ays that are protected from smoke; and a compilation of safety data sheets that is readily available and describes the properties of hazardous substances used in the facility.
Although the 14 above-mentioned points are examples of essential fire protection elements, it would take more than a journal article to provide detailed information on each one. We would, however, like to call your attention to a few.
It is essential that there are designated emergency escape routes from all areas of the facility to a place of safety. These routes need to be clearly marked, continually unobstructed, well lit, and unlocked. In consultation with the local fire service, the emergency action plan may call for a phased evacuation, not evacuating all patients and staff at once. In some facilities there are designated areas of refuge (with specific engineering criteria) where evacuees wait for assistance from the emergency services.
An emergency escape route may be part of a normal passageway. Often times the secondary emergency escape routes may be passageways and doors that are not in constant use. In some locations, during the winter season, the doors leading outside may be obstructed by snow. It is essential that all designated escape routes are regularly inspected by a designated person and are continually unobstructed.
Evacuation in a health care facility includes both ambulatory and non-ambulatory patients, although during a fire emergency, ambulatory patients may become non-ambulatory due to fear or stress. Moving non-ambulatory patients in beds may not be feasible. In a number of facilities an evacuation sheet is used. It is essential, however, that health care facility staff are trained in how to evacuate a patient using a drag sheet or other evacuation mechanisms that the facility uses.
Patients, staff, visitors and others need to be accounted for once outside of the building. A means of accounting for who is missing needs to be set up and described in the emergency action plan. There also needs to be a means of rapidly informing the responding emergency service who is not accounted for and where and when they were last seen. This will greatly influence the search and rescue strategy of the emergency service.
Planning for fires and other emergencies needs to be done in advance. As essential documents are drafted, proposed measures need to be tested and revisited as necessary. When new procedures are designed and implemented and new equipment, materials and products are brought into the facility, plans need to be re-examined and adjusted as necessary. Desk top exercises and evacuation drills are essential means for determining whether plans are effective.
Key to successful emergency planning is the training and education of all staff including hands-on practical training so that their respective roles in a fire and evacuation become second nature. It is also a good practice to provide all staff, during induction, a thorough briefing on fire safety and regular refresher training.
Visitors, contractors and others should also be provided information about fire safety when they work in or visit the facility.
This article suggest three essential documents that should be continually reviewed and updated as necessary. The three documents are the fire risk assessment, the emergency action plan and the fire prevention plan. All documents should be drafted in concert with the local emergency services and should be reviewed with these services before finalised.
The fire risk assessment
According to the publication Fire Safety Risk Assessment: Health care premises and the (UK) Health and Safety Executive, there are five steps for carrying out a risk assessment: identify fire hazards; identify people at risk; evaluate, remove, reduce and protect from risk; record, plan, inform, instruct and train; and review.
The Fire Safety Risk Assessment: Health care premises publication goes into further guidance of what needs to be considered on the following topics: fire risks and preventative measures; fire-detection and warning systems; firefighting 