The potential for fire in a hospital setting can occur from many different sources such as heat-producing equipment, storage of flammable chemicals, and faulty electrical wiring.
There are several different types of equipment and materials that are major contributors to fires in hospitals.
The eight leading causes of hospital fires in the United States are shown in the chart on the right (these figures are based on data from the National Fire Protection Association).
Hospitals have a lot of electrical equipment and often have overworked sockets and cables. Power strips must be plugged directly into an outlet and NOT daisy-chained (linking power strips together).
Fires in kitchen facilities are common because of cooking fats, electrical ovens, toasters, and open flames.
While cigarettes are banned in healthcare facilities, people might sneak them indoors or, while smoking outdoors, don’t properly dispose of them.
Lasers and electrosurgical tools are an ignition hazard, especially near oxygen tanks, surgical clothing, and flammable sterilizing liquids.
Alcohol-based hand rubs are used all over hospitals. However, they are flammable and need to have a 6-foot distance between the sanitation station and any ignition sources.
Gas cylinders and medical oxygen need to be properly stored and secured.
Read the material in each section to find the correct answers to each of the questions. After answering all questions, click the "Check Quiz Answers" button to see your score and a list of missed questions. To correct a question, return to the question, review the material, change your answer, and return to the last section page. Click the "Check Quiz Answers" again to recheck the results.
Do not refresh these pages or you'll have to answer all questions again.
Note: Videos and exercises in our courses are for information only and not required to view. Final exam questions will not be derived from the videos. OSHAcademy is not responsible for video content.
Because of the need to have equipment plugged in, hospitals should not use extension cords to chain the equipment together. Extension cords are a violation, and they can become overheated, sparking a fire.
Hospital fire doors must close or latch correctly. Be sure they do not have holes in them, which would cause them to no longer be fireproof.
Carts, wheelchairs, and medical equipment must not block fire exit doors.
Employers must ensure portable fire extinguishers are in areas that are not obstructed, are properly mounted, and have not been previously discharged. Employers must also ensure that portable fire extinguishers are not past due inspection.
Class A: Fires that involve ordinary combustible materials such as wood, cloth, paper, rubber, and many plastics.
Class B: Fires that involve flammable liquids, combustible liquids, petroleum greases, tars, oils, oil-based paints, solvents, lacquers, alcohols, and flammable gases.
Class C: Fires that involve energized electrical equipment, such as power tools, wiring, fuse boxes, appliances, TVs, computers, and electrical motors.
Class D: Fires that involve combustible metals such as magnesium, potassium, titanium, zirconium, lithium, and sodium.
Class K: Fires that involve combustible cooking oils and fats used in commercial cooking equipment.
There are five different types or classes of fire extinguishers, each of which extinguishes specific types of fire. Newer fire extinguishers use a picture/labeling system to designate which types of fires they are to be used on. Older fire extinguishers are labeled with colored geometrical shapes with letter designations. Both of these types of labels are shown below with the description of the different classes of extinguishers.
Additionally, Class A and Class B fire extinguishers have a numerical rating which is based on tests conducted by Underwriter's Laboratories that are designed to determine the extinguishing potential for each size and type of extinguisher.
Fire sprinklers must be installed throughout a healthcare facility. These systems are installed following NFPA 13: Standard for Installation of Sprinkler Systems and are maintained according to NFPA 25: Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems.
NFPA 25 outlines the required inspection, testing, and maintenance (ITM) frequency and procedures. Major system components are required to be inspected quarterly, semi-annually, and annually. At each of these intervals, specific items must be maintained and tested. There are also weekly and monthly inspection requirements for items that must only be visually inspected—these components include gauges, valves, private hydrants, and fire pumps.
From 2009-2013, only 4% of fires went beyond the point of origin, thanks to the increase in fire sprinklers. Today, 79% of hospitals are protected by fire sprinklers, and it has greatly reduced the spread of fires and fire-related death in hospitals.
OSHA Fire Safety requirements include:
Every workplace must have enough exits suitably located to enable everyone to get out of the facility quickly.
Considerations include the following:
In addition, fire doors must not be blocked or locked when employees are inside. Delayed opening of fire doors, however, is permitted when an approved alarm system is integrated into the fire door design. Exit routes from buildings must be free of obstructions and properly marked with exit signs. See 29 CFR Part 1910.36 for details about all requirements.
Emergency and Fire Action Plans must be provided in accordance with 29 CFR 1910.38 when required by another OSHA standard.
When required, employers must develop emergency action plans that:
For more information about emergency action plans, see OSHAcademy course 717 Emergency Action Plans.
Time frames for evacuation may differ depending on the nature of the threat and the amount of time that can be taken to prepare for moving hospital patients. Specific types of evacuations are as follows:
Immediate: "Emergency move" – evacuate immediately or patients and staff may die; no time to prepare.
Rapid: Evacuate as quickly as possible; limited time to prepare (1 to 2 hours); follow procedures.
Gradual: No immediate danger; sufficient time to evacuate (sometimes hours to several days)
Prepare Only: Do not move patients, but you can start to prepare for evacuation.
There are three main ingredients that constitute a fire: heat, fuel, and oxygen. The image to the right referred to as the “fire triangle,” shows how these three components interact to create a fire.
Fuel is any combustible material that can be used as the source of ignition of the fire, as well as to keep it burning.
Oxygen is an oxidizing agent that reacts with the fuel to start and continue the fire. Lower concentrations of oxygen result in slower fuel combustion.
Heat: Fires require oxygen and fuel reacting with each other at a temperature exceeding a threshold temperature, referred to as the “flashpoint.” Different materials and chemicals have different flashpoints, some at low temperatures and some high. The lower the flash point temperature of a compound, the more easily the compound ignites.
Here are the minimum provisions of a fire prevention plan:
For more information about Fire Prevention Plans, see OSHAcademy course 718 Fire Prevention Plans.
One of the primary considerations in preventing hospital fires is to prohibit the use of combustible structural (e.g., floors, walls, roofs, stairwells, fire escapes) and nonstructural (e.g., doors, windows, ceilings, fixtures, facade, insulation, mechanical and electrical conduits) components in the hospital facility.
New facilities should be designed using building codes and guidelines for fire prevention, and the materials used should have adequate fire resistance ratings. (These ratings refer to the duration, usually in hours, that a given material can withstand fire at a specific maximum temperature before losing its integrity, including its strength and insulation capabilities.) In the case of both structural and nonstructural components, fire resistance ratings/durations can vary from 30 minutes to more than 4 hours.
May 1929: Cleveland Clinic, Cleveland, Ohio, USA—125 Fatalities
The fire started in the clinic’s basement, caused by improper storage and ventilation of 70,000 sheets of X-ray films. Toxic fumes from burnt film spread rapidly throughout the hospital’s vents. Although no one died directly from the fire, people died as a result of the toxic fumes released.
July 2005: Calderón Guardia Hospital, San José, Costa Rica—19 Fatalities
This 62-year-old hospital is one of the busiest in San Jose. The fire started on the fifth floor; patients in the neurosurgery ward and the intensive care unit (ICU) were trapped. Fire escapes extended only to the third floor. Patients tied bedsheets together and used them as ropes to climb out of the windows. The fire alarm did not signal that there was a fire; also, the facility had no evacuation plan and had insufficient signage and lighting.
December 2011: AMRI Hospital, Kolkata, India—91 Fatalities
The fire in this private hospital started in the basement, where highly flammable medical equipment was illegally stored. Hospital staff abandoned the hospital when the fire started and did not try to rescue any patients. The fire service arrived 90 minutes after the start of the fire. Windows and doors were locked; windows had to be broken to gain access. Most deaths were a result of smoke inhalation.
Fire drills are designed to ensure that, through regular training and simulations, staff members will:
If there is a fire threat and management decides to evacuate, there should be a designated person responsible for notifying the entire facility of the evacuation order, using appropriate systems such as overhead announcements, emails, text messages, and internal hospital communication systems with loudspeakers.
Click on the "Check Quiz Answers" button to grade your quiz and see your score. You will receive a message if you forgot to answer one of the questions. After clicking the button, the questions you missed will be listed below. You can correct any missed questions and recheck your answers.