Oxygen usage: hospitals cautioned on fire hazard

Hospitals advised to update fire safety measures and train staff in handling oxygen

All hospitals in the State should immediately update its fire safety measures and train all its staff in the safe handling of oxygen as the increased storage and handling of oxygen cylinders and use of mechanical ventilators during COVID heightens the risk of hospital fires several fold.

Already two incidents of hospital fires have been reported from two COVID hospitals in Gujarat in the past two weeks, one as recent as Friday when at least 18 patients were killed. In both instances, the fire had broken out in the ICUs.

“Fire is a huge risk during this pandemic, especially, as there is a lot of turnover of oxygen cylinders in hospitals. Even a small spark generated while oxygen cylinders are handled – like two cylinders grazing each other creating a minor spark – can set off a fire. It is essential that those handling oxygen cylinders are well-trained in the safety protocols and that they follow it strictly at all times,” says Rajeev Jayadevan, vice chairman, Indian Medical Association’s research wing.

The issue of heightened fire hazard during COVID and the need for hospitals to re-assess fire safety precautions had been brought up during the recent internal discussions between hospitals, Dr. Jayadevan added.

Chief Minister, Pinarayi Vijayan, also flagged the issue on Saturday.

He warned all hospitals of the heightened fire hazard because of the increased handling of oxygen cylinders and to ensure that their Fire and Safety measures were up and running to prevent such incidents in Kerala.

He also asked the Fire Force Department to oversee the safety measures in hospitals

Increased use of mechanical ventilators during COVID can lead to enhanced oxygen levels in the hospital environment. Ventilation is a process wherein additional oxygen is delivered in a pressurised manner to aid physical breathing.

But when there is a surge in the use of ventilators, as during COVID, there is the risk of oxygen leaking from tubes and canisters and masks, leading to an environment enriched in oxygen inside hospital wards/rooms.

Oxygen is not flammable, but it can cause other materials to ignite more easily and to burn far more rapidly.

NHS, U.K, in a guidance it sent to hospitals in March last year, warned of increased risks of combustion in hospitals because of more ventilators being used to treat COVID-19 patients.

The guidance advised hospitals to maximise their levels of air changes through ‘natural and mechanical ventilation’ to lower the combustion risk.

Dr. Jayadevan, who has taken extensive classes on fire safety and hospital drills, recommends that all hospitals carry out risk assessment exercise and provide oxygen safety training to all staff. They should be made aware of the potential risks of oxygen combustion and how to handle oxygen cylinders and how to handle each equipment carefully so as to minimise oxygen leaks.

The rational use of oxygen should be practised and it should be turned off when not in use. Electrical equipment, which are not in use, should be switched off, so that a stray spark does not lead to a fire in the oxygen-enriched environment, he said.

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