Fire safety audit: Igniting awareness, extinguishing danger
Steps to ensure fire safety in any building must be followed and more importantly in a hospital where patients are housed. Thus, every hospital should abide by fire safety measures or else even a small fire may assume dangerous proportions.
It is the universal truth that fire is an excellent servant when under control, but a bad master when out of control. In the latter instance, once it spreads in a murderous rampage, it spares no one. That is why it is essential to ascertain that fire safety norms are given due importance under all settings. In this context, hospitals can be most vulnerable and the reasons for that are not far to seek. In the US the fire code is aimed primarily at preventing fires, ensuring that necessary training and equipment will be on hand. Along with this it must be ensured that the actual design basis of the building, including the basic plan set out by the architect, is not compromised. Therefore, the fire code also addresses inspection and maintenance requirements of several fire protection equipment in order to deliver an optimal active fire protection and passive fire protection measures.
Importance of fire safety
Hospitals are stocked with highly inflammable chemicals and patients in various conditions of ill health are under treatment. In many cases, the patients are hard-pressed to walk. In some cases, they cannot even move a muscle; for instance, in conditions such as paralysis. Thus, in case of any emergency such as a fire, these patients would need to be wheeled out quickly to safety or carried away swiftly to a safe place by able-bodied persons. In such a scenario, if a speedy escape needs to be made during any disaster, overcrowding can hinder a quick exit. Talking on the significance of fire safety audit, Dr Sujit Chatterjee, CEO, Dr L H Hiranandani Hospital, says, “Fire safety is important in any facility that houses people and hospitals are no exception. In fact, the criticality of fire safety in hospitals becomes more important as some patients may not be in a position to move and the basic evacuation can take a long time or may not be at all possible. Further, there are oxygen pipes with pure oxygen available criss-crossing through the entire hospital. In a fire situation this would be like adding fuel to the fire rather than pouring water. Hospitals also have infants or neonates who could easily succumb with a slightest difference in hospital’s temperature or oxygen content. Thus, prevention of fire would be critical and fire safety in hospitals is critical.” Seconding the above thought, D P Tyagi, Chief Security Officer – Rajiv Gandhi Cancer Institute & Research Centre, Delhi, says, “It is imperative to install adequate fire-safety systems in all hospitals. It is also important to follow basic guidelines on fire safety. In 2010, for instance, a basic rule was introduced by the Delhi Fire Service that all hospitals with minimum 500 beds or more should appoint an exclusive fire safety officer. The role of such officials will revolve around creating and maintaining fire-safety norms, training hospital staff and being in charge of an evacuation plan in case of a fire or other emergencies. But almost all hospitals follow this rule only during a breach.”
Down the years
With modernisation in every field, fire safety has also changed over time. Discussing how the concept has changed with time, Dr Chatterjee avers, “Gone are the days when only hand-held fire extinguishers were the fire fighting device available. Today, there is a Building Management System (BMS). From here all the fire censors can be monitored centrally. Fire censors are designed to get activated not only by the heat of fire but also by the smoke that is first generated. The censors set off the alarm in a particular area and the alarm is repeated in the BMS room or other areas as designed by the hospital. With this, there are also automated sprinklers that are linked to a fire hydrant system. While this mechanical system is in place, each hospital has fire wardens who also react to the emergency call and a fire fighting team that can operate high pressure hoses within the hospital to douse the fire by water jet. Different types of fire such as oil or electrical have special chemical fire extinguishers that are also available in hospitals today.”
Elaborating on whether the situation has changed or not Tyagi avers that the situation today is no different from what it was years ago – fraught with risk. There was a time when all organisations depended completely on the state fire services for fire safety. He highlights, “Over the years, the state fire services have improved tremendously. Yet, given the vulnerability of many institutions, including hospitals, it is in interest of everyone concerned to ensure that all entities become self-reliant on the issue of fire safety.”
Factors to be noted
There are certain factors that need to be considered while ensuring fire safety system in hospitals. Dr Chatterjee says that a well designed and integrated mechanical fire fighting system that is centrally connected to the fire fighting water tank and also to the BMS should be there. He highlights, “There should be a manual fire fighting system with high pressure hoses linked throughout the hospital and externally. Ideally, the lifts should be bed-carrying lifts with fire retarding doors that do not open on every floor and can be safely navigated to a safety zone. Clear signages and luminescent sign should be available throughout the hospital to ensure people may see the sign leading them to safety even in dark. There should be special chairs in which patients can be seated and actually pushed down the staircases with safety.” He adds that some may feel the necessity of a ramp linking the entire hospital but this is impractical if it is a high rise building. Tyagi says, “Fire-safety systems and personnel handling such systems should be considered as important as other services. All fire-safety systems should be checked and tested periodically. There should be no compromise on fire safety measures. And all facilities and systems in the hospital should adhere to fire safety norms. Hospitals should follow a golden principle of ‘prevention, detection and suppression’ in case of fire.”
Challenges are a part of every journey. Tyagi says, “The pressure of population and rising numbers mean that whatever resources are arranged happen to fall short sooner or later. This is why it is important to constantly review and update fire safety rules without any compromises whatsoever. Compromises made today on this count could have serious repercussions tomorrow, as was amply evident in the case of the AMRI hospital fire.” He adds, “To overcome all overt and covert challenges, hospitals should have an integrated fire-fighting system in line with guidelines of the state fire services. To safeguard the safety of patients as well as that of other stakeholders, provision should be made for independent budgetary outlays for a fire-safety system. On the issue of fire safety, cost cutting should never be allowed.” Discussing the challenges, Dr Chatterjee avers, “Hospitals should be looking at fire safety from the design point of view. There must be fire sanctuary areas built in to the design for people to be evacuated. But evacuating patients remains a challenge and we may have to give up the orthodox ideas of fire escape. The challenge is when patients have to be evacuated in the bed and there are various forms of stretchers that are available by which this can be done but trained manpower will be required in a fire situation. The main concern is keeping the hospital staff indoors to help with patient evacuation. The way of overcoming the challenge is by ensuring regular training, regular drills, ensuring regular tests of fire fighting equipment and liaising with the fire brigade to learn what is new.” Therefore, it must be remembered that any violation regarding fire safety will jeopardise the lives of patients, physicians and the general public. In the interest of everyone concerned, fire safety should therefore be made an integral part of the healthcare industry’s policy guidelines. This will pay rich dividends and ensure that killer fires like the one at AMRI hospital do not recur.