Hospital treatment

THE HOSPITAL environment is one in which many of the in-patients are not capable of looking after themselves due to severe injury or debilitating ill-health. That being so, they’re highly dependent upon dedicated hospital staff for everything, not just under normal circumstances, but also during an emergent situation such as an outbreak of fire.

Late last year, firefighters from the London Fire Brigade had to bravely battle a blaze at the School of Dentistry. Located at Denmark Hill, the School is part of King’s College Hospital. Fire broke out on the afternoon of Tuesday 8 December. Four fire engines and 25 firefighters addressed the flames which emanated from an area of ducting at the roof of the building and realised thick plumes of smoke. Necessarily, the building had to be evacuated. Due to the necessary observance of emergency protocols, all patients and staff evacuated safely and, thankfully, there were no injuries reported.

There are circa 1,257 hospitals across the UK. The majority are, of course, owned and managed by the National Health Service, while others reside in the private sector. A fire at such an institution could prove to be extremely hazardous and create a serious risk to patients’ safety, not to mention their lives. That being the case, hospital safety management teams must have thorough plans and systems in place should the worst happen.

Holistic view

What, then, comprises an ideal fire safety plan for a hospital premises? The first point to note is that such a plan must adopt an holistic view of fire safety. It entails employing safety practices that help in preventing fire in the first place and adopting the use of early detection technologies.

The initial risk assessment begins with a thorough study of the possible risks posed to the hospital’s occupants (members of staff and patients alike), its structure, available resources and continuity of operations. There are a number of assessment methodologies designed for understanding the potential threats, identifying the assets to be protected and how best to mitigate risk.

Design teams often adopt a multi-disciplinary approach to hazard assessments, looking at potential scenarios such as power failures, cyber attack, civil disorder and, of course, fire. Ultimately, the risk assessment will shine a light on how hospital buildings should be safely managed and operated.

Of course, the sheer scale and complexity of modern hospitals almost inevitably means that the risk of fire cannot be entirely avoided. As alluded to earlier, what’s of critical importance here is that fire is detected quickly, contained and then dealt with to a satisfactory conclusion.

Hospital buildings can undergo amendment over time. There could be an addition to or the modification of an existing area, or even a change of use. Conducting a regular fire risk assessment ensures that these changes are brought under the purview of compliance, thereby leaving no ‘blind spot’ when it comes to overall building safety. These assessments should consider serviceable fire safety equipment and, in so doing, help to prevent complacency creeping in.

BS 5839 compliance

Fire alarms in large, complex buildings like hospitals can be prone to faults. Ensuring that alarms and fire detection system are fully functional and compliant with BS 5839 Fire Detection and Fire Alarm Systems for Buildings ensures a timely alert for any untoward incidents that may occur and minimises any false alarm that might cause disruption and undue panic.

The issue of false alarms is serious. It’s estimated that the UK’s economy loses around £1 billion per annum due to false calls, with almost half of calls to the Fire and Rescue Service being false alarms from fire detection and fire alarm systems.

In the unfortunate event of a fire, emergency lighting will – quite literally – be the guiding light to a place of sanctuary for building occupants, delivering a safe means of egress.

In tandem, maintaining the hospital’s utilities minimises the risk of component failure. A defined schedule for testing and maintaining the Uninterruptible Power Supply (UPS) will ensure back-up power is available on demand with no risk of failure should the need arise. The UPS and back-up generators are influential in delivering vital emergency power supplies to the life-supporting systems serving the building. Should a fire break out in a critical location, this could be life threatening for those in areas of the hospital that are not maintained and operable in times of need if there are power outages.

As mentioned, meticulously planned and well-practised evacuation drills are crucial for all individual wards and departments. Practice means that every member of staff is prepared and trained to remain calm in the event of an emergency like a fire. Dedicated fire wardens and marshal roles must be assigned to shift and department managers.

To orchestrate successful evacuation plans requires sound management and direction. Appointing departmental situation leaders will ensure that plans are adhered to and a successful evacuation proceeds as practised. Understanding which fire extinguishers to use in what scenario is also vitally important when it comes to tackling a fire at the earliest possible opportunity.

Knowing who your trained specialists are and determining their level of competence is key to evaluating the team’s strengths. By not maintaining the correct records, assumptions and complacency can set in which might lead to failures and misfortune when the time of need arises. Determine to ensure that all fire extinguishers are installed, serviced and maintained to BS 5306 Fire Protection Installations and Equipment on Premises.

Take care of housekeeping

Maintaining a clean premises reduces the risk of fire. The accumulation of dust in ducts and ventilation shafts, for example, can serve as tinder for a fire. Dry bearings from an extract fan, rogue embers from a furnace or sparks from a malfunctioning electrical component are all it would take to create a deep-seated invisible fire. 

Good housekeeping also inhibits the initial kindling of fire. Carelessly stored materials might act as the ‘fuel’ for an initial spark and help the fire to grow and spread. Ensuring no build-up of rubbish in refuse areas and eliminating dust concentrations in areas such as plant rooms will help in preventing the spread of fire. For their part, emergency exits must not be blocked or impeded.

Separating and isolating smoking shelters and areas some way away from the main hospital buildings removes the opportunity for smoking paraphernalia to pose any fire risk caused by hot embers falling on rubbish or the advent of venting gases.

Fire protection services such as dry/wet risers and solutions like sprinklers must be maintained to high standards by certified and competent companies. Sprinkler systems are a key line of defence against an established fire, with dry or wet risers designed to BS 9990 assist firefighters in tackling blazes. If not maintained, the repercussions could lead to dire consequences.

High risk catering areas such as cafeterias and kitchens need to be protected with localised automatic fire protection. The installation of an insurance-approved kitchen fire suppression system certified to, for example, FM/UL approvals and the Loss Prevention Certification Board’s (LPCB) LPS 1223 will ensure constant protection on a 24/7 basis.

Information hubs 

Critical information hubs, electrical control panels and server rooms must be protected with dedicated automatic fire protection solutions. The ‘nerve centre’ of any hospital is its data network and the expanse of electrical components and systems. Constant use, modification and upgrades can fatigue components pretty quickly. Installing LPS 1666-compliant, LPCB-certified systems will ensure that the building is protected from rapid fire spread, while also mitigating any damage to local equipment.

Below-ground parking areas must be well ventilated and any electric parking slots and stations protected with automatic firefighting equipment. With an incremental rise in electric vehicles, the requirement to provide charging points for them in dedicated, clustered locations poses a potential fire risk. Should the unthinkable happen, and a battery cell experiences a failure while within the confines of an underground car park, the result could be devastating. Early detection and rapid fire suppression may not be sufficient to fully extinguish the blaze in the first instance, but would certainly reduce the chances of a fire spreading to nearby vehicles.

Building integrity has to be maintained by the use of intumescent seals and passive fire protection measures. Building services must often be run through existing walls, floors and ceilings. That deteriorates the integrity of any natural fire mitigation provided by the building materials. To maintain these engineered fire breaks, any void or penetration created must be adequately protected with sufficient fire stopping solutions. Fire doors must be kept closed and automatic closing doors fitted with fire door retainers to prevent misuse and immobilisation.

Larger internal areas such as reception spaces with their high football may be a challenge to protect, but this task can be accomplished efficiently through the use of a well-designed BS 8524 certified fire curtain designed to prevent fire spread and protect escape routes.

Smoke ventilation systems

Any established fire will produce a significant quantity of smoke. With between 50% and 80% of fire-related deaths resulting from smoke inhalation, the reduction and safe removal of that smoke from inside a burning premises is paramount. Installing a CE EN 12101-2 smoke, heat and exhaust ventilation system is a legal requirement for any large building or public enclosed space.

Many hospitals are constructed over multiple levels with complex corridor layouts. Exit routes may not always be immediately obvious. It follows that the application and location of clear and visible safety signage is vitally important for maintaining a safe fire evacuation plan. BS 5499-compliant signs are readily available from fire safety equipment suppliers.

Since the first COVID-related lockdown in the UK, there has been much speculation over hospital capacity. Last year, there was an average of 127,708 hospital beds available per night across Britain’s healthcare estate. In short, one hospital bed for every 430 Britons, which represents 47% fewer beds when compared to 20 years previously. Given that the number of critical care patients has increased exponentially, it’s all the more important that any fire episode should not disrupt what is an already stretched healthcare system.

Chris Dixon is Technical and Sales Manager for Fire Suppression Solutions at Ceasefire Industries UK Ltd (www.ceasefire.co.uk)