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Fire is a serious threat to any healthcare facility. Many clients have special needs that make them especially vulnerable in a fire emergency, thus increasing the risk of fire casualties. Health care staff must make every effort to prevent fires from starting and be prepared to respond if a fire breaks out.


Fire Hazards

The most common cause of fire in health care facilities is smoking materials. All staff should know the smoking rules and be ready to enforce them if smoking is permitted in or around your facility.

  • Large, deep, non-tip ashtrays should be used if smoking is allowed. Ashtrays should be emptied often into metal containers.
  • Smoking should never be allowed where oxygen is in use or is stored.

Another major fire hazard is faulty or improperly used equipment. All equipment should be checked on a routine schedule. Be especially attentive to the following equipment hazards:

  • Cracked or split cords or plugs on electrical equipment. Overloaded extension cords or cords placed where they may be stepped on.
  • Dirty or greasy kitchen equipment.
  • Full laundry lint screens.
  • Any indicated malfunction of an oxygen machine or gas compressor.
  • Watch for overloaded outlets.
  • Keep flammable materials from ignition sources.
  • Ensure kitchen items like coffee makers are unplugged when not in use
  • Look for faulty electrics such as worn-down cords or light bulbs with a wattage too high for the fixtures.
  • Be on the lookout for forgotten space heaters or materials too close to space heaters.
  • Change batteries in fire alarms regularly.


Hazards with the Health Care Location

Health care facility fires and other disasters are especially dangerous because workers must protect patients while, at the same time, caring for themselves. Approximately one-third of hospital fires start with the careless use of matches and smoking products in inpatient rooms. Other fire causes include malfunctioning or misusing electrical equipment and using matches or other igniter products in an oxygen-enriched environment. The use of igniters in an oxygen-enriched environment should be prohibited, and this subject is covered in procedures and training material.

Inhaling toxic products is the primary cause of death in hospital fires. All employees should familiarize themselves with the location of fire alarms, fire extinguishers, exit signs, and oxygen cut-off valves, as well as fire and other emergency exits. All Fire/emergency exits must also remain open and clear of obstacles at all times.   There have been incidents of locked doors that trapped individuals inside burning buildings. Escape routes should be validated during all fire drills and inspections.


Fire Response


Immediately report all emergencies to the facility management, fire department, and police. A critical component of emergency preparedness is planning for the event before the actual emergency by reviewing and becoming familiar with hospital emergency planning, which may be summarized by the acronym RACER:

  • RESCUE any individual directly threatened by a fire. Patient safety is the primary consideration, so move patients in immediate danger away from smoke and flames. Place the patient in a nearby room behind a closed door.
  • ACTIVATE the alarm if you discover a fire or respond immediately to the alarm if you hear its sound. Fire safety in health care facilities—hospitals, nursing homes, clinics—presents a specialized response. Patients and families have trusted you with the safety of people who, in many cases, cannot help themselves.
  • CONFINE the fire by closing doors to slow the spread of smoke and flame. Close the doors of patients’ rooms. In general, residents are safer in a closed room than in a smoke-filled hallway.
  • EXTINGUISH the fire only if the fire is small and if you know how to operate a fire extinguisher. Be sure the area has been cleared and the fire department called.
  • RELOCATE yourself and the patients to a safe area out of harm’s way. Move visitors and others by your Fire Safety plan. Do NOT use elevators as a means of egress during a fire alarm activation or actual fire except as authorized by police or fire officials.

Once outside, management should take a roll call to ensure that all staff and patients are out of the building. If staff, patients, or others are unaccounted for, immediately notify a representative from the Fire and Police Departments that someone may still be in the building.

Do not re-enter the building until instructed to do so by a representative from one of the aforementioned agencies.

Elevator Entrapment

If you are trapped inside an elevator, activate the elevator emergency phone and notify the police and fire departments of the following:

  • Caller’s name;
  • Location (e.g., building, address, floor);
  • Elevator number and location;
  • Problem (e.g., stalled, stuck between floors, people trapped/number);
  • Any injuries, life-threatening situations, or additional information. Personal information of occupants, health/safety status, cell phone numbers, and physical parameters such as temperature, air quality, and the existence of either smoke or fire.

If you are outside an elevator and know someone is trapped inside, contact the department responsible for the building and/or fire and police.


Fire Safety Overview

Today most commercial structures such as hospitals and nursing homes are designed to be “fireproof” with fire-resistant glass, mattresses, and ductwork fireproofing materials, but preventing and containing fires remains a top priority throughout the healthcare industry for several reasons.:

  • Burning materials often release toxic vapors;
  • Many patients are physically unable to get out of harm’s way;
  • Timing and coordination are critical when lives are at stake.
  • All facilities are not created with these new fireproof technologies.

Consequently, fire safety focuses on practices intended to reduce the likelihood of a fire starting and to reduce the destruction caused by fire if one does occur.

Fire safety measures include those technologies mentioned above used in building construction and/or implemented in structures that are already standing or others that are found to be deficient in some manner (do not meet code).

Fire safety also includes occupants and support personnel training to protect themselves and others to ensure that the damage to people and structures is minimized, such as the RACER response just taught.

The third element of fire safety is to train staff to look for potential danger before a problem occurs. These were discussed in the hazard section.


Actions During An Emergency 

Smoke rises and is potentially deadly as it may contain toxic substances; consequently, when evacuating, stay below the smoke cloud when possible. Always sound the alarm with any suspicion of fire. Call the operator to report the fire and stay on the phone long enough to ensure they got the correct information.

Generally, hospital buildings are separated by fire doors that close automatically when a fire is reported to help contain smoke and fire; however, not all facilities are in traditional hospital-type buildings. It is critical to know your facility’s Fire Safety Plan. For small fires isolated to a patient’s room, it may be appropriate to attempt to extinguish them. If a patient’s clothes are on fire, remove the item. Wrap the patient tightly in a blanket to smother the flames. If electrical equipment catches fire, the power source should be disconnected. If the fire cannot be contained, follow your area’s evacuation procedure.

There are different classes of fire extinguishers for use on fires of different sources. Generally, extinguishers have a label that identifies the type of fire they should be used on.

Class A extinguishers attempt to put out fires by reducing the heat.

Class B extinguishers smother fires.

Class C extinguishers are used near electrical equipment.

Type ABC extinguishers are more flexible and may be used to fight all types of fires.


A typical fire extinguisher contains 10 seconds of extinguishing power. This could be less if it has already been partially discharged. Always read the instructions that come with the fire extinguisher beforehand and become familiar with its parts. Fire prevention experts highly recommend that you get hands-on training before operating a fire extinguisher. Most local fire departments offer this service.

Once the fire is out, don’t walk away! Watch the area for a few minutes in case it re-ignites. Recharge the extinguisher immediately after use.

Use this acronym as a quick reference (it is a good idea to print this reference and pin it next to your fire extinguisher):






Knowing and practicing fire safety and prevention is critical to your job. Safety and prevention should be your top priority. Performing meaningful fire and safety audits and inspections, drills, and training is primarily a company responsibility; however, it is your responsibility to support, participate and contribute to these tasks and incorporate them into your daily activities.

The responsibility for fire safety belongs to everyone.


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