Fire Evacuations in the Procedural Areas
Accreditation Monthly
August 5, 2010
When I ask about fire evacuations in procedural areas such as the cardiac cath lab, PACU, same-day surgery, and operating areas, it is disturbing as a consultant to hear that some of these areas don't take part in fire drills because they are in the "middle of cases" when the practices occur. The next question that I ask is, "Where would you evacuate patients in the event of a fire in this area?" Surprisingly, some staff ponder the question or start a discussion with colleagues about the process, which doesn't give me confidence that patients would be evacuated efficiently and effectively in the event of a fire.
The requirement in the Life Safety Code is that everyone who has a role in the fire response plan will be drilled periodically, with that drilling to include relocation of patients (either through simulation or through the use of empty wheelchairs, stretchers, etc.) to adjacent smoke compartments. Additionally, consider The Joint Commission's position: Although the National Patient Safety Goal on surgical fires applies to ambulatory surgery environments, the original Sentinel Event Alert includes all areas in which surgical fire is a risk.
Although they can be disruptive, schedule practice evacuations on slower days or times to conduct drills in these locations if you are already not doing so. Some facilities practice moving actual patients to the designated area; this takes a lot of coordination, but in the event of a fire, they should have the process down pat. These simulations can affect your response in life-or-death situations. Consider posting an evacuation map in the area that staff can reference. The bottom line is to make sure you can verify that each patient care area knows where to evacuate patients in an emergency, including a fire.
Steve MacArthur
Senior Consultant
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