Any hospital system I've worked for has used RACE for fire safety training. R standing for Rescue people in immediate danger if safe to do so. I wonder what type of training, if any at all this staff had received. The way it sounds from the article, the hospital was severely lacking in fire safety measures. Would that have made difference? According to the article, it took the FD an hour to arrive on scene and there had been a fire there 3 years ago - no mention of how long it took for the FD to respond at that time, but also no mention that there were extenuating circumstances that made the response unusually long. Makes me wonder if this was a factor in the staff response to the fire.
We can't speculate from this article the exact coditions and the types of decisions that the staff had to make. It doesn't say how the fire started, but does allude to the fact that the upper floors of the hospital were affected mainly by smoke.
This article makes me wonder how far you would go to protect your patients. In a dire situation such as this, would you risk your own safety to intervene in a situation where ( presumably) you have not been sufficiently trained. Even in our CPR refresher classes, we are taught to act if the scene is safe. Should this staff be criticized in this manner for doing just that?
Just serving up a dish of food for thought...
It's hard to apply US standards for fire safety to another country. One has to remember that even health care abroad is often nowhere near what Americans are used to. From the article, it reportedly took an hour for fire personnel to reach the scene. This would be rather unusual if this had happened in the US. But in Indian, where municipal fire safety is often not the rule, their crowded streets hampered rescuers. Civil engineering aspects of fire access roads are something that needs to be planned years ahead. Many municipalities in third world countries would find it daunting to even have fire departments, much less change their municipal access routes to suit individual facilities. Unfortunately, it is, what it is.
Additionally, I've been in fire situations in our own hospital, and usually the danger is immediately contained and localized to one singular spot. The rest of the building wouldn't even realize there was a fire unless the alarm was activated. Hence, for a fire to have started in a basement (like the article stated) and then have smoke pervasively penetrate the entire structure so quickly as to cause so many deaths, bespeaks of poor training quality of the personnel, and a lack of automatic fire safety doors.
Institutional fire safety is in it's anticipation, forethought and training, which replaces animal fight or flight fear with scientific knowledge and life saving rationales. Only when staff members know what to do, will tragedies like this be averted. Despite the national differences, theirs was a complete failure of staff preparation and infrastructure maintenance; the fault lies entirely with management.
As for the OP question of whether this staff acted appropriately, I would say that if they were "sufficiently" trained (and note the italics for if) then they would could have been seen to have abandoned their post. However, such training would have dictated closing all doors to prevent smoke from reaching them. In large concrete buildings, people as a rule, generally never ever burn to death, but succumb to smoke. It would have been a very simple matter to close the door to their units and then go back to their patient care. Thus, if all their personnel reacted in the same way (ie fleeing) my suspicion is that the hospital never paid much attention to fire safety training at all. I don't think the staff should be faulted.
Last edit by Emergency RN on Dec 9, '11
Mar 14, '12
by JBudd, MSN Guide
I have worked/visited hospitals in India; we did not have the private rooms, nor big fire doors. We had wide hallways for ventilation in the heat, large ward rooms with many people in them, etc. Crowded conditions, lots of family, no or few elevators. Winding passageways in some areas, no clear route out.
But lots of people get treated for things they would otherwise die of, or being crippled from; for little or no cost. Without all the drama that we moan and groan about with American families/visitors/execs. Totally different world and circumstances.
I feel badly for the families, and the staff.
Last edit by JBudd on Mar 14, '12