Fire suppression in hospitals

[Gordy]

Firecode in Scotland; SHTM 82 Supplement A, since April 03, requires consideration of fire suppression in new hospitals or for projects requiring warrant. I am involved in a project for a new picu (paediatric intensive care unit). I have already dredged a lot of material (home & abroad) and completed a risk analysis. I would be interested to hear from anyone with first hand experience of a hospital sprinkler project, particularly within patient care areas? Or any useful views?

[Peter Wilkinson]

I am currently involved with a new-build adolescent care unit in the private mental healthcare sector.  Although the building is generally HTM81 compliant, the client was keen to include sprinklers within patient care areas.  Currently, a residential sprinkler system is being designed and installed to DD251 with modifications such as semi-recessed anti-ligature heads, etc.

I can talk more about this project privately if you want to get in touch.

[afterburner]

Gordy, I have been working on automatic detection / suppression in secure environments, not coming through construction and installation phases. Although not health care establishments there may be some common ground.
Let me know if you wish further discussion.

[Roy Grogan]

Gordy,
have small single storey building for sec 136 Mental Health Act assessment of patients protected by stand alone sprinkler system.  This domestic standard system allows for four/five heads to be run off mains pressure water.  This site has two sources of piped water.  System is simple , neat and inexpensive.
Wish I could convince others that sprinklers protect so much more than our investment.  
Roy Grogan Fire Officer Kettering General Hospital NHS Trust

[Gordy]

It's awhile since I re-visited my original post, so I offer a belated thanks to those who replied.
Some of you may be interested in an update.

The outcome is that the sprinkler system is now installed throughout the area to be protected and a substantial area below and around the protected area. (The protected area is a paediatric ICU and adjacent HDU ward on the third floor of existing buildings.)

It took some 15 months to convince the design team of the efficacy of the proposal, and the project was already well advanced before installation was undertaken. The client (my employer) took my proposal to an external arbitration group specially set up to consider the proposals and this group found in favour of fire suppression (in a very long report) i.e that a 'protect in place' fire strategy was justified and viable. No equivalency was proposed by the design team who felt that the fire strategy originally proposed was adequate. (SHTM 81 in Scotland makes provision for external verification and the system was used in this case, very successfully for the first time).

The system is a hybrid. It is a double knock dry system. This would not generally be considered as a life safety system, however it was designed after wide consultation to provide the maximum possible protection against false activation, and the probability of slightly delayed activation was felt to be justified on the basis that the area has a very high staff occupancy (almost 1 to 1 patients to staff in ITU and 1 to 4 in HDU) and consequently observation. The potential to deal with small incidents quickly was recognised. The sprinkler is intended to deal with significant incidents outwith the ability of staff to control it (oxygen enhanced fires, fires in enclosed rooms or spaces etc). It is the ultimate safety net for the purchase of time to conduct evacuation in situations where other methods of control are not immediately viable.
(Part of the case was that whilst fires in ITU are rare, the potential for oxygen enhancement is high and the probability of significant harm to patients and staff is also high due to significantly delayed evacuation. The potential severity and harm being the deciding issue in this case - not the frequency of event)

Interestingly, in the age of 'fire engineering', the concept of engineering was not mentioned once in all the discussions and meetings. The decision was based on a thorough risk analysis examining all the issues, including human behavioural issues related to staff capability etc.

I would like to think that this has added weight to the case for sprinklers. Of course we know they're not a panacea, but there is a place for them and we must use them where they are justified.  Cost arguements are now a thing of the past. Risk arguements can no longer be defeated by accountants and accountability makes specifiers and clients nervous, that is their achilles heel. If you feel sprinklers have a place in a design proposal, make a good solid risk case; do your research, use case history and previous events, make your report thorough and don't spare the words supporting your evidence in the interest of brevity. Get it all down on paper and see your case through. It ain't easy, but it sure feels good when you are vindicated.

[ian gough]

Well done Gordy!

[Brian Catton]

I am keen to see the provision of sprinklers in general acute hospitals and as one of you have already pointed outr where oxygen enrichment of the atmosphere is a high risk. I am not however as keen to see them in general use throughout mental health environments. I see them as another thing that mental health patients can interfere with or use to self harm. over the last nine years I have had experience of several fires in mental health wards. Most of theses have been in bedrooms and confined to the bed or furniture in the room. Staff have reacted well to the outbreak and have in the main extinguished the fire before the arrival of the fire service. There was no case established for sprinklers in these buildings.
I think the main considerations are 1. The buildings are designed to allow maximum observation by staff. 2. AFD to L1 standard with BG points in staff areas. 3. Staff training for admisssion and initial risk assessment of patients must include fire prevention and isolating patients from ignition sources.

I have been accused (usually following a fire) of asking questions that
are searching in respect of patient observation procedures. I have never had to investigate a fire where a member of staff had observed  patient deliberately starting a fire.

I will continue to question staff procedures as part of a fire investigation.

[Peter Wilkinson]

Brian,

A semi recessed residential sprinkler head with cover can be less of a temptation to tamper with than a smoke detector head.  I agree with your staff observation point, but it is rarely possible to achieve a high standard of staff observation if the patient accommodation consists of individual bed rooms.  At least a sprinkler system would tackle the incident quickly, as well as acting as a fire alarm.

[Gordy]

There are a number of significant points concerning reliance on staff for fire control;
1. Their next fire is likely to be their first; so they are seriously inexperienced.
2. Even with the best training available, repeated regularly without fail, their competence must be suspect as we all know it is not possible to replicate real fire conditions in an occupied internal space, in the workplace; and repeat the experience regularly. (try it in a hospital with perhaps 3000 staff)
3. You must rely on them to deal with any fire at the earliest possible stage.
4. Their equipment is of limited duration and capability.
5. Their decision to tackle fire is personal and optional - there is no obligation to do so.
6. If for life safety reasons an obligation is implied i.e. there is a corporate expectation that staff will endeavour to tackle a fire, this would surely be legally questionable. (Some expert legal advice would certainly be prudent).
7. No protective clothing is generally provided. If we provide equipment and expect staff to use it we must train them to do so safely (and provide any necessary ppe; even if use of the equipment is optional)
This list can be as long as you wish to make it - but I think you'll get the point.

In life safety cases, you have to ask yourself; is it sufficient to rely on staff as the means of fire control when there are valid questions regarding 'time to escape'? Installed systems with proven reliability are likely to be more effective than inexperienced persons who may. or may not, tackle the fire.
Automatic fire control technology has come a long way over the last few years. Solutions are available to most automatic extinguishment problems and costs are becoming more realistic. There is need for us to be much more pro-active in our approach and more positive about the benefits.
The evidence base for the effectiveness of sprinklers is beyond dispute. Forget about educating people to be safer - it simply will not work beyond a superficial level. Domestic sprinklers will be many times more effective in saving lives, and the legislators know it. Wouldn't it be nice if we could persuade them to do something the public might actually benefit from for once.
But we can make a start in hospitals and healthcare. Let's push boundaries and stop prevaricating.

[ian gough]

Gordy: with those sentiments perhaps you don't need to come along to the sprinkler seminar in Dundee on 27th Oct?

[wee brian]

Gordy is absolutely right. thousands of people die every year in hospital fires because of these very poor standards.

[Peter Wilkinson]

Gordy is absolutely right. thousands of people die every year in hospital fires because of these very poor standards.

Isn't that a slight exaggeration?  Whilst it is true to say that thousands of people die every year in hospitals, I don't think the figure is quite that high for death in hospital fires.

[wee brian]

Oh yes sorry. Its none at all!

[colin todd]

Not quite true wee b. But true for general acutes.