Section 6
Fire Safety for Workers in Long Term Care A fire can happen in your facility on any day, at any time. Fires in long term care facilities occur more often than you might think. Because so many lives are at stake, it is important to know what to do if there is a fire in your facility. This course is designed to help you respond quickly and effectively to a fire emergency in your facility. After completing this course, you will be able to do the following: • State how quickly you need to respond to a fire emergency • List the four components needed to start a fire • Describe the proper way to check behind a door if you think there is a fire • Decide which residents to rescue first in the event of a fire emergency • Describe how to sound the alarm if there is a fire in your facility
Important Things to Know About Fires Because fire grows and spreads so quickly, if one breaks out, you need to act fast! Flames aren’t the only things that can hurt you in a fire. You need to be careful of heat and smoke, too. Smoke and heat rise to the ceiling. To stay safe, keep close to the floor. Smoke can also harm you and your residents, because it contains poisonous gases and reduces the amount of oxygen you are breathing in.
How a Fire Starts and Stops A fire starts (and stops) if the conditions are right. Fire is made up of four basic ingredients. First, you must have fuel. Fuel is anything that can burn. Some examples include paper, oil or natural gas. Next, you must have enough oxygen. There must be at least 16% oxygen present for a fire to burn. The air we breathe is about 21% oxygen, so there is enough oxygen present at all times to fuel a fire. Another ingredient you must have to ignite a fire is heat. Sources of heat include heating and cooking appliances, cigarettes, lighters and matches. Once you have fuel, oxygen, and heat together in the right amounts and under the right conditions, a chemical reaction called “combustion” can happen, and a fire occurs. The important thing to remember is that if you take away any of these four things, a fire will not start or continue to burn. At its most basic level, fire prevention and safety is based on the idea of keeping one or more of these ingredients away from the others. Some simple ways you can help prevent fires include reporting unsafe conditions (for example, frayed electrical wires and broken electrical receptacles) and practicing good housekeeping.
What to Do if You Think a Fire Has Started In another lesson in this course, you learned that fire grows and spreads quickly, so if a fire occurs, you need to act FAST! Because fire can spread quickly, if you smell something strange or see smoke, investigate immediately to find out what is causing it. If you think you smell smoke behind a door, feel the door with the back of your hand first. If the door feels hot, DON’T OPEN IT! Otherwise, stay low and open the door slowly. If you discover a fire in your facility, remember to RACE and follow your facility fire plan.
Rescue Residents If there is a fire in your facility, the first thing you want to do is rescue residents who are closest to the fire. This includes residents in the fire room, next door to the fire room, and directly across from the fire room. When evacuating the remaining residents, ask yourself the following questions: What are the limitations of the residents who need rescuing? Are these residents mentally and physically able to respond in the proper way to the fire emergency? Because they are elderly, ill, or disabled, some residents may not be able to move quickly in a fire emergency. They also might not be able to see very well in the smoke or hear what you are saying to them because of the fire alarm. Residents may be drowsy or disoriented because of their medical condition or the time of day, especially if the fire is at night. Because of these reasons, residents may need more time to evacuate from a fire area and may need your help. Rescue residents who can walk on their own or with little help first. This will give you more time to rescue the other residents. If a resident is blind, tell him there is a fire and that you (or another person) will guide him away from the fire. When guiding a blind resident, stay in close physical contact with him. Offer your arm and have him grab your elbow. Direct him around any obstacles. A deaf or hearing-impaired resident may not hear the fire alarm. Use gestures to tell him what is going on and what to do. You may also write a quick note for a hearing-impaired resident. For example: “FIRE—Go out the exit. NOW. Meet on front lawn.” Sometimes, residents who can walk on their own and don’t have physical challenges may present other challenges. A person with severe Alzheimer’s disease may be physically capable of leaving the area, yet mentally unable to follow directions or respond appropriately. Elderly residents and residents with mental disorders may behave irrationally by ignoring the fire, by not being able to physically move when they see the fire, by resisting rescue efforts, or even by hiding under beds or in closets. To rescue these residents, you need to give directions firmly and calmly. Try to take such residents one-on-one to a safe area if at all possible.
To rescue residents who cannot walk on their own or with little help, use wheelchairs or stretchers if available. Some other ways to move these residents include the swing carry; the blanket drag; or the two-person, singlefile carry. Using the swing carry, you and a co-worker can carry a resident to safety. Do this by forming a cradle with both your arms behind the resident’s arms and knees. The blanket drag enables you to move a resident to safety by yourself. Always stay at the resident’s head to protect it from injury. The two-person,
single-file carry allows you to move a resident with a cast on the lower part of his body (as long as the person can be put in a sitting position).
Activate the Alarm Fire alarms provide a visual and audible alert to everyone in the facility AND to the Fire Department. Some fire alarms have a protective or alarmed cover that must be removed or a glass plate that must be broken before the alarm can be activated. Never yell, “Fire!” Instead, follow your facility’s policy for alerting other people. Work as a team. One person can pull the alarm while another person can start to rescue residents. You will know you successfully activated the alarm when you hear the main fire alarm throughout the building and see the flashing lights on each fire alarm indicator. Once the fire alarm has been activated, the location of the fire (or activated alarm) will be displayed on your facility’s fire alarm indicator panel. The indicator panel helps the person in charge identify the problem area so she can send additional staff, if needed, to evacuate residents. Depending on your facility’s policy, you may need to call the switchboard or person in charge. If this is the case, ask the person to whom you are talking to repeat back to you the exact location of the fire and any other important information. Don’t hang up until the other person has the facts right.
Confine the Fire Once the residents have been rescued from the immediate fire danger, close the door to the room where the fire is located. Staff should never re-open the door to the fire room. Only the fire department should do this. If there is a fire in your facility, take steps to try to confine the fire to keep it from spreading. The fire doors will close automatically when the alarm is sounded. These doors help keep fire and smoke from spreading. Always keep these doorways clear so they can close. Never prop fire doors open or seat residents in the pathway of the doors. You will also need to clear all corridors to allow access for the fire department and for yourself and your coworkers in case evacuation is necessary. Remove all carts, equipment, and so forth from the hallways. You can also help confine the fire and smoke by closing all doors and windows in your area.
Extinguish if the Fire is Small Only try to extinguish the fire if it is small and contained, and you know how to use a fire extinguisher. If the fire is in a trashcan or ashtray, smother the fire with a pillow, towel, rug, or blanket. Without oxygen, the fire will die out.
If a resident’s clothes are on fire, place a blanket, sheet, or something similar on the resident’s upper chest, hold it tightly in place from one shoulder to the other shoulder with your arm and drop it onto the flames. This will protect the resident’s airway from smoke and flames while smothering the fire. Quickly “sweep” out any remaining flames with the sheet or blanket still in place. Without oxygen, even a thin sheet can extinguish these fires. If you catch on fire, you should do the following: • STOP where you are • DROP to the floor • ROLL around on the floor You can also use a fire extinguisher to put out a small fire if you have been trained in how to use one. DO NOT use a fire extinguisher if any of the following are true: • The door to the fire area has already been closed • The fire alarm has not been sounded • The fire is spreading • You are not sure that you can put out the fire • You feel uncomfortable using a fire extinguisher • You are fearful of what may be burning • You do not have an escape route There are many different types of fire extinguishers. Each is used for a different type of fire. Most facilities have either type ABC or type K portable fire extinguishers. It is important that you know where the fire extinguishers are in your facility and what types of fire extinguishers they are. Extinguishers marked ABC may be used on most types of fires that happen in a facility. Type K fire extinguishers should only be used in kitchens for fires involving commercial cooking appliances with vegetable oils, animal oils, or fats at high temperatures. Do you know where the nearest fire extinguisher is located in the area where you frequently work? Can you identify what type of extinguisher it is and what type of fire you could use it for?
If you need to use a fire extinguisher, remember PASS
Pull the pin between the two handles. Aim the nozzle at the base or source of the fire. Squeeze the handles together. Sweep the extinguisher from side to side. After putting out a small fire, be sure to do the following: • Watch the fire to ensure that it does not flare up • Be ready to repeat whatever procedure you used should the fire flare up • Have the fire department inspect the scene • Have the fire extinguisher (if used) replaced or recharged
If a fire can’t be extinguished, you may have to evacuate.
Otherwise, Evacuate You should start by moving residents out of their rooms, away from the fire, through the next set of fire doors, and into a safe area on the same floor. This is called a “horizontal” evacuation. Evacuate residents who can walk on their own or with little help first. This will give you more time to evacuate the other residents. If possible, bring the resident’s card file or chart, because it contains important information you may need later. Follow your facility’s system for tagging the rooms already evacuated. If you can’t move to a safe area on the same floor, work your way down to a lower level. This is called a “vertical” evacuation. Never use the elevators! A sudden loss of electricity could leave you trapped in the elevator. At the safe area, keep your group together. Make sure you can account for all residents and visitors in your area. You and members of your group should NEVER go back into a burning building and should remain in the safe area until you are told otherwise.
Important Things to Know About Fires Because fire grows and spreads so quickly, if one breaks out, you need to act fast! Flames aren’t the only things that can hurt you in a fire. You need to be careful of heat and smoke, too. Smoke and heat rise to the ceiling. To stay safe, keep close to the floor. Smoke can also harm you and your residents, because it contains poisonous gases and reduces the amount of oxygen you are breathing in.
How a Fire Starts and Stops A fire starts (and stops) if the conditions are right. Fire is made up of four basic ingredients. First, you must have fuel. Fuel is anything that can burn. Some examples include paper, oil or natural gas. Next, you must have enough oxygen. There must be at least 16% oxygen present for a fire to burn. The air we breathe is about 21% oxygen, so there is enough oxygen present at all times to fuel a fire. Another ingredient you must have to ignite a fire is heat. Sources of heat include heating and cooking appliances, cigarettes, lighters and matches. Once you have fuel, oxygen, and heat together in the right amounts and under the right conditions, a chemical reaction called “combustion” can happen, and a fire occurs. The important thing to remember is that if you take away any of these four things, a fire will not start or continue to burn. At its most basic level, fire prevention and safety is based on the idea of keeping one or more of these ingredients away from the others. Some simple ways you can help prevent fires include reporting unsafe conditions (for example, frayed electrical wires and broken electrical receptacles) and practicing good housekeeping.
What to Do if You Think a Fire Has Started In another lesson in this course, you learned that fire grows and spreads quickly, so if a fire occurs, you need to act FAST! Because fire can spread quickly, if you smell something strange or see smoke, investigate immediately to find out what is causing it. If you think you smell smoke behind a door, feel the door with the back of your hand first. If the door feels hot, DON’T OPEN IT! Otherwise, stay low and open the door slowly. If you discover a fire in your facility, remember to RACE and follow your facility fire plan.
Rescue Residents If there is a fire in your facility, the first thing you want to do is rescue residents who are closest to the fire. This includes residents in the fire room, next door to the fire room, and directly across from the fire room. When evacuating the remaining residents, ask yourself the following questions: What are the limitations of the residents who need rescuing? Are these residents mentally and physically able to respond in the proper way to the fire emergency? Because they are elderly, ill, or disabled, some residents may not be able to move quickly in a fire emergency. They also might not be able to see very well in the smoke or hear what you are saying to them because of the fire alarm. Residents may be drowsy or disoriented because of their medical condition or the time of day, especially if the fire is at night. Because of these reasons, residents may need more time to evacuate from a fire area and may need your help. Rescue residents who can walk on their own or with little help first. This will give you more time to rescue the other residents. If a resident is blind, tell him there is a fire and that you (or another person) will guide him away from the fire. When guiding a blind resident, stay in close physical contact with him. Offer your arm and have him grab your elbow. Direct him around any obstacles. A deaf or hearing-impaired resident may not hear the fire alarm. Use gestures to tell him what is going on and what to do. You may also write a quick note for a hearing-impaired resident. For example: “FIRE—Go out the exit. NOW. Meet on front lawn.” Sometimes, residents who can walk on their own and don’t have physical challenges may present other challenges. A person with severe Alzheimer’s disease may be physically capable of leaving the area, yet mentally unable to follow directions or respond appropriately. Elderly residents and residents with mental disorders may behave irrationally by ignoring the fire, by not being able to physically move when they see the fire, by resisting rescue efforts, or even by hiding under beds or in closets. To rescue these residents, you need to give directions firmly and calmly. Try to take such residents one-on-one to a safe area if at all possible.
To rescue residents who cannot walk on their own or with little help, use wheelchairs or stretchers if available. Some other ways to move these residents include the swing carry; the blanket drag; or the two-person, singlefile carry. Using the swing carry, you and a co-worker can carry a resident to safety. Do this by forming a cradle with both your arms behind the resident’s arms and knees. The blanket drag enables you to move a resident to safety by yourself. Always stay at the resident’s head to protect it from injury. The two-person,
single-file carry allows you to move a resident with a cast on the lower part of his body (as long as the person can be put in a sitting position).
Activate the Alarm Fire alarms provide a visual and audible alert to everyone in the facility AND to the Fire Department. Some fire alarms have a protective or alarmed cover that must be removed or a glass plate that must be broken before the alarm can be activated. Never yell, “Fire!” Instead, follow your facility’s policy for alerting other people. Work as a team. One person can pull the alarm while another person can start to rescue residents. You will know you successfully activated the alarm when you hear the main fire alarm throughout the building and see the flashing lights on each fire alarm indicator. Once the fire alarm has been activated, the location of the fire (or activated alarm) will be displayed on your facility’s fire alarm indicator panel. The indicator panel helps the person in charge identify the problem area so she can send additional staff, if needed, to evacuate residents. Depending on your facility’s policy, you may need to call the switchboard or person in charge. If this is the case, ask the person to whom you are talking to repeat back to you the exact location of the fire and any other important information. Don’t hang up until the other person has the facts right.
Confine the Fire Once the residents have been rescued from the immediate fire danger, close the door to the room where the fire is located. Staff should never re-open the door to the fire room. Only the fire department should do this. If there is a fire in your facility, take steps to try to confine the fire to keep it from spreading. The fire doors will close automatically when the alarm is sounded. These doors help keep fire and smoke from spreading. Always keep these doorways clear so they can close. Never prop fire doors open or seat residents in the pathway of the doors. You will also need to clear all corridors to allow access for the fire department and for yourself and your coworkers in case evacuation is necessary. Remove all carts, equipment, and so forth from the hallways. You can also help confine the fire and smoke by closing all doors and windows in your area.
Extinguish if the Fire is Small Only try to extinguish the fire if it is small and contained, and you know how to use a fire extinguisher. If the fire is in a trashcan or ashtray, smother the fire with a pillow, towel, rug, or blanket. Without oxygen, the fire will die out.
If a resident’s clothes are on fire, place a blanket, sheet, or something similar on the resident’s upper chest, hold it tightly in place from one shoulder to the other shoulder with your arm and drop it onto the flames. This will protect the resident’s airway from smoke and flames while smothering the fire. Quickly “sweep” out any remaining flames with the sheet or blanket still in place. Without oxygen, even a thin sheet can extinguish these fires. If you catch on fire, you should do the following: • STOP where you are • DROP to the floor • ROLL around on the floor You can also use a fire extinguisher to put out a small fire if you have been trained in how to use one. DO NOT use a fire extinguisher if any of the following are true: • The door to the fire area has already been closed • The fire alarm has not been sounded • The fire is spreading • You are not sure that you can put out the fire • You feel uncomfortable using a fire extinguisher • You are fearful of what may be burning • You do not have an escape route There are many different types of fire extinguishers. Each is used for a different type of fire. Most facilities have either type ABC or type K portable fire extinguishers. It is important that you know where the fire extinguishers are in your facility and what types of fire extinguishers they are. Extinguishers marked ABC may be used on most types of fires that happen in a facility. Type K fire extinguishers should only be used in kitchens for fires involving commercial cooking appliances with vegetable oils, animal oils, or fats at high temperatures. Do you know where the nearest fire extinguisher is located in the area where you frequently work? Can you identify what type of extinguisher it is and what type of fire you could use it for?
If you need to use a fire extinguisher, remember PASS
Pull the pin between the two handles. Aim the nozzle at the base or source of the fire. Squeeze the handles together. Sweep the extinguisher from side to side. After putting out a small fire, be sure to do the following: • Watch the fire to ensure that it does not flare up • Be ready to repeat whatever procedure you used should the fire flare up • Have the fire department inspect the scene • Have the fire extinguisher (if used) replaced or recharged
If a fire can’t be extinguished, you may have to evacuate.
Otherwise, Evacuate You should start by moving residents out of their rooms, away from the fire, through the next set of fire doors, and into a safe area on the same floor. This is called a “horizontal” evacuation. Evacuate residents who can walk on their own or with little help first. This will give you more time to evacuate the other residents. If possible, bring the resident’s card file or chart, because it contains important information you may need later. Follow your facility’s system for tagging the rooms already evacuated. If you can’t move to a safe area on the same floor, work your way down to a lower level. This is called a “vertical” evacuation. Never use the elevators! A sudden loss of electricity could leave you trapped in the elevator. At the safe area, keep your group together. Make sure you can account for all residents and visitors in your area. You and members of your group should NEVER go back into a burning building and should remain in the safe area until you are told otherwise.
