BY TOM KIURSKI
Hospitals, clinics, and nursing homes are target hazards posing a considerable risk to occupants because of the large numbers and nonambulatory nature of these facilities’ residents and the inability to evacuate the residents vertically in the building. You must not overlook targeting a public fire safety education program toward health care facilities; a facility with a trained staff on hand to extinguish small fires or limit fire spread is well worth the effort. Develop a fire safety program appropriate for those community facilities, and then make the circuit, visiting them all with your program.
The basis of your educational program can be built around the acronym RACE. Discuss RACE with the program group, focusing on each letter of the acronym as your four main subjects.
- Rescue
- Alarm or Alert
- Confine
- Extinguish
In an ideal situation, the R (rescue) and the A (alarm or alert) will occur simultaneously. If not, the workers must make an informed decision on which order they will perform them based on the situation.
Rescue includes assisting those in need from the fire area to an area of safety, which may be the closest fire zone away from the fire or outside of the building. This may also include the moving of large numbers of people who may need additional staff assistance out of an area. Such assistance ranges from opening doors and windows to providing a shoulder for someone to lean on, as well as performing various lifts, drags, and carries necessary to remove people who cannot remove themselves. Many beds have wheels on them; unlocking wheels can move people quickly and comfortably. Many floors are tiled, making blanket drags quick and easy to accomplish. Go over these techniques with the staff as a reminder. Perform practice drags for a visual demonstration using a mannequin.
Alarm or Alert may be as simple as telling a fellow worker to call the fire department, activating a manual pull station, or sending out a code over the public address system. The plan must include early fire department notification. We all know how the first few minutes of a fire can be the difference between life and death.
Confining the fire can be a quick and simple procedure resulting in saved occupant evacuation time and in locating the fire when fire strikes. Suggest closing doors behind the last person leaving an area and closing every door on the way out. Confining the fire limits the migration of heat and smoke as residents are moved horizontally on the floor or out of the building.
Extinguishment is an option for staff members who are competent in using a fire extinguisher and are comfortable that building evacuation is underway and they have a clear, unobstructed exit. Do not force those who are uncomfortable with using a portable fire extinguisher to do so, as they can be of assistance in the previously mentioned items (Rescue, Alarm, and Confine), as well as keeping the group together and performing a head count to see if anyone may be missing.
Establish someone in the workplace as a fire department liaison. This person would be responsible for the workplace evacuation, informing arriving fire crews of anyone still inside the building (fighting the fire, final evacuation, etc.); any known missing individuals and their last known whereabouts; and the location of the fire, if known.
Introduce fire extinguishers as limited equipment to fight small fires, while not placing anyone, including the user, in jeopardy. I equate the use of portable, small fire extinguishers with that of bandages. You wouldn’t try to stop a major arterial bleed with a small bandage strip, so don’t try to extinguish a room fire with a portable fire extinguisher.
With the help of the group, identify the three main classes of fire: Class A, Class B, and Class C. If someone in the group mentions a Class D (combustible metal) fire or Class K (kitchen cooking) fire, ask if their facility has them. If not, then briefly identify them and state that the three types cover most fires in any building. Illustrate that the appropriate markings on the portable extinguishers are for agents that put out the different classes of fire. I explain both the U.S. system of colored, geometric shapes as well as the international picture symbols.
Remind the group that fire extinguisher use is an option only after the rescue, alarm/alert, and confinement are accomplished and the fire department is on the way. Only then should they attempt to extinguish, and they should inform someone going outside of their intentions to fight the fire with a portable fire extinguisher. This reminds that person to tell the fire department liaison that someone is missing in the building until it is proven that that person has made it outside. The liaison will relay that information to the first-arriving crews for appropriate action.
Once the worker chooses the correct fire extinguisher, he must remember to keep an exit at his back in case the extinguisher fails to operate properly or cannot completely extinguish the fire.
I usually tell the audience that there is a certain password that will allow them to use fire extinguishers effectively. That password, obviously, is “PASS.” PASS is another acronym that reminds the fire extinguisher user to do the following:
- 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.
Warn the class members that they should expect a slight kickback from the extinguisher once it is activated. Also, tell them not to be startled by the noise as the agent rushes out of the extinguisher, which is most significant in the carbon dioxide-type extinguishers.
If possible, let the class members practice using the fire extinguisher so they can see how much fire they can extinguish in just a few seconds. This also helps those who felt they would never use an extinguisher to see how easy it is to use. Encouragement from you and their coworkers will help. I inform the group that they do not have to use the extinguisher for the class but believe they should at least see how it works by watching others use it.
You can purchase several types of commercially available fire extinguisher trainers. Although excellent, they are expensive, take up space to transport, and take time to set up. A cardboard box is good for transporting an extinguisher and other small items. For setting up the fire demonstration, carry a one-gallon container of water in a metal oil drain pan and carry diesel fuel in a small approved container. Fill the drain pan with half the container of water and cover the surface with diesel fuel. Once lit (with the torch), it will reignite easily. You may have to add a bit more to the pan after a few uses after the fire is out. As a precaution, have another firefighter stand by with a safety extinguisher.
End the class by challenging your group to locate all of the fire extinguishers in their workplace and determine on which classes of fire they can be used safely. Also, discuss home extinguishers and how the “ABC” type is the best; homes have all three hazards. The smaller home fire extinguishers have less extinguishing time available (usually less than 10 seconds), so inform the group that they must be effective with the extinguisher. Use the old adage “Practice makes perfect” to encourage them to try the hands-on part of your class.
As in most businesses, health care workers generally do not have fire safety or fire suppression foremost in their minds as they go about their daily job functions. Remind them that fire does not visit only those prepared for it. Although large hospitals often have in-service training programs in these areas, some smaller clinics and nursing homes may not. Make it a point to stop by and offer your program.
TOM KIURSKI is a 27-year fire service veteran and the training coordinator for Livonia (MI) Fire and Rescue. He has authored more than 200 fire safety magazine articles. He has an associate’s degree in fire science, a bachelor’s degree in fire and safety engineering technology, and a master’s degree in public administration. He is also a Michigan state certified fire instructor.
