Multi-Company Training: Health Care Occupancies - Part I

One of the most dreaded alarms to be broadcast over our radio is the one involving a health care occupancy.

One of the most dreaded alarms to be broadcast over our radio is the one involving a health care occupancy. For this article we will focus upon hospitals or medical centers as they are more commonly referred; and the overwhelming need to train on-site at these facilities. Even though many of these facilities are now protected by an automatic sprinkler system, there remain a large number of facilities that do not have sprinkler protection.

Hopefully your community medical center has a well-maintained automatic sprinkler system. Even so, it remains essential for firefighters to go there and train because smoke, even from a small fire contained by an automatic sprinkler system, will present critical challenges due to the health conditions of the patients. The purpose for such training is obvious, so let's list the more critical reasons:

Reasons for Training:

- There are patients who are incapacitated and unable to exit the occupancy without assistance.

- There is not enough medical staff to assist with moving patients into a place of refuge, or if necessary, out of the building. Here, you might be surprised to learn the staff-to-patient ratio, especially from 11 P.M. to 7 A.M. Plan on having firefighters participating in evacuation activities.

- Should there be smoke in patient rooms or in the hallways, firefighters equipped with full protective clothing and SCBA's will be required to perform the evacuation.

This list could become quite extensive; bottom line is rescue and evacuation!

Pre-Incident Planning:

- Firefighters should have a Pre-Incident Plan for such occupancies, to include:

- A diagram of the occupancy illustrating the floor plan

- The diagram should include stairwells, especially those having stand pipes

- Number of elevators and their location. Elevators in safe area's may be utilized to evacuate patients from upper floors

- The location of the main entrances to be utilized by firefighters

- The Pre-Incident Plan should conform with the hospital's emergency plan

- A pre-determined location to establish a command post is essential

- The ability to communicate is essential! Test your radio's in different sections of the building: multiple floors, stairwells, basement, etc.

- The fire protection features should be identified, i.e. Fire Department Connection

- All firefighters should be familiar with the over-all plan, and be familiar with the building. This may be accomplished by conducting tours of the occupancy.

- The Pre-Incident Plan should be carried on all apparatus

- The Pre-Incident Plan should identify the total number of beds available for patient care, as well as identifying the special care wards which will require particular attention, such as: cardiac care, intensive care, pediatrics, nursery, dialysis, pulmonary, cancer, mental, etc. Identify the number of beds available for patient care in each individual ward as a break down of the total number of available beds, and establish the Pre-Incident Plan toward total occupancy.

- Once the Pre-Incident Plan has been established, and firefighters completed familiarization tours, its time to test the plan by conducting drills. It is important that the drill include the medical staff performing the tasks they would perform in an actual event as well as for all emergency responders.

Identify Critical Agencies:

- In addition to the firefighters and medical staff, identify the other agencies who's services would be required to assist at an actual incident:

- Communications Center: In conducting this type of drill, utilize the radio channels which will be used in an actual event. This should include having a medical staff person activating the alarm at the hospital. While another member calls 911 with vital information, then the 911 operator dispatching the call over the radio. (Note: Track the sequence of the receipt of the alarm from the facility, being certain that the correct location in the building was identified. The time in which the alarm is activated and routed to the communication center is critical)

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