Department of Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Anaesthesia. 2021 Oct;76(10):1377-1391. doi: 10.1111/anae.15511. Epub 2021 May 13.
The need to evacuate an ICU or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: Not only is there a risk that patients may come to harm but also that staff may be injured and unable to work. Designing newly-built or refurbished ICUs and operating theatre suites is an opportunity to incorporate mandatory fire safety features and improve the management and outcomes of such emergencies: These include well-marked manual fire call points and oxygen shut off valves (area valve service units); the ability to isolate individual zones; multiple clear exit routes; small bays or side rooms; preference for ground floor ICU location and interconnecting routes with operating theatres; separate clinical and non-clinical areas. ICUs and operating theatre suites should have a bespoke emergency evacuation plan and route map that is readily available. Staff should receive practical fire and evacuation training in their clinical area of work on induction and annually as part of mandatory training, including 'walk-through practice' or simulation training and location of manual fire call points and fire extinguishers, evacuation routes and location and operation of area valve service units. The staff member in charge of each shift should be able to select and operate fire extinguishers and lead an evacuation. Following an emergency evacuation, a network-wide response should be activated, including retrieval and transport of patients to other ICUs if needed. A full investigation should take place and ongoing support and follow-up of staff provided.
在火灾或其他紧急情况下需要疏散 ICU 或手术室建筑群是一种罕见的情况,但可能充满困难:不仅患者可能会受到伤害,而且工作人员可能会受伤而无法工作。设计新建或翻新的 ICU 和手术室套件是一个机会,可以纳入强制性消防安全功能,并改善此类紧急情况的管理和结果:包括标记明显的手动火灾报警点和氧气关闭阀(区域阀服务单元);能够隔离各个区域;多个清晰的出口路线;小湾或侧室;首选位于一楼的 ICU 位置以及与手术室的互连路线;单独的临床和非临床区域。ICU 和手术室套件应该有一个定制的紧急疏散计划和路线图,并且随时可用。工作人员应在入职时以及作为强制性培训的一部分,在其临床工作区域接受实际的火灾和疏散培训,包括“演练”或模拟培训以及手动火灾报警点和灭火器的位置、疏散路线以及区域阀服务单元的位置和操作。每个班次的负责人应能够选择和操作灭火器,并领导疏散。紧急疏散后,应激活全网响应,包括在需要时检索和将患者转运到其他 ICU。应进行全面调查,并为员工提供持续的支持和后续服务。