What to Do in a Fire: Borrowing a Page from a Safety Manual

Each page of your safety manual should contain key points for the end user. For example, the page about "Code Red, Your Role in a Fire" should break down each employee's role.

TEAM MEMBER FINDING FIRE
1. Rescue and remove patients in immediate danger. Account for all patients. If a move is necessary, go to other side of a firewall.
2. Pull a fire alarm or call the emergency desk (use phone emergency button), announce "CODE RED" and location of fire.

TEAM MEMBER AT THE EMERGENCY DESK
1. Answer phone immediately, "Emergency desk."
2. Overhead page "CODE RED" and location 3 times in a row.
3. Call 911
4. Continue announcing "CODE RED" or any change in emergency.

TEAM MEMBERS RESPONDING TO THE FIRE PANEL
1. Immediately go to the closest fire panel.
2. Acknowledge/read fire panel and silence alarm only.
*** DO NOT RESET PANEL UNTIL VIEWED BY MAINTENANCE
3. Relay the information to the emergency desk.
4. Go to the main entrance and direct the fire department.

TEAM MEMBERS IN A NON-AFFECTED AREA
1. Close all doors and windows. If not giving patient care, turn off equipment. If performing procedure, complete procedure and then turn off equipment.
2. Designated individual(s) should take fire extinguisher to fire location to assist as needed. Always remain between any fire and an exit as an escape route. Do not enter any area of personal jeopardy.
3. Wait for further instructions on overhead page.
4. Assist affected department with any patient evacuation as needed.

TEAM MEMBERS IN CONTROL OF LOBBY
1. Assess location and number of people in the lobby.
2. Communicate and keep calm order.
3. Don't allow use of elevators until fire location is identified.
4. Have plans in place and prepare to evacuate the lobby upon the directive of the fire department.

TEAM MEMBERS WITH PATIENTS RECEIVING OXYGEN
1. RN to stand by with bag-mask-valve constantly with any patient on assisted ventilation until the "CODE RED ALL CLEAR" is announced. The physician will determine alternative methods for patients receiving other medical gases.
2. Turn off any O2 on patients who can do without.
3. Wait for further instructions on the overhead page.

- Nancy Burden, MS, RN, CPAN, CAPA

Example of a Safety Manual Outline

TAB 1 ORGANIZATIONAL INFORMATION
  -  Key Telephone Numbers
  -  Organization Chart & Telephone Tree

TAB 2 EMERGENCIES
  -  Alerts
  -  Bomb Threat & Room Checklist
  -  Code Blue - When to Call
  -  Code Blue
  -  Code Cart Inventory Adult & Pediatrics
  -  Communications Plan ? site-specific
  -  Emergency Medications
  -  Evacuation Process
  -  Fire Plan Code Red
  -  Fire - Your Role
  -  Fire Walls - Locations
  -  Infant Abduction - RAVE
  -  Rescue Carrying Methods
  -  Response Team & Domestic
  -  Severe Weather
  -  Utility Failure Plan

TAB 3 GENERAL SAFETY
  -  10 Outpatient Safety Tips
  -  Five Steps To Safer Health Care
  -  Kid Safe Environment & Checklist
  -  Medication Reaction Information Sheet
  -  Medication Use and Storage
  -  MRI Safety
  -  National Patient Safety Goals
  -  Patient Identification Talking Tips
  -  Prohibited Abbreviations
  -  Security and Safety
  -  Team Member Safety & Security

TAB 4 INFECTION CONTROL
  -  Blood Exposure
  -  Infection Control Plan
  -  Locations of PPE
  -  Standard Precautions
  -  TB Guidelines

TAB 5 HAZARDOUS AND BIOMEDICAL MATERIALS
  -  Biomedical Waste Plan
  -  Hazardous Material Management
  -  Hazardous Waste Explosion
  -  Hazardous Waste Roles
  -  Radiation Safety
  -  Spill Control
  -  Spill Equipment Locations

TAB 6 TEAM MEMBER HEALTH
  -  Proper Body Mechanics
  -  Eye Injury Treatment