The Practical Application of
Emergency Evacuation of Bariatric
Patients in an Acute Teaching
Hospital
Presented by :- Harvey Stewart & Helen Naylor
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HTM 05-03
States:‘Once a fire has started, has been detected and a
warning has been given, occupants should be able to
escape safely, either unaided or with assistance but
without the help of the fire and rescue service.’
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Background
 Old Victorian Building
 Steep, narrow metal fire escapes with 180°switchbacks
 Need to be able to successfully evacuate all patients
unaided by Fire Service
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Process
 Bariatric Working Group - sub group for evacuation
 Identify the areas where bariatric patients are treated
 Identify areas where it is safe to treat this type of patient taking into
account the size of the patient in relation to the fire exit route and
door opening.
 Draw up a plan of rooms that are more suitable with regard to fire
evacuation.
 Any extra fire compensations required were identified e.g. 60
minutes fire doors and fire compartmentation
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Staff Information
 Providing Dignified Care for Bariatric Patients, guidelines
for staff
 Developed Bariatric Risk Assessment and Care Pathway
 Personal Emergency Evacuation Plan
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Personal Emergency Evacuation Assessment and Plan
Name:
Hospital Number:
Current Exact Location: Ward:
Room:
Is the patient located close to the preferred fire exit (for bed evacuation) behind a set of fire doors?
Yes
No
If No why not_________________________________
Can the patient be moved on their bed in both directions behind additional fire doors?
Yes
No
If No why not_________________________________
Is advice required from the Fire Officer?
Yes
No
Advice given: _________________________________________________________________________________________________________________________________
I have the following oxygen requirements…..
I will be evacuated using the following
method…..
I have the following disabilities that could
possibly hinder my evacuation…..
None
24-60% L/min
NIPPV
Full Ventilator Support
I am Independent +/- my walking aid
Impaired Vision
Wheelchair
Impaired Hearing
I can go without this oxygen for a period of…………..
On my bed or by Ski-pad
I am oxygen dependant
Using specialist equipment - EvacMat
I will require the following
number of people to assist in a
horizontal evacuation …..
I will require the following number
of people to assist in an evacuation
requiring me to go down stairs …..
None
None
1-3
1-3
4+
4+
Learning disabilities
……… minutes/hours.
I require the following medication in
order to continue my treatment…..
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
A mental health condition/cognitive
impairment
I require the following specialised
equipment in order to continue my
care/treatment…..
……………………………………………………
……………………………………………………
……………………………………………………
……………………………………………………
……………………………………………………
……………………………………………………
Signed
Assessing Nurse:
Date:
Signed
Assessing Nurse:
Date:
Signed
Assessing Nurse:
Date:
Patient/Relative
Date:
Patient/Relative
Date:
Patient/Relative
Date:
This plan should be re-evaluated if a change has occurred in the patient’s ability. Otherwise it should be re-evaluated weekly, dated and signed. Re-evaluation should be carried
out in collaboration with patient (preferably) or a person acting as next of kin.
Equipment
• Source suitable equipment easier said than
done. Two were found
Evacuation Jack
Evac Mat
Equipment Trials
The first trial was with the Evacuation Jack
The second was with the Evac Mat
Outcome
Evacuation Jack
Pros
• Easy to insert under patient
• Quick to inflate
• Integral back support
• Very easy to move
• Minimal manual handling
Cons
• Quiet wide
• Unflexible to negotiate tight corners
• Difficult to negotiate narrow fire
escape
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Outcome cont.
Evac Mat
Pros
• Easy to insert under patient
• Buckles were quick to connect
• Easy to negotiate tight corners
• Easy to negotiate narrow fire escapes
• Similar process to ski pads already
used in Trust
Cons
• More manual handling involved than
evac jack
• Not as comfortable for the patient
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Next Stage
 Recommendations for evacuation equipment &
additional fire compensations accepted by
Senior Management
 Bariatric assessment & guidelines accepted by
Assistant Chief Nurse
 Recommendation of the fire officer with regard to
the more suitable areas on the wards accepted
by Senior Management
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• 29 Bariatric Evac Mats ordered, delivered &
strategically placed through out the trust.
• Estates are addressing the extra fire
compensations required.
• Laminated plan of most suitable room/s placed
in the fire warden book
• Commence training in the use of the Evac Mat
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Introduction of the Bariatric
Evacuation Mat to the Fire service
A number of practical training sessions using the
Evac Mat have been carried out covering all 4
watches and all local fire stations have been
involved.
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Other Developments
Vertical evacuation of patient theatre
•
•
•
•
A fire evacuation exercise was carried out to evacuate a patient following
major surgery
The patient in relation to weight and size did not warrant the use of the
bariatric evacuation mat.
The senior surgeon who took charge of the mock evacuation decided to
use the Evac Mat instead of the ski pad not for the size of the patient but
because of the amount of medical monitors and equipment that needed
to stay with the patient during evacuation.
The Evac Mat because of its extra size was used successfully to
evacuate this patient and encompass all the equipment safely.
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Other Developments cont.
Fallen Patient
Although the Evacuation jack was not suitable for fire
evacuation the Trust has purchased two systems to be
used for the retrieval of fallen patients.
It can raise a patient from the floor in either a seated or
supine position to bed or stretcher height.
Can be used with a spinal board.
No minimum weight limit maximum weight limit 862kg
(135 stone)
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Suitable Patients
• Suspected spinal fracture (can lift patient whilst on spinal board)
• Any other suspected fracture
• Cardiology / respiratory compromised patients (due to integral back rest)
• Bariatric patients
• Patients with peripheral vascular disease
• Patients with cellulitis / leg oedema where hoisting may cause skin
damage
• Patients with little / no head control
• Neurologically compromised patients
• Any fallen patient where hoist access is not possible
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Thank you for listening
Any Questions?
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