Fire safety

Fires affecting the Critical Care Unit are rare but are particularly difficult in that patients are not easily evacuated; yet their lives depend on services which fire may disrupt. Smoke, while dangerous to staff and the less sick patient who may be breathing spontaneously, is less of a problem to those receiving mechanical ventilation since their fresh gas supply is from outside the affected environment. Therefore, it follows that in the event of fire, the priority is to ensure safety and means of escape for the staff first.

Control of smoke

Smoke and toxic gases are a common association with fire and may, in themselves, be flammable, particularly in association with high concentrations of oxygen. The main techniques for control of smoke include containment (e.g. fire-resisting walls, doors, and seals) and dispersal (e.g. positive pressure air supply), the latter being used in patient areas. The possibility of flammable or toxic fumes should be considered when equipping and furnishing the Critical Care Unit.

Escape from fire

• Escape routes should be well marked and unobstructed.

• The nature of critical illness is such that not all patients can be evacuated.

• The staff should escape first by proceeding to the nearest exit away from the fi re.

• Patients should be evacuated in the order of the least sick first.

• Evacuation of patients should be managed by someone trained in the use of breathing apparatus; in most cases, this will be the fi re brigade.

• If patients are to be evacuated, they should be moved to a place of

safety on the same floor as the Critical Care Unit. Patients should not be moved downstairs (or lifts used) unless first approved by a Fire Officer.

• In the majority of fi res, containment will reduce the need for full evacuation.

Preventing fire

• Automatic smoke or heat alarms should be provided in all areas.

• Cooking areas and laboratory areas must be separated from patient areas by fire doors.

• Fire doors are provided to protect staff and patients, and should not be wedged open.

• If a closed door would compromise the care given to patients but is essential to separate fire compartments, then an electro-mechanical

device should hold the door open and be disabled by the fire alarm.

• Fire extinguishers and blankets of the appropriate types should be readily available and staff should be properly trained in their use.