Muhammad Akhtar

Technical Advisor/M.S

Saudi Aramco Medical Services Organization




Reliable choice of the health care facility for the patients and their families is based on their total trust not merely by looking through a pipe for the treatment only but also safety infrastructure made available for their life safeguard during their stay when most patents cannot help themselves due to their age or illness.

The key role of any of the healthcare facility is to save lives and restore good health with minimum discomfort possible offering to the patients and their loved ones during their stay in and no threat remains hidden after they leave the facility. Therefore, life safety measures made available in any of the healthcare facility must meet stringent codes and standards in practice of contemporary era with no compromise what so ever it may be in this regard.

Fire safety is one of the top listed item must maintain its position from conceptual design stage to building fully brought into functional and yet rest of the entire age of that facility.  Fire is mostly deadly scenario when it breaks and possibly can be brought under control if occupants are fully well versed of the facts of fire and have gone through training and maintained their rehearsal up to date. Every healthcare facility must have their written Fire Safety Management Program according to their available infrastructure, with the consent of their respective (AHJ) Authority Having Jurisdiction under the guidance of applicable codes and standards.    

There are following essential aspects of fire preventions must be considered during laying down of plan/program.

·        Facts about fire and how it starts.

·        Classifications of fire.

·        Types and use of fire extinguishers.

·        Initial fire response plan.

·        When not to fight a fire.

·        How to evacuate a burning building.

·        How to conduct fire drills.

·        Tips on fire prevention.

·        Fire safety shortcomings in hospitals.

·        How to lay down an action plan.

Fire is hot, everyone should be aware of that, spreads very fast and can kill some may not be able to visualize. It takes 2-3 minutes to go from a tiny flame to a raging, and turn’s all-consuming inferno. Produces intense heat that can sear lungs and fuses clothing to skin for further damage. Temperature varies from 90 degrees Fahrenheit (F) near the floor level to 600 degree F at eye level. Temperature at ceiling level can reach 1,000 to 1,300 deg. F.

Fire breaks in result of a chemical chain reaction called combustion involving rapid oxidation or burning of fuel.

Fire needs four elements to occurs, fuel, oxygen, heat and chemical reaction. First three elements when become in correct proportional, chemical reaction takes place and fire breaks.

Fire = Self-Sustained Chemical Reaction      

When correct mixture of fuel, heat and oxygen is present, the fire starts. Heat released from the fire causes additional vaporization which accelerates ignition. This creates a self-sustaining of fire.

FUEL= any substances such as wood, paper, cloth, rubber, oil and grease etc, capable of releasing energy via combustion.

HEAT= Creates flammable vapors & gases from solid and liquid fuels, ignites vapors and gases into flames.

OXYGEN= An oxidizing agent, present in air 21%, reacts with a fuel when there is enough heat present further promotes fire if remain present 21%.


Temperature reduction by eliminating heat sources reduces flammable vapor and gases, thus puts off the fire.

By reducing level of oxygen from 21% to less than 14% that is smothering by covering a fire with a lid or with a moist towel if in a kitchen, cover fire with a fire blanket if available or sand could be very handy if available nearby. This action will put off fire.

Removing fuel, this is stopping the flow of liquid or gas fuel or by removing if solid fuel is in the path of progressing fire can eliminate it.

Extra care must be taken when electricity become part of the fire. Safe switching off of electricity would be very essential. You being a judge of that time will guide you to decide which switch has to be put off, local, branch or main.      

Inhibiting of chemical chain reaction that is by interfering with the process of heat generation and fuel to vapor conversion, fire cannot continue from burning.

Fire has four stages before flashover occurs, 1) incipient (initial) stage, when no visible smoke or flames available but significant amount of combustion particles has generated.

2) Smoldering stage, point where combustion particles become visible by smoke.

3) Flame stage is when ignition occurs and flames develop. 4) The level of visible smoke decreases and the level of heat increases then heat stage starts, extreme heat, flames, smoke and toxic gases are produced. This stage usually develops very quickly almost within seconds.


The flashover occurs when hot gases and room contents ignites simultaneously and usually sound comes like a blast.


The following picture is showing some level of flashover at the time it occurs.


How long it takes from stage # 1 to flashover is less than 2-3 minutes. Therefore every staff member of healthcare facility must learn the ways and means available within jurisdiction of the facility that how to safe guard the occurrence of fire and survival of lives, God forbid if it occurs.

There are five classes of fire and their respective Fire Extinguishers available.  Class “A” fire is from ordinary combustible such as fibrous materials, wood, paper, cloth, rubber and plastic etc. If this kind of fire occurs can be extinguish by cooling with water filled fire extinguish, usually available in stainless steel color.

Class”B” fire is from flammable combustible liquid such as gasoline, oil, grease, paint, paint thinners, alcohol and propane etc. This nature of fire can be extinguished by class B fire extinguisher which is filled with carbon dioxide (CO2).

This type of fire extinguisher can be distinguished from their horn type nozzle and color red.

Class “C” fire is classified when energized electrical equipment or any other electrical device catches fire. This type of fire can be extinguished with same as of class B fire or fire extinguisher filled with dry chemical. Preferably if possible switch off electricity before attempting extinguisher fire.

Class “D” fire usually can occur in metal industry, some metal such as Magnesium, Titanium; Potassium etc can catch fire easily. In order to put off fire of this nature is possible by specially designed fire extinguisher filled with special dry chemical. The fire extinguisher can be recognized by its color yellow.

In most cases, the chemical absorbs heat from the metal itself, cooling it down below the ignition temperature.

Class “K” fires which occur in Kitchen. This new classification from NFPA-10, (National Fire Protection Association standard 10) brought up due to improved cooking appliances, higher heating rate and using unsaturated oils,

These fire extinguishers extinguish flammable combustible liquids, such as greases or gases by removing oxygen, preventing vapors from reaching the ignition source or

inhibiting chemical chain reaction. 

This type of Fire Extinguisher extinguish flammable combustible liquids, greases or gases by removing oxygen, preventing vapors from reaching the ignition source or inhibiting chemical chain reaction. These are filled with special wet chemical as an extinguishing agent.

 There is one more type of Fire Extinguisher, specially designed to be used in MRI area. Since there is strong magnetic field, this Fire Extinguish is made from non Ferris metal (not attractive to magnetic field). This type is good for extinguishing all three classes of fires A, B& C.


Remember the acronym PASS

Pull the safety pin

Aim the nozzle at the base of the Fire

Squeeze the handle

Sweep nozzle from side to side

All types of Fire Extinguishers have safety pin, which need to be pulled out before handle can be squeezed for water, liquid or dry chemical to come out from Fire Extinguisher. Before squeezing the handle, aim the nozzle at the base of the fire. Keeping the nozzle at the base of the fire will extinguish fire faster. Sweep nozzle from side to side during squeeze of the handle. This way whole area under fire shall be covered by extinguishing agent quickly and swiftly and fire would be put off faster. This line of action is good for small nature of fires.


·        If your escape route is not secure….

·        If the fire extinguisher runs out of agent….

·        If the extinguisher proves to be ineffective, and if 

·        You are unable to safely fight the fire

Then, leave the area immediately

As, there is a saying that practice makes a man perfect, rehearsal is very important. Practice, practice and practice for first initial response to a fire. Know your place in relation to safety. Practice for your appropriate reflexes in case of emergency. Panic creates more disaster than from actual event. Therefore respective trainings and periodic rehearsal can compensate several weaknesses.       

After dialing emergency number, the average response time of the Fire Truck is more than 3 minutes most of the time. What does it tell us? You are on your own in the initial stages of the fire. Therefore, everyone in Healthcare Facility must learn how to fight a fire at their initial stages and keep practice up to date.

Make your Fire Response Plan, implement and keep practice up to date.

Time is clicking and passing, reminding you at every second to act before it may be too late.

The lives of patients, visitors, and staff, including your own could depend on your response during the first three minutes after a fire breaks out.

Tips on Fire Prevention

·     Never smoke in prohibited areas

·     Never place portable heaters close to combustible materials.

·     Avoid static electricity when dealing with flammable gases/liquids.

·     Practice the safe use of electrical equipment & devices.

·     Don’t allow devices that produce sparks (including motor-driven toys or appliances) in in-patient areas where oxygen is in use.

·     Store medical compressed gases securely away from patients; cap and chain the cylinders when they are not in use.

·     Inspect all fire-fighting equipment on monthly bases.

·     Report all fire incidences to designated authorities and conduct root cause analysis to prevent future re-occurrences.

Usual Fire Safety shortcoming in Hospitals

·        Fire exits are locked or obstructed.

·        Fire doors are not identified and not marked with their respective ratings.

·        Patients call bells are not operational.

·        No fire exit plans are made available or out dated if available.

·        Fire exit plans are installed at wrong locations.

·        No fire drills are carried out and no fire safety training available.

·        No Inspection and testing of fire detection, fire confinement, fire prevention and fire suppression systems are being conducted.

·        No training on the use of fire extinguishers is available.

·        Mountings of the fire extinguishers are not appropriate.

·        Electrical closets are used for storage.

·        Materials are stored under stairs/fire exit.

·        Compressed gas cylinders are unsecured.

·        Accumulation of combustible materials is excessive in maintenance shops.

Lay down your own action plan for fire safety and act upon without further delay.


·        Patients and their families have trusted your healthcare facility with the safety of those who, in many cases, cannot help themselves.

·        Every staff member of each healthcare facility is responsible for ensuring the safety of patients, staff and visitors.


Work hard and be safe