6.2 Fire Safety: RACE, PASS, Extinguisher Types, Evacuation, and Oxygen Risks

Fire Safety: RACE, PASS, Extinguisher Types, Evacuation, and Oxygen Risks

Quick Answer: If you discover a fire, follow RACE — Rescue residents, Activate the alarm, Contain the fire by closing doors, Extinguish if small or Evacuate. To use a fire extinguisher, follow PASS — Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side. Never use an elevator during a fire.

RACE — Fire Response Steps

RACE is the national standard fire-response acronym used in every healthcare facility, including Indiana LTC facilities. Memorize what each letter means.

R — Rescue

• Remove residents from the immediate area of the fire, starting with those closest to the fire and those who are most helpless (bed-bound, ventilator-dependent, confused).
• If the fire is in a resident's room, move that resident out first, then residents in adjacent rooms.
• Move residents to a safe area behind a closed fire door — usually the next smoke compartment.
• Use a wheelchair, stretcher, or blanket drag if the resident cannot walk.
• Do not stop to collect personal belongings — lives first.

A — Alarm / Activate

• Pull the nearest fire alarm pull station as soon as residents are safe.
• Call the facility's emergency number or 911 per facility protocol to report the fire and location.
• In some facilities, the alarm automatically notifies the fire department; in others, you must call. Know your facility's system.
• Announce the fire location over the intercom if your facility uses code words (e.g., "Code Red, Room 214").

C — Contain

• Close all doors and windows in the fire area and in rooms along the evacuation route. Closed doors slow the spread of fire and smoke.
• Turn off oxygen at the source if the fire involves or is near an oxygen-supplied room.
• Clear the hallways of equipment, carts, and obstacles so firefighters and evacuation can proceed.

E — Extinguish / Evacuate

• Use a fire extinguisher ONLY if the fire is small (wastebasket size), contained, and you are trained. If the fire is large, spreading, or smoky, evacuate instead.
• If you cannot extinguish the fire in one extinguisher's worth of use, evacuate and leave it to the fire department.
• Evacuate horizontally first (to the next smoke compartment), then vertically (down the stairs) if ordered.

Trap callout: RACE is always in this order — Rescue, Alarm, Contain, Extinguish. A common wrong answer puts Alarm before Rescue. The resident's life comes first. However, if you discover a fire and you are alone and the alarm is right next to you, pull it as you pass — use judgment, but the standard sequence is R-A-C-E.

PASS — How to Use a Fire Extinguisher

Once you have decided to use an extinguisher (small, contained fire, trained, safe exit behind you), follow PASS.

P — Pull

Pull the safety pin out of the handle. The pin is held in place by a tamper seal — twist and pull to break it. The extinguisher will not discharge with the pin in.

A — Aim

Aim the nozzle or hose at the BASE of the fire — where the fuel is, NOT at the flames. Aiming at the flames does nothing because the fuel keeps burning.

S — Squeeze

Squeeze the handle together to discharge the agent. Release the handle to stop.

S — Sweep

Sweep the nozzle from side to side, covering the entire base of the fire, moving closer as the fire goes out. Continue until the fire is completely out. Watch for re-ignition.

Trap callout: The exam often asks where to aim the extinguisher. The answer is always the BASE of the fire — not the top, not the flames, not the smoke. The base is where the burning material is.

Fire Extinguisher Types

Know the four classes and what each is designed for. Using the wrong extinguisher can be ineffective or dangerous.

ABC Extinguishers

Most healthcare facility extinguishers are rated ABC — they handle ordinary combustibles, flammable liquids, and electrical fires. These are dry chemical (multipurpose) extinguishers and are the standard in resident rooms and hallways.

Class K Extinguishers

Class K extinguishers use a wet chemical agent that reacts with cooking oil to form a foam blanket. They are found in commercial kitchens with deep fryers. Never use a Class K extinguisher on an electrical fire and never use water on a grease or oil fire — water causes a grease fire to explode and spread.

Trap callout: Never use water on a grease fire (Class B) or an electrical fire (Class C). Water on a grease fire splatters burning oil. Water on an energized electrical fire conducts electricity and can electrocute you. Use a dry chemical (ABC) or CO2 extinguisher instead.

Evacuation Procedures

Horizontal Evacuation (First Priority)

In LTC, the first evacuation step is horizontal evacuation — moving residents through fire-rated doors to the next smoke compartment on the same floor. Smoke compartments are separated by fire doors that close automatically when the alarm sounds. Each compartment can hold residents safely for a period while the fire is contained.

1. Move residents from the fire zone through the nearest fire door to the adjacent compartment.
2. Close all doors behind you to contain smoke.
3. Account for every resident — use the census sheet or resident roster.
4. Do a head count.
5. Reassure residents; keep them calm and seated.

Vertical Evacuation (If Ordered)

If the fire spreads and horizontal evacuation is not enough, vertical evacuation moves residents to a lower floor or out of the building.

• Use the stairs — NEVER the elevator. Elevator shafts act as chimneys for smoke and the elevator can stop or open on the fire floor.
• Carry or assist residents who cannot walk. Use stretchers, wheelchairs, or blanket drag for non-ambulatory residents.
• Move the most dependent residents first, then ambulatory residents.

Resident Priority for Evacuation

Move residents in this order:

1. Residents closest to the fire
2. Ambulatory residents (they can move themselves with direction)
3. Wheelchair residents
4. Bed-bound residents (require carrying or stretcher)
5. Residents on life support (ventilator) — move with equipment if possible; if not, follow facility protocol

Smoking Safety

Smoking is a leading cause of fires in LTC facilities. Indiana LTC facilities must have a written smoking policy under 410 IAC 16.2.

• Smoking is allowed only in designated smoking areas — never in resident rooms, bathrooms, or beds.
• Residents who smoke must be assessed for safety — cognitive ability, ability to handle the lighter and cigarette, oxygen use.
• Never allow smoking in an oxygen-enriched area. Oxygen makes materials ignite at lower temperatures and burn faster.
• Supervised smoking for residents who cannot smoke safely alone.
• Ashtrays must be noncombustible and emptied frequently — never into a paper or plastic bag.
• Matches and lighters must be controlled and stored outside resident rooms when not in use.

Trap callout: A resident on oxygen must NOT smoke, and no one can smoke near an oxygen tank or concentrator. The exam often tests this — if a resident on supplemental oxygen asks to smoke, the answer is always to refuse and explain the fire risk. Oxygen itself does not burn, but it makes everything else burn hotter, faster, and at lower ignition temperatures.

Oxygen-Related Fire Risks

Oxygen is an accelerant — it does not burn by itself, but it dramatically increases the rate at which other materials burn. Oxygen-saturated clothing, hair, bedding, and skin can ignite and burn intensely.

Safety Rules for Oxygen Use

1. Post "Oxygen in Use" signs on the door and inside the room.
2. No open flames — no smoking, no candles, no lighters, no matches in the room.
3. No electrical appliances that could spark (some facilities restrict electric razors, hair dryers, heating pads).
4. Keep oxygen at least 5 feet from heat sources — radiators, space heaters, stoves.
5. Do not use petroleum-based products (Vaseline, petroleum jelly) on the face or lips of a resident on oxygen — these are flammable. Use water-based lubricant instead.
6. Secure oxygen tanks so they do not fall. A falling cylinder can crack the valve and become a projectile.
7. Turn off oxygen at the source during a fire — this slows the fire dramatically.

Trap callout: The most-tested oxygen-fire rule: do not use petroleum-based lip balm on a resident on oxygen. Use water-based. Petroleum products are flammable and can ignite in an oxygen-rich environment.