable patients first and most unstable last while continuing essential organ support, monitoring and essential medications
- Staff should evacuate after all patients have been removed and rooms checked, if safe to do so
- Depending on the extent of the fire this may be:
— Horizontal evacuation through at least one set of fire doors to another part of the ICU or an acute care area on the same floor
— Vertical evacuation via stairs to the floor below
— Out of building evacuation - evacuate to predesignated areas (assembly points)
- Liaison with ED, OT, HDU, CCU and other high care areas in the hospital and/or neighbouring hospitals for ongoing care of the evacuated patients
FIRE EXTINGUISHERS
Appropriate use = PASS
- Pull the lockpin from its place
- Aim the nozzle at the base of the flames
- Squeeze the handles together; and
- Sweep from side to side at the base of the flames
Do not use a fire extinguisher unless there are two trained staff and it is safe to do so
References and links
Journal articles
- Kelly FE et al. Managing the Aftermath of a Fire on Intensive Care Caused by an Oxygen Cylinder. JICS 2014 vol. 15 no. 4 283-287 [Free Full Text pdf]
- Sankaran K, Roles A, Kasian G. Fire in an intensive care unit: causes and strategies for prevention. CMAJ. 1991 Aug 15;145(4):313-5. PMC1335634.
FOAM and web resources
- Safe Anaesthesia Liasion Group, 2013. Promoting Fire Safety on Intensive Care and in Theatre. (pdf)
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
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