Fire Safety Guidelines for New and Existing Hospitals and Healthcare Facility

Medpoint Hospitals Project Provides Fire Safety Guidelines for New and Existing Hospitals and Healthcare Facility:+91 8838051686

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Provisions laid down in this chapter shall establish the minimum requirements for a reasonable degree of safety from fire emergencies in hospitals, such that the probability of injury and loss of life from the effects of fire are reduced. All healthcare facilities shall be so designed, constructed, maintained and operated as to minimize the possibility of a Fire emergency requiring the evacuation of occupants, as safety of hospital occupants cannot be assured adequately by depending on evacuation alone.

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Hence measures shall be taken to limit the development and spread of a fire by providing appropriate arrangements within the hospital through adequate staffing & careful development of operative and maintenance procedures consisting of:

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1.?????Design and Construction;

2.?????Provision of Detection, Alarm and Fire Extinguishment;

3.?????Fire Prevention

4.?????Planning and Training programs for Isolation of Fire; and,

5.?????Transfer of occupants to a place of comparative safety or evacuation of the occupants to achieve ultimate safety.

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Expected Levels of Fire Safety In Hospitals

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Hospitals shall provision for two levels of safety within their premises:

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1.?????Comparative Safety: which is protection against heat and smoke within the hospital premises, where removal of the occupants outside the premises is not feasible and/or possible. Comparative Safety may be achieved through:

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a.??????Compartmentation

b.?????Fire Resistant wall integrated in the Flooring

c.??????Fire Resistant Door of approved rating

d.?????Pressurized Lobby, Corridor, Staircase

e.??????Pressurized Shaft (All vertical openings)

f.??????Refuge Area

g.?????Independent Ventilation system

h.??????Fire Dampers

i.???????Automatic Sprinkler System

j.???????Automatic Detection System

k.??????Manual Call Point

l.???????First Aid

m.????Fire Fighting Appliances

n.??????Fire Alarm System

o.?????Alternate Power Supply

p.?????Public Address System

q.?????Signage

r.??????Fire Exit Drills and orders

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2.?????Ultimate Safety: which is the complete removal of the occupants from the affected area to an assembly point outside the hospital building. Ultimate Safety may be achieved through:

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a.??????Compartmentation

b.?????Fire Resistant Door of approved rating

c.??????Protected Lobby, Corridor, Staircase and Shaft

d.?????Public Address System

e.??????Signage

f.??????Fire Drills and orders

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Structural Elements of Fire Safety

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Open Spaces

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1.?????Hospitals shall make provisions for sufficient open space in and around the hospital building to facilitate the free movement of patients and emergency/fire vehicles.

2.?????These open spaces shall be kept free of obstructions and shall be motorable.

3.?????Adequate passage way & clearance for fire fighting vehicles to enter the hospital premises shall be provided.

4.?????The width of such entrances shall be not be less than 4.5 mtrs with clear head room not less than 5 mtrs.

5.?????The width of the access road shall be a minimum of 6 mtrs.

6.?????A turning radius of 9 mtrs shall be provided for fire tender movement.

7.?????The covering slab of storage/static water tank shall be able to withstand the total vehicular load of 45 tone equally divided as a four point load (if the slab forms a part of path/drive way).

8.?????The open space around the building shall not be used for parking and/or any other purpose.

9.?????The Set back area shall be a minimum 4.5 mtrs.

10.???The width of the main street on which the hospital building abuts shall not be less than 12 mtrs & when one end of that street shall join another street, the street shall not be less than 12 mtr wide.

11.???The roads shall not be terminated in dead ends.

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Basements

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1.?????Basements, if provided shall be of type-1 construction and material used shall conform to class A material.

2.?????Basements shall be used only for parking vehicles and shall be protected with automatic sprinkler systems.

3.?????Each basement shall be separately ventilated.

4.?????Each vent shall have a cross-sectional area (aggregate) not less than 2.5% of the floor area spread evenly round the perimeter of the basement.

5.?????A system of air inlets and smoke outlets shall be provided & clearly marked as “AIR INLET” & “SMOKE OUTLET”.

6.?????Clear headroom of minimum 2.4 mtrs shall be provided for the entire basement.

7.?????A minimum ceiling height of any basement shall be 0.9 mtrs and maximum 1.2 mtrs above the average surrounding ground level.

8.?????The access to the basement shall be separate from the main and alternative staircase providing access and exit from higher floors. Where the staircase continues, in the case of buildings served by more than one staircase, the same shall be of enclosed type serving as a Fire Separation between the basement and higher floors.

9.?????Open ramps shall be permitted if they are constructed within the building line and surface drainage does not enter the basement.

10.???The staircase of the basement shall be of enclosed type having fire resistance not less than 02 hrs & shall be situated at the periphery of the basement to be entered at ground level from the open air and in such a position that smoke from any fire in the basement shall not obstruct any exit serving the ground & upper stores of the building. The staircase shall communicate with the basement through a lobby provided with fire resisting, self closing doors of 02 hrs resistance. Additional stairs shall be provided if travel distance does not meet specifications given in Table 22 of the NBC.

11.???For multi-storey basements, one intake duct may serve all basement levels, but each level & basement compartment shall have a separate smoke outlet duct or ducts. The ducts shall have the same fire resistance rating as the compartment itself.

12.???Mechanical extractors for smoke venting system from lower basement levels shall also be provided. The actuation of the system shall be incorporated with the detection and sprinkler systems. The performance of the system shall be superior than standard units. (13) Mechanical extractors shall have an interlocking arrangement, so that extractors shall continue to operate and supply fans shall stop automatically with the actuation of fire detection system.

13.???Mechanical extractors shall be designed to permit 30 air changes per hour in case of a fire emergency.

14.???Mechanical extractors shall have an alternate source of electricity supply.

15.???Ventilation ducts shall be integrated with the structure of the building and shall be made out of brick masonry or reinforced cement concrete as far as possible. Wherever this duct intersects the transformer area or an electrical switch board, fire dampers shall be provided.

16.???The basement shall not be permitted below the ward block of a hospital.

17.???No cut outs to upper floors shall be permitted in the basement.

18.???An openable window on the external wall shall be fitted with locks that can be easily opened.

19.???All floors shall be compartmented by a separation wall with 2 hrs fire rating, such that

20.???each compartment shall have a surface area not exceeding 750 sq. mtr. Floors which are fitted with sprinkler systems may have their surface areas increased by 50%. In long building fire separation wall shall be at distances not exceeding 40 mtrs.

21.???Lift/Elevators shall not normally communicate with basements; if, however, Lifts are in communication, the lift lobby of the basement shall be pressurized. A positive pressure between 25 & 30 Pascal (Pa), shall be maintained in the lobby & a positive pressure of 50 Pa shall be maintained in the Lift shaft. The mechanism for pressurization shall act automatically with the Fire Alarm. Provision shall be made to operate the system manually as well. The Lift car door shall have a Fire resistance rating equal to the Fire resistance of lift enclosure. The material used for interior finishing shall conform to class-1 materials.

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Means of Escape/Egress

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A means of escape/egress is a continuous and unobstructed way to exit from any point in a building or structure to a public way. Three separate and distinct parts of an escape/egress are:

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a.??????The Exit access,

b.?????The Exit, and

c.??????The Exit discharge.

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1.?????A means of Escape/egress comprises the vertical and horizontal travel and shall include intervening room spaces, doorways, hallways, corridors, passageways, balconies, ramps, stair enclosures, lobbies, and horizontal exits leading to an adjoining building at the same level.

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2.?????The exits in Healthcare facilities should be limited to doors leading directly outside the building, internal staircases and smoke proof enclosures, ramps, horizontal exits, external exits and exit passage.

3.?????Exits shall be so arranged that they may be reached without passing through another occupied unit.

4.?????Vertical evacuation of occupants within a health care facility is difficult and time consuming. Therefore, horizontal movement of patient is of primary importance. Because of the time required to move patients, exit access routes should be protected against Fire effects. Spaces open to the corridors shall neither be used for patients’ sleeping, as treatment rooms nor for storing hazardous material.

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Internal Staircases

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1.?????Internal staircases shall be constructed with non-combustible materials

2.?????Internal stairs shall be constructed as self-contained units along an external wall of the building constituting at least one of its sides and shall be completely closed

3.?????A staircase shall not be arranged around a Lift shaft.

4.?????Hollow combustible construction shall not be permitted

5.?????The construction material shall have 02 hrs fire resistance.

6.?????Minimum width of stairs shall be 2 mtrs.

7.?????Width of the tread shall not be less than 300 mm.

8.?????The height of the riser shall not be less than 150 mm and the number of stairs per flight shall not exceed 15

9.?????Handrails shall be provided at a height of 1000 mm, which is to be measured from the base of the middle of the treads to the top of the handrails.

10.???Banisters or railings shall be provided such that the width of staircase is not reduced.

11.???Minimum head room in a passage under the landing of a staircase and under the staircase shall be 2.2 mtrs.

12.???The staircase shall be continuous from ground floor to the terrace and the exit door at the ground level shall open directly to the open spaces or a large lobby.

13.???The number of people in between floor landings of staircases shall not be less than the population on each floor for the purpose of the design of the staircase.

14.???Fire/Smoke check doors shall be provided for a minimum of 2 hrs fire resistance rating.

15.???(15) Lift openings and any other openings shall not be permitted.

16.???(16) No electrical shaft and panel, AC ducts or gas pipelines, etc. shall pass through or open onto the staircases.

17.???No combustible material shall be used for decoration/wall panelling in the staircases.

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Protected Staircases

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Provisions given for internal staircases shall apply to protected staircases. Also, additional safeguards shall be provided as under:

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1.?????The staircases shall be enclosed by walls having 02 hrs fire resistance

2.?????The external exit doors at ground floor shall open directly onto open spaces or a lobby and Fire & Smoke check doors shall be provided.

3.?????Protected staircases shall be pressurized. Under no circumstances shall they be connected to a corridor, lobby and staircase which is unpressurized.

4.?????Pressurization systems shall be incorporated in protected staircases where the floor area is more than 500 sq. mtr. The difference in pressurization levels between staircase and lobby/ corridor shall not be greater than 5 Pa. Where 2 stage pressurization system is in use the pressure difference shall be as under:

a.??????In normal conditions - Minimum 8Pa to 15 Pa.

b.?????In emergency conditions - 50 Pa.

5.?????The pressurization system shall be interconnected with the automatic/manual fire alarm system for actuation.

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External Staircases

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1.?????External staircases serving as a required means of egress shall be of permanent fixed construction.

2.?????External staircases shall be protected by a railing or guard. The height of such a guard/railing shall not be less than 1200 mm.

3.?????External staircases shall be separated from the interior of the building by walls that are fire resistant and have fixed or self closing opening protectives’, as required for enclosed stairs. External staircases shall extend vertically from the ground to a point 3 meters above the topmost landing of the stairway or the roof line whichever is lower, and atleast 3 meters horizontally.

4.?????All openings below and outside the external staircases shall be protected with requisite fire resistance rating.

5.?????External staircases shall be so arranged to avoid any discomfort/obstruction for persons with a fear of heights, from using them.

6.?????External staircases shall be so arranged to ensure a clear direction of egress to the street.

7.?????External staircases shall be continuous from the ground floor to the terrace level

8.?????The entrance to the external staircases shall be separate and remote from internal staircases.

9.?????External staircases shall have a straight flight with a width not less than 2 mtrs, a tread not less than 300 mm, a riser not more than 150 mm and the number of risers shall be limited to 15 per flight.

10.???The handrail shall have a height not less than 1000 mm and not exceeding 1200 mm.

11.???Banisters shall be provided with a maximum gap of 150 mm.

12.???Stair treads shall be uniformly slip resistant and shall be free of projections or lips that could trip stair users

13.???External staircases used as fire escapes shall not be inclined at an angle greater than 45o from the horizontal

14.???Unprotected steel frame staircases shall not be acceptable means of egress; however steel staircases in an enclosed compartment with a fire resistance of 2 hrs will be accepted as means of escape.

?15. Elevators constitute a desirable supplementary facility though they are not counted as required exits. Patient’s lifts shall have sufficient space for Stretcher trolley.

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Horizontal Exits

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A horizontal exit implies that the occupants will be transferred from one side of a partition to the other. Essential fire safety provisions for horizontal exits are as follows:

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1.?????Width of the horizontal exits shall be same as the exit doorways.

2.?????A horizontal exit shall be equipped with at least one fire/smoke door of minimum 2 hrs fire resistance of self closing type. Further they shall have direct access to the fire escape staircase for evacuation.

3.?????A refuge area of 15 Sq. Mtr. or an area equivalent to 0.3 Sq Mtr. per person for the number of occupants in two consecutive floors, whichever is more, shall be provided on the periphery of the floor or preferably on an open air cantilever projection with at least one side protected with suitable railings/guards with a height not less than 1 mtr.

4.?????Within the aggregated area of corridors, patient rooms, treatment rooms, lounges, dining area and other low hazards areas on each side of the horizontal exit, a single door may be used in a horizontal exit given that the exit serves one direction only. Such doors shall be swinging doors or a horizontal sliding door.

5.?????Where there is a difference in the level between areas connected by a horizontal exit, ramps not more than 1 in 10 mtr slope shall be provided. The steps shall not be used.

6.?????Doors shall be accessible at all times from both sides.

7.?????A horizontal exit involving a corridor 8 ft or more in width serving as a means of egress from both sides of the doorway shall have the opening protected by a pair of swinging doors arranged to swing in the opposite direction from each other.

8.?????An approved vision panel is required in each horizontal exit. Center mullions are prohibited.

9.?????The total exit capacity of other exits (stairs, ramps, doors leading outside the building) shall not be reduced to below one third of the amount that is required for entire area of the building.

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Exit Doors

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1.?????Every door and every principal entrance that also serves as an exit shall be so designed and constructed that the way of Exit travel is obvious and direct.

2.?????Width of the doors shall be minimum 2 mtr and other requirements of the door shall comply with the NBC.

3.?????Doors shall not be equipped with a latch or lock that requires the use of tool and/or key from the egress side. Mental hospitals are permitted for door locking arrangements.

4.?????Where door locking arrangements are provided, provision shall be made for the rapid removal of patients by such reliable means as remote control of locks or the keys of all locks made readily available to staff who are in constant attendance.

5.?????Doors in fire resistant walls shall be so installed that they may be normally kept in an open position, but shall close automatically. Corridor doors opening into the smoke barrier shall be not less than 2000 mm in width. Provision shall also be made for double swing single/double leaf type doors.

6.?????The fire resistance rating of doors shall meet fire resistance rating of construction material.

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Corridors and Passageways

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1.?????The minimum width and height of corridors and passage ways shall be 2.4 mtr. The exit corridor and passage ways shall have a width not less than the aggregate required width of Exit doorways leading from them in the direction of travel to the exterior. Corridors shall be adequately ventilated.

2.?????Corridor walls shall form a barrier to limit the transfer of smoke,toxic gases and heat.

3.?????Transfer grills, regardless of whether protected by fusible link operated dampers, shall not be used in corridor walls or doors.

4.?????Openings if required in corridor walls for specific use, shall be suitably protected.

5.??Fixed wired glass opening vision panel shall be permitted in corridor walls, provided they don’t exceed 0.84 Sq Mtr in area and are mounted in steel or other approved metal frames.

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Compartmentation

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1.?????In buildings or sections occupied by bed ridden patients where the floor area is over 280 Sq Mtr., facilities shall move patients in Hospital beds to the other side of a smoke barrier from any part of such a building or section not directly served by approved horizontal exits from the floor of a building to outside.

2.?????Any section of the building more than 500 Sq.Mtr. shall be suitably compartmented with fire resistance of not less than 2 hrs.

3.?????Every storey used by inpatients for sleeping or treatment shall be divided into not less than two smoke compartments

4.?????Every storey having an occupant load 50 or more persons, regardless of use, shall be divided into two smoke compartments.

5.?????The size of each smoke compartment shall not exceed 500 Sq Mtrs.

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Ramps

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1.?????All ramps shall comply with the applicable requirements for stairways regarding enclosure, capacity and limiting dimensions except in certain cases where steeper slopes may be permitted with inclination less than 1 in 8 ( under no condition shall the slopes greater than 1 in 8 be used).

2.?????Ramps shall be surfaced with approved non skid & non slippery material.

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Service Shafts/Ducts

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1.?????Service shafts/ducts shall be enclosed by walls with 2 hr and doors with 1 hr fire resistance rating. All such ducts/shafts shall be properly shielded and facilities shall be available to control fires along these shafts/ducts at all levels.

2.?????A vent opening at the top of a service shaft shall have an area between one fourth and half of the area of the shaft.

3.?????Refuge chutes shall have openings at least 1 mtr above the roof level for venting purpose and they shall have an enclosure wall of non combustible material with fire resistance rating of 2 hrs. They shall not be located within the staircase enclosure or service shaft and be as far away from the exit as possible.

4.?????The inspection panels and doors of air conditioning shafts shall be well fitted, with a fire resistance rating of 1 hr.

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Openings in Separation Walls and Floors

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1. At the time of designing openings in separation walls and floors particular attention shall be paid to all factors that will help limit the spread of fire through these openings and the fire ratings of these structural members shall be maintained.

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2.?????For type 1 to 3 construction, a door way or opening in a separation wall on any floor shall be limited to 5.6 Sq.Mtr. in area with a maximum height/width of 2.75 mtr. Every wall opening shall be protected with fire resistant doors having the fire rating of not less than 2 hrs. in accordance with accepted standards.

3.?????Every vertical opening between the floors of a building shall be suitably enclosed or protected as necessary to prevent the spread of fire, smoke and fumes such that there is a reasonable level of safety for the occupants using the means of egress. It shall be ensured to provide a clear height of 2100 mm in the passage

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Fire Stop or Enclosure of Openings

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1.?????Where openings are permitted for external walls they shall not exceed 3/4th the area of the wall and shall be protected with fire resisting assemblies or enclosures with a fire resistance equivalent to that of the wall in which these are situated. Such assembles and enclosures shall also be capable of preventing the spread of smoke and fumes through the openings so as to facilitate the safe evacuation of building in case of a fire.

2.?????All openings in the floors shall be protected by vertical enclosures extending above and below such openings. The walls of such enclosures shall have a Fire resistance of not less than 2 hrs. and all openings therein shall be protected with a fire resisting assembly.

3.?????For type 4 constructions, openings in separation walls or floors shall be fitted with 2 hrs fire resisting assemblies.

4.?????Openings in the walls and floors which provide access to building services like cables, electrical wiring, telephone cables, plumbing pipe etc. shall be protected by enclosures in the form of ducts/shafts with a fire resistance of not less than 2 hrs.

5.?????The inspection doors for electrical shafts and ducts shall have fire resistance rating not be less than 2 hrs and all other service shafts and ducts shall have a fire resistance rating not less than 1 hr.

6.?????Medium and low voltage wiring in shafts/ducts shall either be armoured or run through a metal conduit. The space in between the conduit pipes and the walls/slabs shall be filled by a filler material that has a fire resistance rating of not less than 1 hr. The above parameters shall not be applied on patients and goods lift well opening.

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Non-Structural Elements of Fire Safety

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Underground Static Water Tank for Fire Fighting

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Provisions shall be made for a dedicated fire fighting tank, of suitable capacity as per NBC P-IV, that shall remain full at all times. However, special attention shall be given to calculating the actual capacity of the water tank to ensure its compatibility to the installed fire fighting system.

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1.???A four way collecting head shall be provided at an easily accessible location near the tank.

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Fire Pump Room

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1.?????Provisions shall be made to have a centralized room to house the pumps that supply water to the various fire fighting systems. The pumps shall be as per NBC P-IV.

2.?????The following pumps shall be installed:

a.??????Jockey Pump: An electrically driven centrifugal single/two stage pump of 280 LPM capacity shall be installed to maintain the system pressure upto 7 kg/cm2. They shall be activated automatically whenever the pressure falls below 5.5 kg/cm2.

b.?????Main Fire Pump: An electrically driven centrifugal Multi stage pump of 2850 LPM capacity shall be installed to feed the Fixed Fire Fighting System. Provisions shall be made for an alternate electric supply with a changeover switch for this pump.

?c. Diesel Fire Pump: A diesel driven prime mover multi stage pump of 2850 LPM capacity shall be installed to feed the Fixed Fire Fighting system in case of failure to main Fire Pump.

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Yard Hydrant

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1.?????Provision shall be made to install a yard hydrant throughout the premises. The distance between two successive hydrants shall not exceed 45 mtr.

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Wet Rising Mains

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1.?????A vertical rising main of G.I. C class steel pipeline with an internal diameter of 100 mm shall be provided from the ground floor to the top most floor of the hospital along with hydrant outlets fitted at the height of 0.9 mtr from the flooring at each floor.

2.?????First Aid hose reels with a diameter of 25 mm and length of 45mtrs, shall be provided at each floor fitted with a 6.5mm diameter shut off type nozzle.

3.?????An air release valve shall be provided at the top of the rising main.

4.?????A Fire service inlet shall be provided at the ground floor.

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Hose Box

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1.???A glass front cabinet containing two RRL type delivery hoses, each 15 mtrs in length and with a diameter of 63mm instantaneous coupling fitted with associated branch pipe, shall be provided.

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Automatic Sprinkler System

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1.?????The entire building including the basements shall be fitted with sprinklers connected to a gong bell/fire detection panel, which shall be located in the central control room.

2.?????The entire building including the basement shall be fitted with an Automatic Fire Detection and Alarm system comprising of smoke detectors, and manual call points which shall be connected to the fire alarm panel in the central control room.

3.?????The sprinkler, fire detection and alarm systems shall be provided with an alternative source of power supply.

4.?????Initiation of required fire alarm system shall be by manual means or by means of any detection device.

5.?????An internal audible alarm shall be incorporated.

6.?????Pre-signal systems are prohibited.

7.?????Corridors shall have an approved automatic detection system.

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Emergency and Escape Lighting

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1.?????Emergency lighting shall be powered from a source independent of the normal lighting system.

2.?????Emergency lights shall clearly and unambiguously indicate the escape routes.

3.?????Emergency lighting shall provide adequate illumination along escape routes to allow the safe movement of persons towards and through the exits.

4.?????Emergency lighting shall be provided in a manner to ensure that fire alarm call points and fire fighting equipments provided along the escape routes are readily located.

5.?????The horizontal luminance at floor level on the center line of an escape route shall be not less than 10 lux. Additionally, for escape routes that are upto 2 mtrs in width, 50% of the route width shall be lit to a minimum of 5 lux.

6.?????The emergency lighting shall be activated within one second of the failure of the normal lighting.

7.?????The luminaries shall be mounted as low as possible but at least 2 mtrs above the floor level.

8.?????Emergency lighting shall be designed to ensure that a fault or failure in any open luminaries does not further reduce the effectiveness of the system.

9.?????Emergency lighting luminaries and their fittings shall be of non flammable type.

10.???The emergency lighting system shall be capable of continuous operation for a minimum of 1 and a half hours (90 minutes).??