Fire, Disaster, Security and Hazardous Materials

Fire Safety Protocols and Evacuation Procedures

When responding to a healthcare fire, memory aids structure every second of decision-making. The acronym RACE guides overall fire response: Rescue, Alarm, Confine, and Extinguish or Evacuate. The primary and immediate nursing action upon discovering a fire is rescuing clients in immediate danger. For example, if a wastebasket catches fire in an occupied room, the nurse immediately moves the client out into the hallway before pulling an alarm pull-station or attempting containment.

Confining a fire prevents smoke and toxic gases from spreading throughout the unit. This step includes closing doors and, when safe and appropriate, shutting off oxygen to the affected area without endangering other clients. If fighting an early-stage fire, the acronym PASS guides fire extinguisher operation: Pull the pin, Aim at the base, Squeeze the handle, and Sweep from side to side. When operating a fire extinguisher, aim the nozzle at the base of the fire rather than at the flames to direct the extinguishing agent at the burning fuel.

When evacuation becomes necessary, careful staging protects vulnerable individuals. After rescuing clients in immediate danger, staff follow the facility evacuation plan: ambulatory clients can generally move first, followed by clients needing wheelchairs, and finally those requiring bed transport. Evacuate horizontally to a safe compartment first when feasible; if vertical evacuation is necessary, use the designated stairways and direction specified by the facility fire plan. Do not use elevators during a fire unless their use is specifically authorized and controlled by the fire response team. If traversing a smoke-filled room or corridor, stay low to the floor, where there is generally less smoke and heat.