Saturday, January 26, 2008

Smoke and fire

Smoke in the corridor – visibility was, maybe, 25 yards. There were patients in there!

That is my memory from perhaps 15 years ago when an elevator motor fire caused smoke on a patient floor. It was a brief episode, readily addressed by Community General Hospital's Fire Brigade. No one was hurt. No one had to be moved.

But I still remember the momentary panic in my stomach as I saw smoke in the corridor.

Yesterday Community had two fire alarms, one right after the other. The first was a fire drill about 10:30 a.m. The second alarm, coming just minutes later, was triggered when someone, smelling an odor, pulled the fire box. Coming after one another, the alarms caused uncertainty – just as there would be in a real emergency.

It’s because of the potential for confusion and uncertainty that Community has procedures for all to follow during an alarm. One of the first procedures is to close all doors and stay where you are. When I was new to the hospital, that rule seemed counterintuitive to me – shouldn’t we open the doors and get out?

No.

Hospitals are constructed in compartments that can withstand a fire for a matter of hours. That means, if it was the real thing, the fire itself could be contained in a single area, allowing time to get patients (and ourselves) to safety in an orderly way.

But if the integrity of a compartment is broken, fire or smoke can spread, dangerously shortening the time and ability we have to get patients out of harm’s way. That is why following procedures during a fire alarm is so important.

Yesterday, one of the fire alarm monitors told me she was distressed to find an employee, and later, a visitor trying to walk down a corridor during the alarm, despite the monitor’s request to please stay put. That is dangerous. People traffic has to stop during a fire alarm. The air system shuts down. Doors have to remain closed. The integrity of compartments must be maintained.

That is the reason we have drills – to practice how to behave in a real emergency, as if from habit. A drill has to be treated as the real thing, every single time, because our behavior during a fire alarm is the best protection we have for patients, for coworkers, and for ourselves.

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