Safety: 4 Common Firefighting Mistakes OR Staff Make

I've conducted more than 1,000 fire drills at surgery centers. OR staff make the same 4 mistakes when trying to extinguish a simulated fire. These simple errors can lead to serious injury or even loss of life for your patients and staff.

My fire drills are as realistic as they come. I use a $16,000 digital fire extinguisher training system to simulate fire conditions. We can display fires at varying levels of difficulty and intensity, with authentic sound, on a 24-inch LED monitor. When you pull the pin and lock to activate the laser-driven infrared dry chemical extinguisher, it emits a realistic-sounding discharge. You have to sweep the extinguisher slowly, or else the "fire" doesn't go out.

Because of the simulator's small size, I'm able to use it for every fire drill by placing it in utility rooms, patient care areas, administrative areas and break rooms. I'll position the simulator's extinguisher near the closest real extinguisher. Once all the parts are in place, I'll call the code and the drill begins. Invariably, I'll see these 4 mistakes:

1Failing to contain the fire area. I frequently place fires in rooms with doors that aren't equipped with self-closing hardware (break rooms, for example), or in rooms with a door that's held open by a door stop. It's in these rooms that the first mistake most often occurs: failing to contain the fire area by closing as many doors between the fire and life as possible.

Once the fire simulator is started, the staff member that spots the "flames" will go to the closest phone to call the code, then find the closest fire extinguisher and return to the room to attempt extinguishment. What did she forget? Confine? It's the third letter in the fire algorithm R.A.C.E. (rescue, alarm, contain, extinguish), but closing the door to the fire area is the first action you must take. By leaving the door open, you're not only letting the products of combustion spread throughout the facility, you're also giving the fire plenty of air to grow and spread.

Now, let's place the fire in a room with a door that's equipped with self-closing hardware and held open with a door stop. You can see the glow of the fire under the door and hear the crackle in the OR corridor. A nearby staff member turning over a room in preparation for the next case sees the fire, kicks out the door stop, goes to the nearest phone, calls the code, then retrieves the nearest extinguisher and heads back to the fire room. Upon her return, she swings the door open and enters while the door behind her closes. As you'll see, this is a huge problem that will yield very serious consequences.

2Never enter a fire area before checking the door for heat. Doors in most healthcare occupancies are built of 1 ?-inch solid bonded wood core construction. These doors hold a tremendous amount of heat and smoke, but you wouldn't know the conditions that lurk within from the exterior.

A sure way to check a door for heat is by using the back of your hand on the door knob. Door hardware is made of metal, which is an excellent conductor of heat. Don't rush and grab the door knob in haste. If it's hot, you may feel the heat radiating from the metal before your skin makes contact, avoiding the possibility of a burn.

Another effective way to check a door for heat is to place the back of your hand low on the door surface, running it up toward the top. This will keep your hand safe as the heat gradually increases when your hand gets higher on the door surface. Remember, if the door is hot, don't open it.

If you're able to enter the room to attempt extinguishment or rescue, open the door slowly, not only from a low position, but from the correct side of the door opening. For example, when the door is outward swinging (swings toward you), your body should be on the door side, using it as a shield from the smoke and heat. For doors that swing inward (away from you), position your body on the wall side, this time using the wall as a shield. A good rule-of-thumb: Never leave the safety of the door frame. Hook your foot on the frame and don't leave it until it's time to evacuate yourself.

3Before entering the fire area with an extinguisher, have it ready to use. When the human body is under panic-induced stress, 2 functions critical to operating a fire extinguisher start to fail: fine motor skills and peripheral vision. Check the door for heat, have the extinguisher ready before opening the door, position your body correctly, stay low and don't leave the door frame. As in fighting a real fire, you must sweep the laser extinguisher slowly or else the "fire" won't go out.

If your center doesn't have a facility-wide paging system, two-way radios are a good substitute. These radios must be assigned to specific areas and to specific people for the system to work effectively. And all staff, whether it be physicians, management, full-time, part-time or per diem, must know the locations of basic safety equipment: extinguishers, fire alarm pull boxes, exits, medical gas shut-offs and electric panels. OSM