Hospital-fires are a growing hazard in the summer months as temperatures climb. This article presents an advisory issued by the Health Ministry and NDMA jointly, to prevent hospital-fires during the summer.

Hospital-fires

Hospital-fires might become a serious hazard in the wake of rising temperatures, according to a joint letter from the Health Secretary and member and head of department (HOD), NDMA, written to chief secretaries of all states and UT administrations.

To address this problem, all states and Union Territories (UTs) received a joint advisory from the National Disaster Management Authority (NDMA) and the Union Ministry of Health and Family Welfare on probable hospital-fire prevention during the summer.

Guidelines

1. A comprehensive set of guidelines detailing the steps hospitals must take to guarantee fire safety compliance was sent with the letter.
2. The instructions include fire safety exercises, staff training, and regular testing, maintenance, and inspection of fire safety equipment such as alarms, hydrants, and extinguishers.
3. The joint recommendation said that "all hospitals should also annually renew valid fire no objection certificates (NOCs) and other compliances from respective state fire departments."
4. Along with rigorous no-smoking guidelines, the advice ordered all hospitals to put controls on heat sources and oxygen tanks or piped oxygen in their locations.
5. To adhere to the most recent fire safety regulations specified in the National Building Code of 2016, hospitals must also routinely assess and upgrade their infrastructure.
6. The joint advice said that the integrity of healthcare institutions and patient safety should come first. It said that the UT and state authorities were advised to carry out follow-up evaluations and guarantee the rigorous application of these vital safety precautions.
7. Chief Secretaries of all States and UTs have also received a comprehensive set of instructions detailing the actions and procedures that hospitals must take to guarantee fire safety compliance, with the recommendation that they distribute the information to all recognised hospitals.

The following actions must be taken right away by all certified hospitals under the authority of state health departments and state disaster management authorities, and they must be coordinated closely:

1. Extensive inspections: To evaluate fire safety compliance, conduct thorough fire safety audits and on-site inspections at all hospitals. Verify the presence and proper operation of all fire-fighting equipment, such as fire hydrants, fire extinguishers, smoke detectors, fire alarms, and fire lifts.
2. Electrical load audits: Take care of the important problem of inadequate electrical load capability. Electrical load assessments are a must for hospitals regularly, especially when new equipment is added or existing areas are converted to ICUs. Any disparities that are found have to be fixed right away.
3. Fire NOC compliance: Hospitals are required to abide by regulations and receive valid fire No-Objection Certificates (NOCs) from the state fire departments where they are located. Give recalibrating electrical loads in older buildings, built before fire safety regulations were adopted on priority.

Guidelines to stop fire events

The guidelines that must be followed to stop fire events from happening in hospitals and other healthcare facilities are as follows:

1. Functional fire-fighting systems: Fire extinguishers, fire hydrants, and alarms must all undergo routine inspections by hospitals. This includes making sure fire alarms are activated and audible throughout the building, verifying the extinguisher expiration dates, and making sure hydrants are reachable and have sufficient water pressure.
2. Frequent testing and maintenance: Provide a timetable for all of the safety equipment in your area. Monthly testing of fire extinguishers, quarterly testing of fire alarms and hydrants, and yearly expert inspections to verify their efficacy in compliance with applicable Indian Standards should all be part of this.
3. Frequent audits of electrical loads: Every two years, conduct electrical audits to assess the hospital's power use, especially in areas with high demand, such as the intensive care units. According to the National Electrical Code of India-2023, upgrades or changes must be evaluated by a professional electrician to guarantee they fulfil safety requirements without overloading the system.
4. Oxygen safety: Adopt stringent no-smoking regulations and heat source limitations in places containing oxygen tanks or piped oxygen. These locations should be properly marked with signage, and employees should get training on the dangers of working in high-oxygen settings.
5. Installing smoke detectors and fire alarms: Make sure that every hospital space has smoke detectors and fire alarms installed, especially the patient rooms, corridors, and common spaces. As required by IS2189, test these systems monthly, and change the batteries every year or as needed.
6. Combustible material control: Examine building and furniture materials used in hospitals to find and swap out combustible components with non-combustible or fire-resistant ones, particularly in patient care areas.
7. Materials that are not combustible for electrical ducts: Verify that intumescent firestop sealants, which stop smoke and fire from spreading via apertures, are used to seal electrical ducts.
8. Refrain from overloading energy sources: To keep an eye on electrical loads and avoid overloading, use power management systems. Make sure no single circuit has more than one high-power gadget attached to it. Review power distribution often to ensure that new equipment is securely accommodated.
9. Installing hosepipes and water sprinklers: Install accessible hosepipes and automated sprinkler systems in crucial places, such as operating rooms and intensive care units. To be triggered in the case of a fire, these systems have to be connected in time with the fire alarm system.
10. Strict compliance with the National Construction Code: Ensure that hospital infrastructure is routinely reviewed and updated to meet the most recent fire safety requirements specified in the National Building Code of 2016. This entails making certain that stairwells and hallways have emergency lights, fire-resistant doors, and adequate ventilation systems.
11. Getting an NOC for fire safety: Renew the local fire department's fire safety NOC on an annual basis following state fire safety regulations. This entails presenting the most recent fire safety plans, as well as documentation of personnel training and equipment upkeep.
12. Staff drills and training: Provide all employees with ongoing instruction on fire safety, emergency protocols, and the use of firefighting apparatus. Hold biannual fire drills, which should include evacuation exercises, to make sure that patients, staff, and physicians are aware of how to The Chief Secretaries of all States and UTs have also received a comprehensive set of instructions detailing the actions and procedures that hospitals must take to guarantee fire safety compliance. The recommendations include encouraging the Chief Secretaries to distribute the information to all accredited hospitals.
13. Preparations for evacuation: Create thorough preparations for evacuation that include designated safe gathering sites, unobstructed emergency exits, and obvious, well-marked escape routes. Plans need to be publicly shown in staff training initiatives as well as across the institution. Every hospital is required to create a protocol that must be adhered to in the event of a fire.

Healthcare fire prevention protocol

• Functional fire-fighting systems
• Regular electrical load audits
• Regular maintenance and testing of safety equipment
• No smoking near oxygen tanks or piped oxygen
• Installation of smoke detectors and fire alarms
• Avoid overloading power sources
• Installation of water sprinklers and hosepipes
• Adherence to the National Building Code
• Obtaining a fire safety no-objection certificate
• Staff training and regular drills
• Comprehensive evacuation plans

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Monish Raut is a practising super specialist from New Delhi.