“CODE RED” is a term hospital staff use for fires. Although fires in hospitals aren’t an everyday occurrence, you’ll surely respond to one if any hospitals are in your district. These fires are often minor, but they can involve a multiple-alarm assignment with personnel used for moving patients through a smoke barrier/horizontal exit or removing patients from a floor, mitigating a hazardous materials incident, or assisting in smoke removal with exhaust fans. Due to the physical state of many of the patients, sheltering them in place is often done. Closing the door to the room and throwing towels on the floor will prevent smoke and water from entering.
Cigarettes/Mattress/Motors
Both patients and visitors often ignore “No Smoking” signs in hospitals. In many instances, fires in hospitals are caused by people smoking to help alleviate stress. Often, these fires occur in a bathroom. Unfortunately, the smoke alarm usually triggers after a few puffs. In their panic not to get caught, people usually try to extinguish the cigarette under the sink’s running water and discard it in a garbage can still smoldering. Then the rubbish and paper towels begin to burn, creating smoke and havoc on the floor. At one hospital, such fires often occurred near the emergency room because of the number of transient people there.
We’re often accustomed to the smell of paper, and when the nurses say the incident is in a bathroom, we know we usually just have to discharge the pressurized water can on the rubbish and remove the garbage can from the area. Next come the smoke removal efforts, which may entail using some of the building maintenance personnel to assist us. Most windows on the floors don’t open. Often, they need a special “hex” key or tool to open them. Most smoke removal will be through the hallway and into the stairwells, which hopefully terminate on the roof to pull the smoke up and out of the structure. The building engineer on duty may also be able to use the building’s ventilation system to expedite smoke removal.
Other common hospital fires are mattress fires combined with patients smoking and on oxygen. Usually, the nurses have removed the patients by the time we arrive and hopefully have shut down the oxygen. These fires are often controlled by the sprinkler head in the room, but the rubberized hospital mattresses can often still be smoldering, creating a moderate to heavy smoke condition on the floor. In addition, the water from the sprinkler is flooding the area.
We must ensure first that the patients have been removed from the room, then focus on whether the fire was successfully extinguished by the sprinkler before we shut the sprinkler down. If the sprinklers extinguished the fire, we can shut the system down, which can take a while because of the size of these buildings and the time it takes to find the appropriate shutoff. Again, using building personnel is very important in this stage of operations. Once the mattress is extinguished, roll it up and tie it with utility rope. Then remove it using the stairwell to an area outside the building. Don’t put it in the elevator and get trapped with a possibly smoldering mattress!
Smoke removal will be a big issue when fires like this occur. Multiple exhaust fans may have to be deployed and hopefully the hospital has some for us to use, too. At one hospital, we had a mattress fire twice in one week in the same room. The emotionally disabled patient was in a quarantine wardroom and managed to ignite the mattress. The air handling system was a separate system allowing smoke removal to the specific room and area on each floor. That assisted us in ventilation, but what made matters worse was the patient had a very rare type of tuberculosis and we all had to take TB tests because we had been exposed.
Many times, we’ll arrive on the scene of a “burning odor” later in an incident, especially in hospitals. Perhaps this is due to it being reported to a staff member, security, or building personnel, who will investigate it first. When we arrive on a floor, we’ll often get that “food on the stove” smell and begin looking for a microwave, but if you have a burning electrical smell, it’s going to take some time to investigate the area.
Motors are all around, and usually many are hidden above the drop ceilings for the HVAC system. We may encounter a burned-out motor or a bad belt with the rubber smell permeating the air. Sending personnel to the roof to check the units there may also tell us where this odor is coming from. Another location can be in a patient’s room. The motor on the bed could be faulty and even overheat, causing the electrical odor.
Unfortunately, we had a victim who succumbed to his injuries in a hospital bed fire. It is believed that the control for the bed was wedged under the victim, causing the motor and bed to move for hours. The motor eventually ignited and lit the mattress with the victim in it.
Construction Incidents
Hospitals are always upgrading, renovating, and building additions. Although many are known for the automatic fire alarm run, we can’t get too complacent when responding. At one fire, what once was an open-air atrium for many floors was being renovated into new floor space. Welding the structural steel in place caused sparks to light off building materials and rubbish below. Stretching off the standpipe required two engine companies to get the line in place while the truck company deployed a search rope to assist in the search efforts through the mazelike conditions in the construction area.
MICHAEL N. CIAMPO is a 38-year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC International Truck Essentials H.O.T. program. He wrote the Ladders and Ventilation chapters for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and the Bread and Butter Portable Ladders DVD and is featured in “Training Minutes” truck company videos.
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