Preplanning Pays Off at St. Louis State Hospital Fire

Preplanning Pays Off at St. Louis State Hospital Fire

Truckmen raised aerials and elevating platforms to heavily barred windows of St. Louis State Hospital. Fog nozzles were used to check flames until hand lines reached fire areaDirector of Public Safety Robert Duffey, Chief Olsen and hospital official examine destroyed storage room

—St. Louis Globe Democrat photos

1200 mental patients evacuated and fire extinguished-all in one hour

PREPLANNING by fire fighters and intensive drilling by the hospital staff averted a major holocaust at the St. Louis State Hospital, St. Louis, Mo., on January 15, when fire raged through a storage room on the third floor of the sprawling, four-story, 100-year-old building. Two women died but 1200 were evacuated safely, some suffering from minor smoke inhalation.

The fire originated in Ward 3C, in a room used for the storage of clothing and bed linens. The room was constructed of ordinary wood 2×4’s enclosed on both sides by 1/2-inch painted plywood, and measured 20 by 10 feet. A dividing partition of the same material separated the room into two separate units. Located in the west wing, the ward contained a total of 53 persons at the time of the outbreak. Most of the patients had retired for the night and occupied beds in 18 rooms on either side of a 153-foot corridor.

Exits from the ward are located at the head of the corridor on the east end and lead to the main entrance. The solarium exit serves as the secondary means of egress but was not used in the evacuation, permitting the unhindered advancement of hose lines.

At 9:21 p.m., the fire alarm office received an ADT Aero Alarm and dispatched a pumper, hook and ladder, and a battalion chief to the hospital. Immediately a box was struck, dispatching a full first-alarm assignment of three pumpers and two hook and ladder companies. When the first companies arrived, the evacuation signal had been sounded and the patients were filing down the stairs in an orderly manner. Firemen were immediately assigned to evacuation duty, even though no fire was showing at the front of the building. Other firemen covering the rear of the building located the fire and reported smoke and flame issuing from two windows at the thirdfloor level. The battalion chief in charge immediately called for a thirdalarm assignment.

The major problem at that moment was the assignment of men and equipment in such manner and at proper points that evacuation, rescue and fire control could be carried out efficiently.

First hand line to reach fire was stretched from ladder through windows of extension (lower right) and taken to solarium (far right)


The hospital with its many rooms and wards is some 800 feet in length and from 90 to 100 feet in depth. It is divided into 13 sections and extends to a height of 85 feet, with a dome topping the roof level. The entire structure is of fire-resistive construction.

The various sections are divided by fire walls and fire doors, and all stairways are properly enclosed. Great numbers of windows are present at both the front and rear, but all of them are heavily barred with close-fitting steel bars and small window panes glazed with transparent, extra-strength glass.

While some of the lesser buildings in the complex are sprinklered, the old hospital building is sprinklered only in the area of the dome. All sections are equipped with a rate-of-rise type alarm system, with annunciators located at the desk of the telephone operator and at selected points on the exterior of the building. There are no standpipes but numerous hand-type extinguishers.

Evacuation plan

The responsibility for fire safety and evacuation of patients is entrusted to the state fire inspector assigned to the hospital and the hospital superintendent. both are full-time employees hired by the state and their responsibility and duties are limited to the hospital complex.

The evacuation plan has been in use for the past eight years under the guidance and supervision of the state fire inspector. This plan, in the form of drills, is carried out regularly and changes made from time to time. Regular drills are a must, due to the types of patients involved.

The key to a successful evacuation is entirely dependent on the ability of those in charge to maintain the desired separation of groups. Those who are greatly disturbed cannot be permitted to intermingle with those who are moderately disturbed. In this way panic is averted in the patients who are highly susceptible to it.

The plan of evacuation with diagrams is placed in the hands of all hospital personnel. They not only study the plan, but are regularly tested as to their knowledge of it.

Primary and secondary means of egress are indicated for all wards. Drawings of wards are included, depicting stairs, elevators, corridors, rest rooms, bedrooms, dining rooms, termination points, and dimensions. Location of fire doors and extinguishers are also included in the drawing of floor and exit plan.

The key person is the telephone operator, who on receiving the location of the fire or other emergency, checks the alarm annunciator, notifies the fire department, and then in turn calls the hospital superintendent and state fire inspector. Either of the two can then inform the operator, depending on the nature and extent of the emergency, if the general-alarm evacuation plan is to be initiated. If so, the alarm is then transmitted through the intercom system, alerting all personnel who respond to predesignated posts to stand by for further orders; or take the necessary action as conditions demand in their particular section.


When the fire fighters arrived the east stairways were crowded with patients and barred windows prevented entry for rescue or for stretching hose lines over ladders and into the interior. Nevertheless the absence of standpipes necessitated the stretching of hose lines up stairs. Therefore direct attack ou the fire from the front was temporarily delayed.

Truckmen raised an aerial in the rear directly beneath the fire and the stream from its ladder pipe was directed through the barred windows. This stream had good effect, but could only cover a limited area and it was not known how far the fire had advanced. An elevating platform and two aerial ladders with attached pipes were raised to the third-floor level in the front, and fog streams were operated through a fan light to absorb heat, to curtain the east section of the corridor, and to halt the horizontal spread in that direction.

As additional companies arrived, more men were assigned to assist in the evacuation, and a search and rescue team equipped with masks was ordered to search the third floor for possible victims. While evacuation progressed, a hose line was laid up the stairway at the main entrance to the third floor. A second line was laid to the third floor, using the stairway on the west side which opened Into the solarium.

The search and rescue team, on reaching the third-floor corridor, found the fire doors closed and on passing them met intense heat and dense smoke in the corridor of Ward 30. Fire fighters were forced to crawl the length of the corridor, groping for patients.

As the flow of patients from the building lessened, more men were assigned to ventilation. The rescue team finally met a hose crew who, with the use of masks, had worked their way through from the west side passing through the solarium and into the corridor. Ventilation now had its desired effect and fire began to show as it smoldered and flamed in the bedroom opposite the cleaning and linen room. The aerial ladder stream had controlled most, but not all of the fire. Fire was now effectively attacked from the interior and when several more lines were brought to bear, it was soon completely extinguished.

A more intensive search of all floors was immediately set up as men engaged in evacuation became available. This search revealed two victims: one in the solarium beneath a bed and the second in one of the small bedrooms off the main corridor. Cause of death was given as smoke inhalation.

During the overhauling and salvage process it was found that the fire had involved a relatively small area. However, it did extend to the furnishings in the adjoining bedroom and the heat of the fire scorched and blistered the corridor while spalling the concrete in the clothing room area as well as the corridor. The wood and plywood-covered partition was completely consumed. Considerable clothing and bed linens were charred and burned to the very bottom of a huge pile that covered the entire 200 square feet of the room to a depth of 2 feet or more.

Evacuation orderly

Of the 2600 patients at the institution, 1200 of them were evacuated from 18 wards without panic or injury. That the evacuation was orderly speaks well for the continual fire drills held at this institution, and emphasized the importance of such drills in any institution. It also shows a dedicated hospital personnel who performed courageously in the face of a potential disaster and by their devotion to their patients averted a catastrophe that the city and state might well remember for a long time to come.

This fire emphasized that not only must the fire department know the buildings, but also they must know the evacuation plans for the building so that in the process of fire extinguishment, they do not hinder the evacuation or permit the evacuation to hinder their operation. The best way in which this can be accomplished is through a continual inspection program by company commanders, who in turn impart the knowledge gained in their inspections to the members of their companies through the in-service training program. Preplanning, resulting from these inspections and in-service training sessions is the only method by which a large mortality rate can be avoided, not only in institutions of this type, but in any building in which many people are quartered.

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