RACE and PASS

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By learning the basics of fire response. you can be prepared for any fire emergency.

Today’s laboratories are safer than ever before, with modern construction, absence of open flames and automatic detection and sprinkler systems. But electrical equipment, paper clutter and chemicals still provide plenty of fuel for any fire. By learning the basics of fire response using the acronyms R.A.C.E. and P.A.S.S., you can be prepared for any fire emergency.

The danger of fire is real. A 2008 fire in a hospital in Perambur, India’s fourth largest city, gutted a laboratory, an area connected to patient wards.1 That same year, a fire started in a laboratory in London’s Royal Marsden Hospital, a leading cancer hospital, triggering a total evacuation and destroying much of the roof.2 And a fire at a lab collection site in West Seneca in April 2012 forced an indefinite closure, with smoke and water damage throughout.3

These events are rare, but they do happen. Much more likely are smaller fires related to common fuel sources present in every laboratory: paper, chemicals and electronics. All fires combust fuel and produce poisonous smoke.

While visible smoke is a mixture of heated particles and gases, many products of combustion are odorless and invisible. A fire’s consumption of oxygen, along with chemicals produced, can displace oxygen in the lungs, irritate and injure mucous membranes, and interfere with cellular chemistry. Carbon monoxide poisoning is the leading cause of death in smoke inhalation, which causes 50-80 percent of fire deaths.4

Small fires can grow and spread quickly. Fire needs oxygen, a fuel source and enough heat to ignite the fuel. Depending on a building’s construction, fire can be contained to one area or one floor for a time, but a closed room can be quickly engulfed, given enough accelerant and fuel. Smoke and lethal gases can enter air handler systems or exit doors and windows. It can and does happen.

Rescue — rescue or remove people from the area of danger. This includes opening doors, directing people to a safe zone beyond fire doors or outside, or assisting caregivers with patient lifting. Generally, rescue does not mean entering an area where there is fire or smoke. It is never, ever safe to enter a room where the door is closed and the handle or door itself feels warm or hot, no matter what you hear.RACE
If you are involved in a fire or discover a fire, the acronym R.A.C.E. will save lives. Your organization training probably includes a review of this common mnemonic, which may also be posted in egress hallways and fire safety signs. R.A.C.E. stands for:

  • Alarm — sound the alarm by activating a pull station in a hallway, telling a coworker, calling your switchboard, or all of the above. Ideally, “Rescue” and “Alarm” happen simultaneously. Depending on the location of the fire emergency, it’s better to alarm first; if light gray smoke is coming from a restroom at the end of a hallway, for example, pull the alarm on the way.
  • Contain — close windows, doors, and keep unauthorized people away from the area of danger. In many hospitals with automated fire systems, the building itself will contain and extinguish any fire to some degree. But a containment strategy also controls people and traffic; this means clearing hallways and stationing someone at exits to direct emergency personnel to the fire.
  • Extinguish or Evacuate — small fires can sometimes be extinguished using portable fire extinguishers, or it may be necessary to evacuate. As a rule, you should only try to put out fires smaller than you.

PASS
One of the first things you should learn on the job is the location of fire extinguishers in your area. Chances are, these are near exits and egress hallways. They should be clearly visible or marked with signs and accessible at all times. As a hospital employee, you need to be aware of their principles of use and how to use them.

Proper deployment and use of fire extinguishers is an essential part of R.A.C.E. A fire extinguisher can blast an area once or twice to help people escape an area, to help shut a door, or to extinguish enough to remove immediate danger. The range, scope, and duration of most extinguishers limits their primary functions to rescue and containment. That’s a big reason they are placed near exits and hallways.

If you need to use a fire extinguisher in an emergency, the handy acronym P.A.S.S. will help:

  • Pull — pull the pin; you’ll want to place the extinguisher on a hard surface or cradle the base in your arm first. Turn away from the fire and squeeze one or two test bursts to make sure it’s working.
  • Aim — aim the nozzle (or horn if a CO2 extinguisher) at the base of the fire where the fuel is being combusted.
  • Squeeze — squeeze the handle while aiming.
  • Sweep — continue squeezing while sweeping back and forth beyond the edge of the fire. Be careful to advance slowly on the fire; never circle the fire, since that can trap you in the area. So long as the exit is behind you, you can escape should the fire re-ignite.

As fire embers, smoke, and the extinguishment material itself still presents risk, it’s always a good idea to contain the area by evacuating and shutting the door, even if it seems like a fire is completely out. As one fire safety consultant correctly points out, “Healthcare professionals do not have the advanced training and knowledge to safely extinguish even a small fire.”5

It’s best to leave fire emergencies to professionals. By following R.A.C.E. and using P.A.S.S. when necessary to rescue and contain, extinguishing if possible, you can keep people away from the area of danger and return as soon as possible to the important work of providing better patient care.

References

  1. The Hindu. Fire at hospital laboratory. Available at: http://www.hindu.com/2008/01/03/
    stories/2008010359440300.htm. Last accessed: 7/23/12.
  2. Medical News Today. Serious fire at Royal Marsden Hospital, London. Available at:
    http://www.medicalnewstoday.com/articles/92871.php. Last accessed July 23, 2012.
  3. YNN. Fire forces closure of medical laboratory. Available at: http://buffalo.ynn.com. Last accessed July 23, 2012.
  4. eMedicineHealth. Smoke inhalation. Available at:http://www.emedicinehealth.com/smoke_inhalation/article_em.htm. Last accessed July 23, 2012.
  5. Taluba J. What health risks do fire extinguishers pose to health-care facilities? Available
    at: http://www.emergencymgmt.com/health/Health-Risks-Fire-Extinguishers.html. Last
    accessed July 23, 2012.
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About Author

Scott Warner, MLT(ASCP)
Scott Warner, MLT(ASCP)

Scott Warner grew up in Western Maine. After a stint in the Air Force, he moved to the Maine coast. He has been a hospital laboratory generalist for more than 30 years and manager since 1998. As a freelance writer, his work has appeared in Advance for Medical Laboratory Professionals and other publications. He now lives in northern Maine with his family.

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