Fire Protection for Immobile Patients: Top 3 Questions to Ask

fire protection for immobile patients

Writer:  Sarah Block, Marketing Director at The Moran Group

On Sunday, February 17, 1957, a visitor at Katie Jane Nursing Home in Warrenton, Missouri saw flames shooting out of a utility closet during religious services. One hundred and fifty-five people lived in the two and a half story nursing home at the time of the fire, but only eighty-five people survived the fire. It was determined that the facility had inadequate fire escapes, no sprinkler system, no alarm system, no evacuation plan, and some residents were locked inside their rooms. This fire helped pave the way for fire protection in assisted living facilities.

Beginning August 13, 2013, a fire sprinkler mandate will require all assisted living facilities, nursing homes, and senior living facilities to have fire sprinklers installed to protect residents from fire. People 65 and older are more than twice as likely to perish in a residential fire, and oftentimes, residents in assisted living facilities are immobile, adding a new level of difficulty in the event of a fire. For this reason, it is imperative for nursing homes and assisted living facilities to have a multi-tiered defensive fire protection plan.


What are the risks for non-ambulatory patients in a fire emergency?

From 2002 to 2005 2,810 structure fires ignited in nursing homes. This caused 16 civilian deaths, 130 injuries, and $6.6 million in direct property damage per year. Most fires began with a mattress, bedding material, electrical wiring, or cable insulation in the kitchen or bedroom. Bedroom fires were by far the most fatal. However, with automatic fire suppression, the death rate in a nursing home is lowered 94%. Immobile patients do not have a way to escape on their own. This is why fire sprinklers are a necessary part of any assisted living facility fire emergency plan.

How do you coordinate patients during a fire sprinkler installation?

There are several questions a facility will have when installing fire sprinklers in a nursing home with residents. How do you install in occupied rooms? How do contractors coordinate around planned activities?

When working with a qualified fire protection solution provider, the contractor will first have a meeting to learn the special needs of the facility. 
• What are the scheduled events and activities?
• Are there any non-critical areas?
• Is the facility 100% occupied?
• Do you have any stylistic preferences?

Once this is complete, a custom bid can be created to accommodate all the needs of the nursing home. The bid would include a room block schedule and contingencies. Then, a final meeting with all pertinent facility staff should take place. Everyone from the property manager to the nursing staff should include their input to ensure the schedule works. Once the schedule has been finalized, the contractor will use the non-critical area for storage and begin installing. When it is time to install in an occupied room, the resident will already be scheduled in either an activity or scheduled to room with another patient. The installation will take 4-8 hours per room, so it will never effect sleeping arrangements. Because of the meticulously coordinated schedule, patients, both mobile and immobile, are occupied during the installation, so it never affects them adversely.

How do I help non-ambulatory patients during a fire emergency?

The NFPA recommends the "Defend in Place" tactic during nursing home fires. Nursing homes and assisted living facilities should incorporate the combination of fire resistant building construction, sprinkler systems, detection, alarm systems, horizontal movement, compartmentalization (instead of an open concept, each room has fire-resistant walls, a ceiling, and floor), and staff training to reduce the likelihood of having to evacuate immobile patients.

Evacuating patients is a last resort, but if it must be done, first attempt to relocate to another part of the building, also called horizontal relocation. If evacuating from the building is necessary, there are several options to evacuate immobile patients.

• Safety Sheets - safety sheets can be used on mattresses. They have straps that allow staff to strap the patient to the sheet and remove them from the building.
• Evacuation Chair - if the non-ambulatory patient can sit, they can be placed on an evacuation chair and be taken to the ground floor.
• Paraslyde - this utilizes a stretcher made of cardboard. It weighs about 7 pounds and can fit a patient inside a compartment, allowing a technician to slide the patient down the stairs.
• Mattresses - if nothing else is available, patients can be removed using their mattress.

Protecting residents from fire in a nursing home or assisted living facility should be a priority for staff and owners. With a combination of fire sprinklers, smart construction, and trained staff, patients can rest easy knowing they are safe.

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