157. CCA Study Notes: Fire Prevention, Emergency Response, Evacuation, and Burn Safety

The Big Picture

Fire safety starts before a fire happens. You need to know how to prevent common fire hazards, where emergency equipment and exits are located, and what actions to take if a fire starts.

During a fire, the order of your actions matters. You also need to recognize when an extinguisher is appropriate, follow evacuation rules, and know how to respond to different types of burns.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

Preventing Fires

Fires are a danger in both homes and facilities. Important causes include:

• unsafe smoking
• cooking accidents
• faulty electrical equipment and wiring
• heating equipment

The health care team needs to stay alert to fire hazards and take steps to prevent fires.

A hazardous material is a substance that presents a physical hazard or health hazard in the workplace.

Smoking Safety

Follow these fire-prevention rules around smoking:

• Smoke only in approved smoking areas.
• Do not smoke in a client’s home.
• Supervise clients who smoke.
• Supervision is especially important when a client is confused, disoriented ⓘ, or sedated.
• Give ashtrays to clients who are allowed to smoke.
• Check smoking areas and furniture for dropped cigarettes and ashes.
• Make sure cigarettes, cigars, and ashes are completely out before emptying ashtrays.
• Empty ashtrays into a metal container partly filled with sand or water.
• Do not empty ashtrays into plastic containers or wastebaskets lined with paper or plastic bags.
• Do not allow clients to smoke in bed or while lying down.
• Do not light matches or lighters or smoke near flammable liquids or materials.
• Keep matches and lighters away from children.

Cooking and Heat Safety

Cooking and heating equipment also create fire risks.

• Avoid deep-frying in oil because oil is highly flammable.
• When deep-frying is necessary, use a deep-fryer instead of a shallow pan.
• Do not hang tea towels or other material over an oven door.
• Use potholders to remove hot items from an oven. Do not use tea towels.
• Follow the manufacturer’s directions for space heaters.
• Keep space heaters at least 1 m (3 ft.) from curtains, drapes, and furniture.
• Do not leave a space heater unattended.
• Keep flammable liquids and materials away from fireplaces, radiators, heat registers, and other sources of heat or flame.
• Store flammable liquids in their original containers.

Electrical Fire Prevention

Electrical equipment also needs careful handling.

• Do not run electrical cords under carpets.
• Use extension cords only as a temporary measure.
• Follow equipment-accident prevention guidelines.

Smoke Detectors in Home Care

Working smoke detectors are essential on every floor of a home. Ideally, smoke detectors should also be outside each sleeping area.

Identify the smoke detectors in each client’s home. The homeowner holds responsibility for making sure they work.

Report: If you find a smoke detector that does not work, notify your supervisor and the family.

Oxygen and Fire Risk

Some clients receive oxygen therapy because they have difficulty breathing or do not get enough oxygen from the air. Physicians prescribe oxygen therapy.

Additional oxygen reaches the client through a nasal tube or face mask. Oxygen sources include:

• portable oxygen tanks
• wall outlets
• oxygen concentrators

Oxygen supports combustion ⓘ, which makes it a serious fire hazard. Keep combustible and easily ignited items away from the oxygen source.

Examples include petroleum jelly and clothing, towels, or sheets with static charge.

Safety Around Oxygen Equipment

Follow these precautions wherever oxygen is used or stored.

Smoking and Flames

• Never smoke around oxygen equipment.
• Remove ashtrays, lighters, and other smoking items from the room.
• Place “No Smoking” and “Oxygen in Use” signs on the front door of the client’s home, apartment, or room.
• Place signs near the area where oxygen is directly used.
• Remind the client, family, and visitors never to smoke around oxygen equipment.
• Keep oxygen tanks away from open flames, including pilot lights, candles, and incense.
• Keep tanks away from heat sources, including stoves, heating ducts, radiators, and space heaters.

Flammable Materials

Remove materials that ignite easily from the room. Examples include:

• alcohol
• nail polish remover
• oils
• greases

When a client receives oxygen, make sure the client does not use flammable toiletry products such as:

• perfume
• petroleum jelly
• hairspray
• aftershave lotion

Electrical Equipment Around Oxygen

• Turn electrical items off before unplugging them. Unplugging an item while it remains on might create a spark.
• Use electrical equipment only when the prongs are intact and the equipment works properly.
• This rule includes electric shavers, hair dryers, radios, and stereo equipment.
• Before using an electric shaver, blow dryer, or curling iron on the client, shut off the oxygen source and remove it from the client because these items present a spark risk.

Fabrics and Static Electricity

Remove wool and synthetic fabrics from the room because they might create static electricity.

Use:

• cotton uniforms
• cotton blankets
• cotton clothing for the client

Keep the oxygen supply company’s phone numbers readily available for an emergency.

Prepare Before a Fire Happens

Preparation helps the health care team respond quickly and responsibly.

Know:

• your employer’s fire-emergency policies and procedures
• where fire alarms are located
• where fire extinguishers are located
• where emergency exits are located

Facilities hold fire drills so workers practise emergency fire procedures.

Fire Planning in a Client’s Home

Plan for fire emergencies the first time you enter a client’s home.

Plan two fire escape routes from every room.

If the client lives in an apartment building, identify the fire alarms in the hallways.

RACE: What to Do When You Find a Fire

Use RACE to remember the correct order.

1. R, Rescue

Rescue people in immediate danger.

Move them to a safe place.

2. A, Alarm

Sound the nearest fire alarm.

Notify the switchboard operator ⓘ.

In a client’s home, call 9-1-1.

3. C, Confine

Close doors and windows to confine the fire.

Turn off oxygen or electrical equipment being used in the general area of the fire.

4. E, Extinguish or Evacuate

Use a fire extinguisher only on a small fire that has not spread to a larger area.

If the fire does not extinguish easily, evacuate.

Keep equipment away from exits so the exits remain passable.

Fire Extinguisher Rules

Rules for extinguisher use differ among facilities. Some facilities allow only supervisory or registered staff to use them. Other facilities require all employees to demonstrate extinguisher use.

Know your agency’s rules and receive proper training.

Fire extinguishers are readily available in facilities. Home care clients should also have a fire extinguisher available.

Checking a Home Fire Extinguisher

When a client has a fire extinguisher at home, identify it and check three things:

1. The pin is intact.
2. The plastic seal remains secured to the extinguisher.
3. The pressure dial reads “full.”

If any of these parts are missing or incorrect, notify your supervisor and the family.

When Not to Fight a Fire

Never try to fight a large or spreading fire with an extinguisher.

Use an extinguisher only for a small fire that has stayed where it started, such as a wastebasket or cushion fire.

Do not use a fire extinguisher on a fire fed by gas or flammable liquid.

Classes of Fire Extinguishers

Different extinguishers suit different types of fires.

Class	Memory Word	Type of Material
Class A	Ash	Materials that burn and leave ash, such as paper and wood
Class B	Burn/Boil	Materials that burn or boil, such as oil and grease
Class C	Current	Materials with electric current, causing electrical fires

Using the wrong type of extinguisher makes a fire worse.

Some extinguishers are multipurpose and are designed for all types of fires.

PASS: How to Use a Fire Extinguisher

Learn extinguisher use before an emergency. When you need to use one, remember PASS:

1. P, Pull the pin out.
2. A, Aim at the base of the fire.
3. S, Squeeze the handle.
4. S, Sweep from side to side while spraying the extinguisher contents.

Evacuating During a Fire

Facilities have their own evacuation policies and procedures.

When evacuation becomes necessary, take clients closest to the danger out first.

Clients who walk receive blankets to wrap around themselves. A staff member escorts them to a safe place.

Emergency rescue procedures for people who do not walk are for emergency evacuation only. Do not use these procedures as routine methods for moving clients.

Once firefighters arrive, they direct rescue efforts.

Important Evacuation Safety Rules

Never Use an Elevator

Never use elevators when a building is on fire.

Elevators might fill quickly with smoke or stop working during a power outage.

Check Doors Before Opening Them

Touch a door before opening it.

• Do not open a hot door. Find another way out.
• If the door feels cool, open it carefully.
• If heat and smoke rush in, close the door again.

Moving Through Smoke

Look for a smoke-free escape route first.

If you must leave through smoke:

• cover your nose and mouth with a damp cloth
• cover the client’s and family’s noses and mouths with damp cloths
• have everyone crawl toward the nearest exit to stay below the smoke

If Your Clothes Catch Fire

Do not run.

1. Drop to the ground.
2. Cover your face.
3. Roll to smother the flames.

If possible, wrap a rug or blanket around yourself.

If a client’s clothing catches fire, have the client roll on the floor until the flames go out.

Another option is to cover the person with a blanket or coat. Protect the client’s head and neck first. Lay the blanket or coat over the burning area, then pat the area until the fire goes out.

After Leaving the Building

Once you and the client leave a burning building, do not go back inside.

If Fire or Smoke Traps You in a Room

• Shut the door.
• Block gaps, including the space under the door, with blankets or other thick material to keep smoke out.
• If possible, call 9-1-1 or the fire department.
• Tell emergency responders exactly where you are in the building.
• Go to the window and shout for help.
• Hang a large towel, sheet, piece of clothing, or other large material from the window to attract firefighters’ attention.

Understanding Burns

Burns range in severity. Severe burns might disfigure or disable a person and might lead to death.

Most burn injuries occur in the home.

Infants, children, and older people have the highest risk.

Degrees of Burns

First-Degree Burn

A first-degree burn causes:

• red skin
• pain
• no blistering

Second-Degree Burn

A second-degree burn affects both the epidermis and dermis layers of the skin.

It causes:

• pain
• redness
• blistering
• swelling

Third-Degree Burn

A third-degree burn extends below the dermis into underlying layers and nerves.

The skin appears:

• blackened
• charred

The burned area might feel numb.

Causes of Burns

Burns have several causes:

• Dry heat: fire, stoves, space heaters
• Moist heat: hot liquids, steam
• Chemicals: oven cleaner, drain cleaner, rust remover
• Electricity: faulty electrical equipment, live wires, lightning
• Radiation: sunlight

When a Burn Is More Serious

Burns require emergency help when:

• the burn involves the head, face, neck, hands, feet, or genitals
• the burn covers a large area of the body
• the burned person is under 2 years old
• the burned person is over 50 years old
• the person has a pre-existing medical condition, such as diabetes or hypertension

The burn’s size and depth also affect its severity.

First Aid for a Minor Burn

Use these steps for a minor burn limited to a small area.

1. Cool the burn immediately. Put the area in a sink of cool water, run cool water over it, or cover it with a clean, wet, cool cloth. Cooling reduces pain, swelling, blistering, and tissue damage.
2. After the pain decreases, gently pat the skin dry.
3. Cover the area with dry, lint-free, clean cloth or gauze.
4. Secure the covering with tape. Do not let the tape touch the burn.
5. Report the burn to your supervisor.
6. Seek medical attention if necessary.

Emergency Care for a Serious Burn

For a serious burn, activate the emergency medical services system for your area, usually by calling 9-1-1.

The next actions depend partly on the source of the burn.

Chemical Burns

For a chemical burn:

1. Carefully and quickly brush away loose chemical powder with a cloth.
2. Flush the area with large amounts of cool water for 15 to 20 minutes.
3. Carefully remove contaminated clothing while flushing the area.

Electrical Burns

Safety first: Do not touch a person who remains in contact with an electrical source.

Have the power turned off or remove the electrical source first.

Use an object that does not conduct electricity, such as rope or wood, to remove the electrical source.

Do not apply water to an electrical burn because water increases the risk of shock.

Burns From a Heat Source

Stop the burning process and protect yourself from the source.

Extinguish flames with water, or roll the person in a:

• blanket
• coat
• sheet
• towel

Clothing, Jewellery, and Swelling

Remove burned clothing only when it does not stick to the skin.

Do not pull clothing that sticks to the burn.

Remove jewellery, tight clothing, and belts before the injured area swells.

Rescue Breathing and CPR

Give rescue breathing and cardiopulmonary resuscitation, CPR, as needed.

Cooling a Serious Burn

Use cool water, not ice.

• Do not use cold water on large third-degree burns.
• Do not place a burn in ice water.
• Cover the burn with a clean, cool, moist compress.
• For burns on the hands, feet, or face, reapply the cool compress for up to 20 minutes.
• For second-degree burns, reapply the cool compress for up to 1 hour.
• Pat the area dry afterward.

Covering the Burn

Loosely cover the burn with a clean, dry covering.

Thick sterile gauze is preferred. Towels, sheets, or another clean cloth also serve as coverings.

Tape the covering in place without letting the tape touch the burn.

What to Avoid With Serious Burns

Do not:

• put oil on the burn
• put butter on the burn
• apply salve
• apply ointment
• break blisters

Cover the client with a blanket or coat to prevent heat loss.

Watch for Signs of Shock

Watch for:

• lack of alertness
• loss of consciousness
• rapid heartbeat
• weak pulse
• rapid breathing
• sweating
• paleness
• decreased urine output or no urine output

Stay with the client until help arrives.

Common Mix-Ups

Wrong Idea	Better Idea
An extinguisher is appropriate for any fire.	Use one only on a small fire that has not spread.
Every facility follows the same extinguisher-use rule.	Follow your agency’s rules and training requirements.
Class A, B, and C extinguishers all match the same fire type.	A relates to ash-producing materials, B to oil and grease, and C to electrical fires.
Fire evacuation procedures are routine ways to move clients.	Emergency evacuation procedures are for emergencies only.
Ice is the correct way to cool a burn.	Use cool water. Do not place the burn in ice water.
Water belongs on every type of burn.	Do not apply water to an electrical burn while electrical shock remains a risk.
Stuck burned clothing should be pulled off.	Leave clothing that sticks to the burn in place.