Standpipe Operations at a Hospital Fire

BY MICHAEL KENNEDY AND ANDREW BOX

On Tuesday, October 12, 2021, at 1528 hours, the Ann Arbor (MI) Fire Department (AAFD) initially responded to a reported fire alarm activation that rapidly escalated to an active fire on the third floor of a hospital complex that required a standpipe hoseline operation for fire attack. A fire of this scope was not deemed a likely scenario given the building had code-compliant fire alarm and protection systems. This was a complex, adaptive incident that reached a third alarm—very rare for the AAFD. The fire caused significant property damage to the complex’s critical infrastructure and affected a regional health care facility. However, firefighters’ outstanding actions combined with planning, training, and equipment upgrades prevented loss of life and limited damage and impact. The narrative behind the success of this incident starts well before October 12, 2021.

• Gustin: Standpipe Operations: Preparation | Preparing for Fire Attack
• Standpipe 101, Part 1: A Beginner’s Guide to Standpipe Firefighting | Part 2 | Part 3 | Part 4 | Part 5
• Standpipe Snafu! What Do You Do?

High-Rise Response Upgrade

The AAFD’s high-rise training, procedures, and operations had not been updated since the mid-1990s and included the use of single-jacketed, 1¾-inch high-rise hose bundles. Over the past 15 years, the city of Ann Arbor has seen significant vertical growth downtown because of new construction. To address this burgeoning vertical challenge, in December 2019, the fire administration planned to completely revamp all the department’s high-rise operations in 2020. As initial efforts began, the COVID-19 pandemic struck and the project was paused, but it was relaunched in early 2021.

Resistance to change is the same within the AAFD as with most fire departments. Given this, the planning team researched national experts in high-rise operations to assist in this massive undertaking. We did not have the internal expertise to complete this project independently.

In late January 2021, Chief (Ret.) Michael Veseling and the Oswego (IL) Fire Protection District hosted Denver (CO) Fire Department (DFD) District Chief David McGrail and welcomed the AAFD to his lecture on high-rise and standpipe operations. The AAFD is grateful for the access to this program, which would revolutionize the AAFD. After attending the program, the AAFD recognized that our then-current high-rise and standpipe operational policies, procedures, and equipment may have been 99-percent effective historically; however, for the remaining one percent, the AAFD was inadequately prepared in policy, procedure, equipment, and training. The department began preparing for the “one-percent” fire emergency in the future. “Preparing for the one-percent” became the AAFD’s mantra for this generational change.

Adapting McGrail’s recommendations to our operational constraints, we identified the hose, straps, appliances, tools, bags, and related equipment that would bring AAFD into alignment with current high-rise operations. This included a new standard operating procedure (SOP) and training plan. In June 2021, McGrail and Lieutenant Jeff Larsen, also with the DFD, conducted four days of robust, hands-on training for the AAFD and surrounding fire departments that respond to the city of Ann Arbor on escalating alarm assignments. This training was an era change for the AAFD’s high-rise operations.

Following up on the June training and to reinforce the new standpipe hoseloads and high-rise operations, the AAFD worked with the University of Michigan (UM) to use an offline residence hall for several weeks of practical training evolutions starting in September 2021 and ending the week prior to this fire. Firefighters reviewed all aspects of the new hoseloads and tactics (photos 1-3).

Previously, the AAFD had a massive bag that contained a single-jacketed 1¾-inch hose bundle attached to a Y-gate and an assortment of tools that varied across the department. The least senior firefighter had to carry this cache alone, which was an unequal distribution of equipment weight and dramatically fatigued the member carrying it. Our hose and nozzles did not account for potential pressure issues, nor did we have elbows, bleeder valves, or inline pressure gauges for the standpipe connections.

Fire at University Hospital

The fire occurred on the third floor of the University Hospital building, part of a vast network of interconnected buildings comprising the UM’s main medical campus adjacent to Ann Arbor’s downtown district. University Hospital is an 11-story, 550-bed hospital of 1.79 million square feet. It contains an adult emergency department and a regional Level I trauma burn center, diagnostic equipment, clinical laboratories, operating rooms, and inpatient and intensive care units.

University Hospital’s third floor is a full-height floor dedicated entirely to the complex’s critical infrastructure, including air filtration and handling, medical gases, water, and electric. The entire building is alarmed and equipped with several Class I wet risers. In Michigan, all fire inspection and code enforcement of inpatient health care facilities falls under the Michigan Bureau of Fire Services jurisdiction. During this incident, the fire alarm, elevator recall, suppression, and standpipe systems were operational as they related to fire department operations.

Fire Station 1 is located 1.3 miles from University Hospital. Tower 1-1 (T1-1), staffed with a captain, driver/operator, and firefighter, is the suppression apparatus assigned out of Station 1 and responds to University Hospital and the UM medical campus several times a week on automatic fire alarms and elevator emergencies. Firefighters are familiar with the complex and switch to an “InterOp” talkgroup to communicate with the UM’s public safety dispatch center and hospital security officers.

Initial Operations

On October 12, 2021, at 1528 hours, T1-1 was dispatched to a reported alarm at University Hospital. The AAFD responds with a single company to automatic fire alarms. While en route, the UM’s public safety dispatch center advised that maintenance personnel on scene were reporting an “active fire” on the third floor. T1-1 upgraded the assignment to a still (two engines, a ladder company, and a battalion chief).

The T1-1 acting captain and firefighter followed procedures as the first-arriving unit and performed reconnaissance. The T1-1 driver/operator started the fire department connection (FDC) and hydrant connections. Since dispatch was reporting an active fire, Chief 1 (C1) responded along with Battalion Chief 1-1 (BC1-1); both arrived just after T1-1 but before additional units.

On arrival at 1535 hours, BC1-1 established University Hospital command and assigned C1 as Division 3 to determine the scope of the incident. The incident was upgraded to a first alarm and then shortly to a second alarm. Each additional alarm assignment consists of two engine companies, one truck company, and a chief officer with a minimum of 10 personnel.

T1-1 made the third floor with wayfinding assistance from maintenance. There was a significant smoke condition on the third floor with active fire in an air-handling unit. The five air-handling units are each approximately 15 feet deep, 40 feet long, and 12 feet high. Each unit has two main parts: a bank of air filters and a fan motor. Each unit also had a second backup fan motor on the top of it. The entire inside of one of these air handlers was involved in fire. The fuel load was the unit’s filters and insulation. These air handlers supply ventilation to operating rooms and critical care units, which require massive air filtration. Maintenance confirmed that electricity to the unit was shut off (photo 4).

Significant and worsening smoke conditions made it impossible to initially determine the size of the air-handling unit and the volume of fire. Convective heat had activated several sprinkler heads above the air-handling unit, but the main body of fire was inside the unit and thus shielded from the suppression system water. The air handler’s large side access panels allowed direct access to the fire. T1-1 initiated fire attack with a water can and several local dry chemical extinguishers to extinguish the fire but, despite these efforts, the fire intensified so the extinguisher effort was abandoned.

Standpipe Operations

Division 3 advised University Hospital command that fire suppression would require a standpipe operation; at this time, University Hospital command requested a third-alarm assignment. A protected stairwell was identified with a Class I standpipe from which to stretch the high-rise bundles. University Hospital command assigned the five remaining first-alarm companies to the following groups: fire attack, attack backup, supply and forward driver/operator (D/O) positions, ventilation, and air monitoring. Based on the AAFD’s new high-rise/standpipe SOP, each assigned company brought up a full complement of high-rise hose bundles (three two-inch 50-foot lengths of hose), a standpipe kit, a thermal imaging camera (TIC), and additional equipment.

The initial deployment off the standpipe in zero visibility used 250 feet of two-inch hoseline for fire attack. The forward D/O was assigned to the stairwell standpipe and used an inline pressure gauge to gate appropriate pressure while coordinating with the supply D/O as T1-1’s D/O because of their arrival sequence and immediate access to the FDC.

At 1606 hours, Division 3 reported “water on the fire.” Once the standpipe line was in operation, the fire was quickly extinguished. Additional fire crews were assigned to check the fourth floor for extension and smoke spread. As the smoke was ventilated, the air was monitored. There was no fire spread beyond the third floor.

Patients and staff on the fourth floor (the floor above the fire) were horizontally evacuated. There was no vertical or building evacuation of patients. Nurses, doctors, and other clinical staff performed truly heroic actions to care for patients in parts of the building impacted with significant smoke spread during this incident. University Hospital has a very complex layout, and maintenance staff were a critical resource to provide wayfinding and assisted with having the closest elevators in phase II to assist with operations.

After the Incident

The University Hospital incident lasted three hours and nine minutes and involved the following resources: seven fire departments, 46 fire suppression personnel including six chief officers, seven engine companies, three truck companies, two rescue companies, and seven staff vehicles. The incident affected the Level I Trauma Burn Center’s regional services, the critical/intensive care units, all operating rooms (including the critical surgical care units), the main pharmacy, and all elevators throughout the complex. The hospital leadership and staff had to manage unique challenges of each affected unit. The AAFD’s overarching goal was to extinguish the fire as soon as reasonably possible to allow recovery to begin.

Since the incident exhausted the resources of the AAFD and surrounding mutual-aid communities, off-duty callback personnel and third-alarm mutual-aid companies provided continuity of emergency services for more than 121,000 residents. During the University Hospital response, station coverage companies responded to one fatal motor vehicle accident, numerous medical emergencies, and public service calls.

Lessons Learned

Although the University Hospital was an extremely complex incident that presented challenges never imagined, we learned several critical lessons.

Incident management. We did not use a unified command system during an incident of this magnitude. Representatives of the AAFD and the following entities of UM—the Department of Public Safety and Security, Health System Executive Leadership, and Health System Facilities and Maintenance—will develop an emergency action plan that establishes a predetermined emergency operations center/location.

Standpipe operations. The incident commander (IC) must manage declared standpipe operations within an occupied building, according to the AAFD High-Rise SOP. Either the fast-attack officer or IC needs to ensure a first-alarm response anytime a standpipe is in operation.

Fire suppression entry. Because of the interior layout involving multiple stairwells and extended corridors, deployment of some crews to the location of the fire on Division 3 was delayed. There is a need to have hospital personnel provide wayfinding to each crew from the initial building entry point to the incident location.

Fire suppression operations. The AAFD and mutual-aid personnel recognized the intrinsic value of the recently implemented high-rise response and standpipe program and subsequent in-service training sessions for building on new skill sets.

TICs. On entry on Division 3 in zero visibility conditions, T1-1, the recon company, used their TIC and found high heat readings and signatures (images) from the involved air-handling unit. Interpret such readings as a high probability indication that the fire has developed past the incipient fire stage and beyond the capability of portable extinguishers, requiring standpipe operations. The AAFD must train its fire suppression personnel to interpret TIC information obtained in commercial environments and incorporate live tactical information into their situational awareness and initial action plan and communicate this information in a conditions, actions, and needs report to the IC.

Positive pressure fans. Battery-powered positive pressure fans were instrumental in ventilation operations during fire suppression and salvage and overhaul operations in removing carbon monoxide levels on Division 3.

Reference

University of Michigan Health. “University Hospital.” https://www.uofmhealth.org/our-locations/university-hospital.

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MICHAEL KENNEDY is a 27-year fire service veteran and chief of the Ann Arbor (MI) Fire Department. He is a CPSE chief fire officer, a Michigan Fire Fighters Training Council Instructor II, and a contract instructor for the International Society of Fire Service Instructors. He has a bachelor’s degree in political science from the University of Michigan and a master’s degree in public administration from Eastern Michigan University.

ANDREW BOX is a 35-year fire service veteran and assistant chief of the Ann Arbor (MI) Fire Department. He is a graduate of the National Fire Academy Executive Fire Officer Program and Texas A&M Fire Service Chief Executive Officer Program. He has a bachelor’s degree in fire science from Madonna University and a master’s degree in public safety administration and emergency management from Eastern Michigan University.