HealthStream Regulatory Script
Fire Safety
Version: May 2007
Lesson 1:
Lesson 2:
Lesson 3:
Lesson 4:
Introduction
Fire and Fire Safety
Fire Prevention and Facility Safety
Fire Response
Lesson 1: Introduction
1001
Introduction
Welcome to the introductory lesson on fire safety. This
introductory lesson gives the course rationale, goals, and
outline.
IMAGE: 1001.JPG
As your partner, HealthStream strives to provide its customers with excellence in
regulatory learning solutions. As new guidelines are continually issued by regulatory
agencies, we work to update courses, as needed, in a timely manner. Since
responsibility for complying with new guidelines remains with your organization,
HealthStream encourages you to routinely check all relevant regulatory agencies
directly for the latest updates for clinical/organizational guidelines.
If you have concerns about any aspect of the safety or quality of patient care in your
organization, be aware that you may report these concerns directly to The Joint
Commission.
Page 1 of 4
2
1002
Course Rationale
Patients are often too sick to protect themselves from harm.
This means that fires in healthcare facilities can be especially
dangerous.
IMAGE: 1002.JPG
Healthcare workers must be able to identify fire risks to
prevent fires. They must also know what to do if a fire does
occur.
This course will teach you:
• How to identify fire risks and prevent fires
• How to respond to a fire emergency
• How The Joint Commission and CMS expect
accredidated facilities to handle fire safety
Page 2 of 4
1003
Course Goals
After completing this course, you should be able to:
• Identify the three sides of the fire triangle
• List sources of fuel, oxygen, and heat in the healthcare
setting
• Discuss the importance of fire safety
• List the primary goals of the Life Safety Code
• List common causes of fire in the healthcare setting
• List methods of preventing fires
• Identify high-risk areas for fires
• List the steps of RACE
• Identify methods of carrying patients to safety
• Identify how to contain a fire
• Recognize when it is safe to use a portable
extinguisher to fight a fire
• List guidelines for patient evacuation
IMAGE: 1003.JPG
Page 3 of 4
1004
Course Outline
Lesson 1 provided the course rationale and goals.
FLASH ANIMATION: 1004.SWF/FLA
Lesson 2 will introduce fire and fire safety.
Lesson 3 will describe fire prevention and facility safety.
Lesson 4 will explain how to respond to a fire.
Page 4 of 4
Lesson 2: Fires and Fire Safety Introduction
2001
Introduction & Objectives
Welcome to the lesson on fire and fire safety.
FLASH ANIMATION: 2001.SWF/FLA
After completing this lesson, you should be able to:
• Identify the three sides of the fire triangle
• List sources of fuel, oxygen, and heat in the healthcare
setting
• Discuss the importance of fire safety
• List the primary goals of the Life Safety Code
Point 1 of 8
2002
Fire
Fires need:
• Fuel
• Oxygen
• Heat
FLASH ANIMATION: 2002.SWF/FLA
These three items make up the fire triangle.
A fire will break out whenever these items come together in
the right amounts.
Point 2 of 8
2003
Healthcare Facilities and the Fire Triangle
Can you think of sources of fuel, oxygen, and heat in your
healthcare facility?
Take a moment to come up with some ideas. Then, click the
links below to check your ideas:
•
•
•
Fuel
Oxygen
Heat
Clearly, the three sides of the fire triangle are present
throughout the healthcare setting.
Therefore, there is always a risk of fire.
CLICK TO REVEAL
Fuel
There are many sources of fuel in a hospital. For
example, all of the following burn easily: linens,
dressings, ointments, alcohol-based solutions,
catheters, and tubing.
Oxygen
Oxygen is present all around us, in the air we
breathe. In the healthcare setting, oxygen is often
present at unusually high levels. This occurs because
of the use of high-oxygen medical gases. When extra
oxygen is available, fire is even more likely to break
out.
Heat
Lasers and other types of medical equipment produce
heat. Damaged electrical devices can spark to start a
fire. Cigarette-smoking is another source of heat that
can complete the fire triangle.
Point 3 of 8
2004
Fire Safety: Prevention
When you know what to do to help prevent fires from starting,
you can reduce the risk of fire in your facility.
IMAGE: 2004.GIF
This can help keep patients and staff safe.
Always remember that prevention is the best defense against
fire.
Point 4 of 8
2005
Fire Safety: Standards
Even with the best efforts at prevention, fires sometimes
occur.
IMAGE: 2005.JPG
Therefore, healthcare facilities must have fire safety programs
in place and up-to-date. These programs keep the facility,
patients, and staff as safe as possible in the event of fire.
Both The Joint Commission and CMS [glossary] set standards
for fire safety programs in healthcare facilities.
Both groups base their standards on the National Fire
Protection Association (NFPA) Life Safety Code.
Point 5 of 8
2006
Life Safety Code
The Life Safety Code provides guidelines to keep hospitals
safe in the event of fire.
IMAGE: 2006.JPG
For example, according to the Life Safety Code, hospitals
must:
• Have clearly marked exits and exit paths, including
back-up exits
• Keep exit paths clear and well lit
• Use fire-alarm systems
• Use doors and windows that can contain fire
In the next lesson, we will take a closer look at strategies for
preventing fires and following the guidelines of the Life
Safety Code.
Point 6 of 8
2007
Review
FLASH INTERACTION: 2007.SWF/FLA
Complete the table with sources of fuel, oxygen, and heat/ignition in
the healthcare setting.
Fuel
Oxygen
Heat/Ignition
Alcohol.bmp
Ointment2.bmp
Air.bmp
O2.bmp
ESU2.bmp
Laser.bmp
Point 7 of 8
2008
Summary
You have completed the lesson on fire and fire safety.
NO IMAGE
Remember:
• The three sides of the fire triangle are fuel, oxygen,
and heat. A fire will break out whenever these three
items come together in the right amounts. Removing
any one item will prevent a fire.
• Hospitals have many sources of fuel, oxygen, and heat.
This means there is always a risk of fire.
• Prevention is the best defense against fire.
• Even the best efforts at prevention sometimes fail.
Therefore, healthcare facilities must have fire-safety
programs. Drills should be conducted to identify any
weaknesses in the plan. These programs keep the
facility, patients, and staff as safe as possible during a
fire.
• The Joint Commission and CMS set fire safety
standards for healthcare facilities. These standards are
based on the NFPA Life Safety Code.
• The Life Safety Code provides guidelines to help keep
people safe during a fire.
Point 8 of 8
Lesson 3: Fire Prevention and Facility Safety
3001
Introduction & Objectives
Welcome to the lesson on fire prevention and facility safety.
FLASH ANIMATION: 3001.SWF/FLA
After completing this lesson, you should be able to:
• List common causes of fire in the healthcare setting
• List methods for preventing fires
• Identify high-risk areas for fires
Point 1 of 19
3002
Fire Prevention and the Facility
You can help prevent fires in your facility.
IMAGE: 3002.JPG
However, even the best efforts at prevention sometimes fail.
If this happens, your facility has safety measures in place to
help keep the facility, patients, and staff as safe as possible
during a fire.
Point 2 of 19
3003
Common Causes of Fires
Thousands of fires occur in healthcare facilities each year.
IMAGE: 3003.JPG
Common causes include:
• Cigarette smoking
• Electrical malfunction
• Equipment misuse
Point 3 of 19
3004
Common Causes of Fires: Prevention
To help prevent fires caused by smoking:
• Follow your facility’s rules about smoking.
• Smoke only in areas where smoking is permitted.
• Instruct visitors and patients to smoke only in
designated areas.
IMAGE: 3004.JPG
To help prevent fires caused by electrical malfunction:
• Remove damaged equipment from service.
• Report faulty equipment for repair.
• Inspect all equipment prior to use.
• For more information on electrical hazards, see the
course Electrical Safety.
To help prevent fires caused by equipment misuse:
• Receive training BEFORE using any piece of
equipment.
• For more information on equipment hazards, see the
course Medical Equipment Safety.
Point 4 of 19
3005
Common Fire Locations
Fires are most likely to occur in areas that have a lot of fuel,
oxygen, or heat. These areas include:
• Laundries
• Laboratories
• Boiler rooms
• Storage rooms
• Surgical suites
FLASH ANIMATION: 3005.SWF/FLA
Note: Surgical fires are rare. However, devastating fires can
and do occur in the surgical setting.
Point 5 of 19
3006
Fires and Alcohol-Based Hand Rubs (1)
In October 2002, the CDC [glossary] released updated
guidelines for hand hygiene. These guidelines recommend
alcohol-based rubs for routine use in the clinical setting.
IMAGE: 3006.JPG
Alcohol-based hand-rub dispensers are usually placed in:
• Patient rooms
• Treatment rooms
• Suites
• Corridors
Alcohol is a good fuel. Alcohol-based rubs can burn readily
and easily.
Point 6 of 19
3007
Fires and Alcohol-Based Hand Rubs (2)
Precautions must be taken to make sure that alcohol rubs do not IMAGE: 3007.JPG
become a source of fuel in a hospital fire.
Alcohol dispensers should not be located above, near, or on:
• Heat or ignition sources
• Electrical outlets
• Light switches
Alcohol dispensers can only be placed in carpeted areas if the
area is in a sprinklered smoke compartment.
Large supplies of alcohol-based rubs should be stored in
cabinets or other areas approved for materials that burn readily.
Finally, when using an alcohol rub, be certain to rub your hands
until they are dry. This is especially important in areas of the
hospital where there are high levels of oxygen, such as
operating rooms.
Point 7 of 19
3008
Safety Features
If prevention efforts fail and a fire breaks out, your
organization must be prepared to respond.
FLASH ANIMATION: 3008.SWF/FLA
Your facility has safety features to ensure an effective
response.
These safety features include:
• Fire alarm systems
• Fire extinguishers
• Emergency exit routes and doors
• Smoke and fire doors and partitions
• Fire plan
Let’s take a closer look at each safeguard. As you review each
safeguard, pay attention to YOUR related role.
Point 8 of 19
3009
Safety: Fire Alarm Systems
Fire alarm systems include both automatic and manual devices.
FLASH ANIMATION: 3009.SWF/FLA
Automatic devices include smoke detectors and sprinkler
systems. Smoke detectors give early warning of fires. Sprinkler
systems respond to help extinguish fires automatically.
Manual alarm devices include manual pull stations.
YOUR ROLE: Know the location of manual pull stations on
your unit.
Point 9 of 19
3010
Safety: Fire Extinguishers
Fire extinguishers fight fires by removing sides of the fire
triangle.
FLASH ANIMATION: 3010.SWF/FLA
They do this by releasing materials that:
• Cool the burning fuel
• Remove oxygen from the fire
These materials include:
• Water
• Carbon dioxide
• Dry chemical powder
Point 10 of 19
3011
Fire Extinguishers: Materials
Different types of fire-extinguisher materials fight different
types of fires. This is shown in the table to the right.
IMAGE: 3011.GIF
Each fire extinguisher has a label to show which types of fires it
can fight.
Types of fires include:
• Class A: wood, cloth, paper, and plastic fires
• Class B: gasoline, kerosene, and oil fires
• Class C: electrical fires
Point 11 of 19
3012
Fire Extinguishers: You and Your Facility
Your facility must:
• Place fire extinguishers in appropriate locations
• Provide appropriate types of fire extinguishers
• Train staff on how to select and use fire extinguishers
IMAGE: 3012.GIF
YOU must:
• Know where to find the nearest fire extinguisher
• Know which types of fire extinguisher are available in
your facility
• Follow guidelines for choosing a fire extinguisher for a
particular type of fire
• Know how to use a fire extinguisher
Point 12 of 19
3013
Fire Extinguishers: How to Use
All workers in your healthcare facility should know how to use
a fire extinguisher.
IMAGE: 3013.GIF
Use the acronym PASS to help you remember:
• P: Pull the pin.
• A: Aim the nozzle at the base of the fire. You should be
standing six to ten feet away from the fire.
• S: Squeeze the handle in five-second bursts. Do not
move toward the fire too soon. If you do, the fire might
be pushed backward, where it can flare up again.
• S: Sweep the nozzle from side to side across the base of
the fire.
Point 13 of 19
3014
Safety: Emergency Exit Routes and Doors
Emergency exit routes and doors are another important safety
feature.
IMAGE: 3014.GIF
Your facility must:
• Inform you of exit and evacuation routes
• Place exit lights over emergency exit doors
YOU must:
• Know exit and evacuation routes
• Keep exit routes and exits clear
• Know where to find equipment for evacuating patients
during a fire
• Know how to use this equipment
Point 14 of 19
3015
Safety: Fire and Smoke Doors and Partitions
Hospital facilities have:
• Automatic fire doors
• Fire and smoke partitions
IMAGE: 3015.JPG
These safety features separate the building into many zones.
Fire and smoke in one zone should not spread easily to other
zones.
Therefore, fires can be contained. This means that fewer
patients need to be evacuated during a fire. In many cases:
• Only patients within a single zone must be evacuated.
• These patients are moved to a safe zone of the hospital.
They do not have to leave the building.
YOUR ROLE: Make sure that automatic fire doors are not
blocked. Make sure that these doors are not propped or wedged
open for any reason. Fire doors must be able to close
automatically in the event of a fire.
Point 15 of 19
3016
Safeguards: Fire Plan
Your facility must have a fire plan in place. The fire plan
describes what to do during a fire.
IMAGE: 3016.JPG
Some of the safety features previously described may be included
in the fire plan. For example, the fire plan should give exit and
evacuation routes.
Your facility must:
• Train you on your duties and responsibilities under the
plan
• Conduct routine fire drills on each shift.
YOU must:
• Know your duties and responsibilities under the fire plan
• Attend all training classes related to fire safety
• Participate in all fire drills, as required
Point 16 of 19
3017
Review
FLASH INTERACTION: 3017.SWF/FLA
Did you recall all of the following?
Common causes of fires in the healthcare setting are smoking,
electrical malfunction, and equipment misuse. How may fires
related to these causes be prevented?
To help prevent fires caused by smoking:
• Follow your facility’s smoking policy
• Smoke only in designated areas
• Instruct visitors and authorized patients to
smoke only in designated areas
Type your thoughts in the box below, then click Submit to
compare your answer to ours.
To help prevent fires caused by electrical
malfunction:
• Remove damaged or faulty equipment
from service
• Report malfunctioning equipment so that it
may be repaired
To help prevent fires caused by equipment
misuse:
• Receive training BEFORE using any piece
of equipment
Point 17 of 19
3018
Review
PASS stands for:
a.
b.
c.
d.
Pop, Approach, Stand, Spray
Pull, Approach, Squeeze, Sweep
Pull, Aim, Squeeze, Sweep
Pop, Aim, Stand, Spray
MULTIPLE CHOICE INTERACTION
[CORRECT ANSWER: C]
[FEEDBACK FOR A: Incorrect. The correct
answer is C. When using a fire extinguisher, Pull
the pin, Aim the nozzle, Squeeze the handle, and
Sweep from side to side.]
[FEEDBACK FOR B: Incorrect. The correct
answer is C. When using a fire extinguisher, Pull
the pin, Aim the nozzle, Squeeze the handle, and
Sweep from side to side.]
[FEEDBACK FOR C: Correct. When using a fire
extinguisher, Pull the pin, Aim the nozzle,
Squeeze the handle, and Sweep from side to side.]
[FEEDBACK FOR D: Incorrect. The correct
answer is C. When using a fire extinguisher, Pull
the pin, Aim the nozzle, Squeeze the handle, and
Sweep from side to side.]
Point 18 of 19
3019
Summary
You have completed the lesson on fire prevention and facility
safeguards.
NO IMAGE
Remember:
• Common causes of fire in the healthcare setting are
smoking, electrical malfunction, and equipment misuse.
• To prevent fires related to these causes, smoke in designated
areas only. Use and maintain equipment properly.
• Fires occur most commonly in laundries, laboratories, boiler
rooms, and storage rooms.
• Alcohol-based hand rubs should be stored in areas approved
for materials that burn readily. Dispensers should be placed
only in safe locations. After applying an alcohol-based rub,
rub your hands until they are dry.
• Know where to find fire alarm pull stations on your unit and
how to operate them.
• Know where to find the nearest fire extinguisher on your
unit. Know the different types of extinguishers available and
which type to use in a given situation. To use an
extinguisher, PASS.
• Know exit and evacuation routes. Keep exit routes clear.
• Never block or prop open automatic fire doors.
• Know your duties and responsibilities under the fire plan.
Participate in all required training and drills.
Point 19 of 19
Lesson 4: Fire Response
4001
Introduction & Objectives
Welcome to the lesson on the fire response.
FLASH ANIMATION: 4001.SWF/FLA
After completing this lesson, you should be able to:
• List the steps of RACE
• Identify methods for carrying patients to safety
• Recognize ways of alerting others to a fire
• Identify how to contain a fire
• Recognize when it is safe to use a portable extinguisher
to fight a fire
• List guidelines for patient evacuation
Point 1 of 16
4002
RACE (1)
When you hear the fire alarm in your facility, you may not
know if it is a drill or a true fire emergency.
IMAGE: 4002.GIF
Treat each alarm as if it is a true emergency. Respond
accordingly.
The RACE acronym can help you remember what to do.
Point 2 of 16
4003
RACE (2)
Respond to a fire emergency using the RACE protocol:
•
•
•
•
R: Remove or Rescue
A: Alarm or Alert
C: Confine or Contain
E: Extinguish or Evacuate
Click on each of the steps in the list above to learn more.
CLICK TO REVEAL
[Remove/Rescue] – 4003a.GIF
[Alarm/Alert] – 4003b.GIF
[Confine/Contain] – 4003c.GIF
[Extinguish/Evacuate] – 4003d.GIF
Note: The steps of RACE are presented in a specific order. In
practice, they often overlap. For example, if you discover a fire
in a patient’s room, you may rescue the patient (R) and call out
for help (A) at the same time.
Nevertheless, RACE is a useful framework. Let’s keep the
RACE acronym in mind as we take a closer look at what to do
in the event of a fire.
Point 3 of 16
4004
Rescue/Remove and Alarm/Alert
If you discover a fire in a patient’s room, you should
immediately call for help. Use your hospital’s fire code. For
example, some hospitals use “Dr. Red” and the room number.
IMAGES: 4004.JPG
This addresses the first two steps in the RACE protocol:
•
•
(R): You have called for help to Remove the patient
from danger. Once help arrives, it is time to remove the
patient to safety.
(A): You have given the Alarm.
Point 4 of 16
4005
Rescue/Remove Techniques
In an emergency situation, you may have to carry patients to
safety. Carrying techniques include:
• Side-by-side assist
• Chair lift
• Swing carry
• Cradle drop
• Extremity carry
CLICK TO REVEAL
Click on each of the methods in the list above to learn more.
[Cradle Drop] – 4005d.GIF
Be sure to check with a supervisor for a list of transfer
techniques approved for use in your facility.
[Extremity Carry] – 4005e.GIF
[Side-by-side assist] – 4005a.GIF
[Chair lift] – 4005b.GIF
[Swing Carry] – 4005c.GIF
Important note: Patients in critical condition should be moved
in their beds.
Point 5 of 16
4006
Confine/Contain and Alarm/Alert
As soon as patients in the room of fire origin [link to glossary]
have been removed to safety:
• Confine (C) the fire. Close the door to the room. Then,
place a wet towel along the bottom.
• Back up your previous call for help (A) by:
• Activating a manual pull station
• Phoning the fire department
IMAGE: 4006.GIF
When you call the fire department, give:
• Your name
• The phone number from which you are calling
• Your exact location
• A description of the fire, including what you see and
smell
At this point, continue to confine the fire by closing all nearby
doors.
You also may need to shut off all medical gases to decrease the
supply of oxygen to the fire. Follow your facility’s fire safety
policies.
Point 6 of 16
4007
Extinguish
So far:
• Patients in immediate danger have been removed to
safety (R).
• The fire alert or alarm has been given (A).
• All doors and windows in the immediate area have been
closed (C).
IMAGE: 4007.GIF
Now, it is time to think about extinguishing the fire (E).
Only use a fire extinguisher if:
• The fire is small enough to put out with a single
portable extinguisher.
• You are certain you know how to use a fire
extinguisher (see lesson two).
• You are certain that you can extinguish the fire without
allowing your escape route to become blocked.
Point 7 of 16
4008
Extinguish: Fire Size
The fire may have looked small when you discovered it.
IMAGE: 4008.JPG
Fires can spread rapidly.
Before re-entering the room with an extinguisher, touch the
closed door with the back of your forearm.
If the door is warm, do NOT open it. The fire behind the door
is probably too large to fight.
Point 8 of 16
4009
Evacuate
You may decide that the fire is too large to fight with an
extinguisher. Or, you may try to put out the fire, but find that a
single extinguisher will not do the job.
IMAGE: 4009.JPG
In either case, the next step is evacuation (E).
Designated personnel within your facility are responsible for
ordering the evacuation of patients.
Once the fire department arrives, they will coordinate with your
facility to continue the evacuation.
Point 9 of 16
4010
Evacuate: Defend-in-Place
Defend-in-place is a strategy of defending against the danger of
a fire, while remaining inside the building.
NO IMAGE
Patients are evacuated from the danger zone to a safe zone.
Patients closest to the fire are moved first.
Full evacuation of sick patients can be difficult and dangerous.
Therefore, defend-in-place is an important strategy for
healthcare facilities.
Point 10 of 16
4011
Evacuate: Order of Evacuation
Any patients in the room of fire origin should be moved to a
protected location immediately (R), as described earlier in the
lesson.
IMAGE: 4011.GIF
Remaining patients should be removed from the danger zone
in this order:
1. Patients in rooms next to the room of fire origin,
regardless of their mobility
2. Patients in rooms directly across the hallway from the
room of fire origin, regardless of their mobility
3. Other patients in the danger zone, in this order:
a. Walking patients
b. Wheelchair patients
c. Bed or litter-borne patients
The graphic on the right shows an example of how to evacuate
patients. Notice that the patients able to walk are evacuated
before the patient in a bed (see point 3 above).
Point 11 of 16
4012
Evacuate: Horizontal
Horizontal evacuation is the first strategy used to defend-inplace.
IMAGE: 4012.GIF
Patients are moved down the hall, out of the danger zone,
through at least one set of fire or smoke doors.
Point 12 of 16
4013
Evacuate: Vertical
Vertical evacuation involves moving patients down the stairs to
a lower floor or safe area of the facility.
IMAGE: 4013.GIF
In general, the fire department orders vertical evacuations.
Point 13 of 16
4014
Evacuate: Important Points
When evacuating patients:
• Do not evacuate any patient past the room of fire origin.
Patients who cannot reach a fire or smoke door without
passing the room of fire origin may need to be
evacuated to the outside of the building. These patients
then may enter a safe zone of the building from the
outside.
• After removing all patients from a room, close the room
door. Mark the room as empty, according to facility
guidelines. For example, some facilities place a pillow
on the floor outside the room.
• Move charts with patients.
• During vertical evacuations, use stairwells. Avoid
elevators.
NO IMAGE
Point 14 of 16
4015
Review
FLASH INTERACTION: 4015.SWF/FLA
Did you recall the following?
The RACE acronym can help you remember what to do in the
event of a fire. What are the steps of the RACE protocol?
R: Rescue all patients from the immediate area of
the fire. If the fire originates in a patient’s room,
immediately remove the patient.
Type your thoughts in the box below, then click Submit to
compare your answer to ours.
A: Initiate the alarm. Alarm initiation may include
any or all of the following:
• Calling out for help
• Activating a manual pull station
• Phoning the fire department
C: Confine the fire by closing the door to the room
of fire origin.
E: If the fire is small enough to be extinguished
with ONE portable extinguisher, attempt to
extinguish. Otherwise, prepare to evacuate.
Point 15 of 16
4016
Summary
You have completed the lesson on fire response.
NO IMAGE
Remember:
• Respond to a fire using the RACE protocol: Rescue/Remove,
Alarm/Alert, Confine/Contain, Extinguish/Evacuate.
• If you discover a fire in a patient’s room, immediately call for
help. Do not yell FIRE. This might panic the patients. Remove
the patient from the room. Be sure to use an approved
carrying technique.
• After removing all patients from the room, close the door to
confine the fire. Activate a manual pull station and/or call the
fire department.
• Consider using a fire extinguisher only if the fire is small and
you are certain you know how to use an extinguisher (PASS).
• If it is not possible to put out the fire using a single
extinguisher, evacuate all patients in the danger zone.
• Defend-in-place by relocating patients from the smoke zone to
a safe zone. Evacuate patients in this order: 1) patients closest
to the fire, regardless of mobility, 2) other patients in the
smoke zone.
• Other patients in the smoke zone should be evacuated in this
order: 1) walking patients, 2) wheelchair patients, and 3) bedor litter- borne patients.
• Do not evacuate any patient past the room of fire origin. Mark
all evacuated rooms.
Point 16 of 16
[Fire Safety]
Course Glossary
#
1.
Term
room of fire origin
Definition
the room in which a fire starts
2.
3.
4.
5.
6.
7.
CMS
CDC
Centers for Medicare and Medicaid Services
Centers for Disease Control and Prevention
[Fire Safety]
Pre assessment
1. Which of the following statements is true?
a. High levels of oxygen are rare in the healthcare setting.
b. Although high levels of oxygen are likely in the surgical setting, there are no sources of fuel in this setting.
c. A faulty ECG machine could start a fire.
d. Together, alcohol, surgical drapes, and ointment will start a fire.
Correct answer: C
Rationale: Medical equipment and electrical devices of all kinds can start a fire if faulty or damaged.
2. The Life Safety Code (LSC) requires that:
a. Hospitals keep exit routes clear.
b. Hospitals provide lighted signs for exit doors and exit routes.
c. Hospitals provide backup exit routes.
d. All of these are requirements of the LSC.
e. None of these is a requirement of the LSC.
Correct answer: D
Rationale: All of these are included in the LSC.
3. All of the following statements are true EXCEPT:
a. Thousands of fires occur in healthcare facilities each year.
b. Equipment use is a common cause of fires in the healthcare setting.
c. Hospital fires often originate in storage rooms.
d. Surgical fires account for most fires in the healthcare setting.
Correct answer: D
Feedback: Devastating fires can and do occur in the surgical setting. Overall, however, surgical fires are rare. Fires are more frequent
in hospital laundries, laboratories, boiler rooms, and storage rooms.
4. All staff members are responsible for knowing all of the following EXCEPT:
a. The location of manual fire alarm pull stations
b. How to use a fire extinguisher
c. How to coordinate both horizontal and vertical evacuations
d. The location of exit and evacuation routes
Correct answer: C
Rationale: You should know how to evacuate patients. Designated personnel within your facility order and coordinate horizontal
evacuations. The fire department coordinates vertical evacuations.
5. Automatic fire doors in healthcare facilities:
a. May be propped or wedged open during day-to-day hospital operations.
b. Open automatically when there is a fire, for more rapid evacuation of patients.
c. Decrease the need for patient relocation in the event of fire.
d. All of these are true.
e. None of these is true.
Correct answer: C
Rationale: Fire doors must always remain free to close automatically. They must never be blocked, wedged, or propped open. When
fire doors close properly, fire and smoke do not spread easily from one zone of the hospital to another. This minimizes the need for
patient evacuation.
6. You enter a patient’s room and discover a small fire burning on the bed. The patient appears to have fallen asleep while smoking.
You should immediately:
a. Awaken the patient and scold him for smoking in an unauthorized area.
b. Call out for help to remove the patient from the room as quickly and safely as possible.
c. Try to smother the fire with a blanket from the patient’s bed.
d. Leave the room to find the nearest manual fire alarm pull station.
Correct answer: B
Rationale: As soon as you discover the fire, call out for help so that you can remove the patient from the room quickly and safely.
7. Choose the answer that is FALSE. In an emergency situation:
a. The side-by-side assist is best for carrying patients who require minimal assistance.
b. Both the swing carry and the extremity carry require two caregivers.
c. The chair lift involves dragging a patient across the floor in a tilted chair.
d. The cradle drop is the safest transfer technique for the patient.
Correct answer: D
Rationale: The cradle drop involves wrapping the patient in a blanket and dragging the patient across the floor. This may be dangerous
for the patient. It should be used only in extreme circumstances.
8. You discover a fire in a patient room. You remove all patients from the room. You then close the room door and place a wet towel
along the bottom of the closed door. Why?
a. To help confine the fire
b. To help prevent smoke from spreading to the rest of the facility
c. To help minimize the flow of oxygen to the fire
d. All of these
e. None of these
Correct answer: D
Rationale: Closing the door on a fire can help confine the fire.
9. You discover a small fire in a patient room. You remove all patients and close the door to the room. You then hurry to the nearest
manual pull station to activate the fire alarm system. You return to the room with a portable extinguisher. You touch the closed door
with the back of your forearm. The door feels warm. You should:
a. Pull the pin on the extinguisher prior to entering the room, so that you are ready to use the extinguisher as soon as you enter.
b. Get a second extinguisher before entering the room, as the fire has probably grown too large to fight with a single extinguisher.
c. Notify your supervisor that the fire has grown too large too fight with an extinguisher, and stand by for instructions regarding
patient evacuation.
d. Immediately begin to evacuate all patients on the unit.
Correct answer: C
Rationale: If a door feels warm to the touch, it is too large to fight with a single extinguisher. If a fire is too large for a single
extinguisher, prepare to evacuate, and allow the fire department to fight the fire.
10. A fire has broken out. You have been given orders to begin evacuation of your unit. Which of the following patients should you
evacuate FIRST?
a. A bedridden patient in a room right next to the room of fire origin.
b. A wheelchair-bound patient in a room directly across the hallway from the room of fire origin
c. An ambulatory patient two rooms down from the room of fire origin
d. A bedridden patient several rooms away from the room of fire origin, but right next to the emergency exit
Correct answer: A
Rationale: Patients in rooms next to the room of fire origin should be evacuated FIRST, regardless of their mobility.
11. Whenever possible, vertical evacuation of patients is preferable to horizontal evacuation.
a. True
b. False
Correct answer: B
Rationale: Horizontal evacuation is preferable. Vertical evacuation should be used only when safe horizontal evacuation is not
possible.
[Fire Safety]
Final Exam
1. Common locations for fires in the healthcare setting include all of the following EXCEPT:
a. Laundries
b. Waiting rooms
c. Storage rooms
d. Laboratories
Correct Answer: Waiting rooms
Answer Rationale: Fires are most likely to occur in areas with a lot of oxygen, fuel, or heat. Such areas include laundries, storage
rooms, laboratories, boiler rooms, and operating rooms, but not waiting rooms.
2. Alcohol-based rubs should be applied to the hands, then allowed to air-dry.
a. True
b. False
Correct Answer: False
Answer Rationale: When using alcohol-based hand rubs, be sure to rub your hands until they are dry. This can help decrease the risk
of fire.
3. A water extinguisher is always the best choice for fires involving wood, cloth, paper, or plastic.
a. True
b. False
Correct Answer: False
Answer Rationale: Both water and dry-chemical extinguishers are rated for this type of fire. The best choice of extinguisher in this
situation depends upon other factors.
4. Fire doors and partitions help contain fires and decrease the need for patient evacuation.
a. True
b. False
Correct Answer: True
Answer Rationale: Fire doors and partitions divide a facility into separate zones. This helps to contain fires and decreases the need
for patient evacuation.
5. You discover a fire in a patient’s room. True or False: You should try to put out the fire before removing the patient.
a. True
b. False
Correct Answer: False
Answer Rationale: Always call for help and remove the patient FIRST.
6. Which of the following can help prevent the spread of smoke and fire from a room?
a. Closing the door of the room
b. Placing a wet towel at the bottom of the closed door of the room
c. Closing the doors to rooms next to and across the hall from the room
d. All of these answers
Correct Answer: All of these answers
Answer Rationale: All of these methods can help prevent the spread of smoke and fire.
7. If you are unable to put out a fire with a single portable extinguisher, you should:
a. Go get another extinguisher.
b. Call for someone to bring you another extinguisher.
c. Attempt to smother the fire with a blanket.
d. Confine the fire and prepare to evacuate.
Correct Answer: Confine the fire and prepare to evacuate.
Answer Rationale: If a fire cannot be put out with a single extinguisher, confine the fire and evacuate.
8. Which of the following statements is TRUE?
a. After evacuating a room, leave the door open to indicate that it is empty.
b. Use elevators for vertical evacuation.
c. If a patient is located on the far side of a smoke zone, that patient must be evacuated past the room of fire origin.
d. Move charts with patients.
Correct Answer: Move charts with patients.
Answer Rationale: Move charts with patients to help ensure continuity of care.
9. You should respond to a fire emergency using the ____ protocol.
a. Life Emergency Code
b. PASS
c. RACE
d. HELP
Correct Answer: RACE
Answer Rationale: When responding to a fire emergency, Rescue, Alarm, Confine, and Extinguish or Evacuate. PASS helps you to
remember how to use a fire extinguisher.
10. A fire has broken out. You have been given orders to begin evacuation of your unit. Which of the following patients should you
evacuate FIRST?
a. A bedridden patient in a room right next to the room of fire origin.
b. A wheelchair-bound patient in a room directly across the hallway from the room of fire origin
c. An ambulatory patient two rooms down from the room of fire origin
d. A bedridden patient several rooms away from the room of fire origin, but right next to the emergency exit
Correct answer: A
Rationale: Patients in rooms next to the room of fire origin should be evacuated FIRST, regardless of their mobility.