Fire safety and emergency evacuation guidelines for intensive care units and operating theatres: for use in the event of fire, flood, power cut, oxygen supply failure, noxious gas, structural collapse or other critical incidents

Abstract

Summary The need to evacuate an ICU or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: Not only is there a risk that patients may come to harm but also that staff may be injured and unable to work. Designing newly‐built or refurbished ICUs and operating theatre suites is an opportunity to incorporate mandatory fire safety features and improve the management and outcomes of such emergencies: These include well‐marked manual fire call points and oxygen shut off valves (area valve service units); the ability to isolate individual zones; multiple clear exit routes; small bays or side rooms; preference for ground floor ICU location and interconnecting routes with operating theatres; separate clinical and non‐clinical areas. ICUs and operating theatre suites should have a bespoke emergency evacuation plan and route map that is readily available. Staff should receive practical fire and evacuation training in their clinical area of work on induction and annually as part of mandatory training, including ‘walk‐through practice’ or simulation training and location of manual fire call points and fire extinguishers, evacuation routes and location and operation of area valve service units. The staff member in charge of each shift should be able to select and operate fire extinguishers and lead an evacuation. Following an emergency evacuation, a network‐wide response should be activated, including retrieval and transport of patients to other ICUs if needed. A full investigation should take place and ongoing support and follow‐up of staff provided.

Hospitals’ Evacuation Preparedness; A Survey Among 42 Thai Hospitals According to the Flexible Surge Capacity Concept.

“…As described in other studies, training, practical exercises, and simulation training enhance the disaster response [41][42][43] . Most of the respondents in this study con rmed the invaluable impacts of disaster simulation rehearsal, including re evacuation, at least once a year.…”

Assessing Thai Hospitals’ Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool

“…In summary, the findings of this study accentuated the shortcomings of hospital evacuation preparedness in terms of comprehensive surge planning including staff, stuff, and structure capacities and capabilities to create effective systems, seamless multiagency collaboration, and opportunities for community engagement. Previous studies have demonstrated the value of realistic and practical exercises and training in improving disaster responses (Sammut et al 2001 ; Berlin and Carlström 2015 ; Khorram-Manesh et al 2015 ; Kelly et al 2021 ). Moreover, they facilitate the identification of contingency plan gaps and potential technical and strategic challenges.…”

Nitrous oxide cracking technology in the labour ward to reduce occupational exposure and environmental emissions

“…Similar systems can be used to remove anaesthetic gases from hospital effluent, and working systems have already been installed in some hospitals [5]. Alternative approaches are also available; if retrofitting a hospital's waste gas scavenging system is not practical, the anaesthetic gas can be captured using canisters of activated carbon and recovered at a central facility.…”