India: 73 patients die in hospital fire


    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...
  2. Visit Flare profile page

    About Flare

    Joined: Jul '05; Posts: 3,757; Likes: 11,001


  3. by   VickyRN
    Many many years ago I worked in a facility that also had a ventilator unit. Most of these patients were totally dependent (quads, etc). My major safety concern was that there was no ramp or quick safe way to get these patients out of the building in case of a fire. There was a stairway, but no ramp.
  4. by   leslie :-D
    Quote from VickyRN
    Many many years ago I worked in a facility that also had a ventilator unit. Most of these patients were totally dependent (quads, etc). My major safety concern was that there was no ramp or quick safe way to get these patients out of the building in case of a fire. There was a stairway, but no ramp.
    wow...i'm surprised that was even legal.

    this article was devastating on so many levels.
    nearly half of the pts died???
    i too, have to wonder if there were any inservices/education re fires and evacuation.

    i agree, hospital needs to be shut down the very least.
    someone needs to be held accountable.

  5. by   sugarmagnoliaRN
    Makes me wonder why there aren't specific hospital staff required to have some training on this (i.e. non-medical staff trained especially for emergencies such as this)... it seems worthwhile in facilities where so many people are incapacitated and may not be able to get themselves out of danger's way.
  6. by   CompleteUnknown
    It sounds like it was a very poor effort all round, with tragic results, but you wouldn't know for sure unless you were there and newspapers can't be relied on to get their facts right.

    We have annoyingly frequent fire training and drills and we are always told not to become a casualty ourselves. If isn't safe to get to a patient, you have to leave them, and that's abandoning them. Sounds very harsh but is it any better to have a number of staff deaths as well?

    A fire at work is one of my worst nightmares. I think I would put myself at risk, probably to a greater extent than I really should, but I don't want to die.
  7. by   merlee
    Okay, people, this was NOT an American, or even 'western' type hospital. Although some of the workers did apparently abandon the patients, the article clearly states the the streets were too small to get the fire trucks to the hospital in a timely basis.

    And would someone tell me which U.S. hospitals have all of their ICU and vent-dependent patients on the ground floor? How would you get anyone out from, say, the 11th floor??

    The smoke was apparently drawn through the ventilation system, making rescue very difficult.

    This is so very sad.
  8. by   sugarmagnoliaRN
    Totally agree - but especially because that is most people's mindset, I just wonder why hospitals don't think it's justified to put together specific staff members for this type of thing. My company has numerous people working on "business continuity" - i.e. what would happen if there were a natural (or unnatural) disaster, and how would we continue to protect clients. And no one's life depends on our servicing our clients...
  9. by   Emergency RN
    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
  10. by   sugarmagnoliaRN
    PS - the "totally agree" part of that post was in response to CompleteUnknown's comment... forgot to quote!
  11. by   nerdtonurse?
    You're on your floor, at your facility. Your smoke detector doesn't go off, but you smell smoke. What do you do? You start looking for someone who's smoking, who's brought in a crock pot to feed Uncle George, maybe check the wiring around the computers or printers to see if you can see what's wrong. You call the operator, and say, "hey, I smell something that smells hot, but don't see smoke or anything? What's up?" Maybe the operator's in another part of the building and there's nothing going on there. Meanwhile, Mr. Smith's got to use the BSC again, Ms. Jones is wanting her pain pill, Mrs. Baker's daughter is wanting a blanket --

    The door to the stairwell opens, and suddenly black, oily smoke is pouring into your floor. Not only can you not breathe, you can't half see. Patients and their families start screaming. You know there's a fire, but is it above or below? You know not to use the elevators, but what about the guy in traction? The people with spinal cord injuries, on vents, the fresh cath or the person who just got back from an open bowel resection who's still pretty out from the anesthesia. You've got 20 people on your floor. What do you do, if you can't see or breathe yourself?

    Do you try to get out the ones that are able to walk under their own power, leaving the orthos, the Alzheimer's patients, the immediate post-ops? Do you stand there and die with them, saving no one rather than chosing to leave someone to die while trying to save the few you can?

    The execs, hang'm, got no trouble coughing up the money for the rope. But the floor nurses, who were confronted with a horrible situation, I've got nothing but pity. They will spend the rest of their life haunted by what they couldn't do.
  12. by   GitanoRN
    unquestionably, i'm at a lost for words, this was a senseless tragedy not only for the patients involved also for their families & friends. furthermore, there are some many unanswered questions to this tragedy, i'm positive it will take a long time before we could hear the results of the investigations. my thoughts & prayers are with everyone involved with this unfortunate event.
  13. by   JBudd
    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