fire hazard in neonatal units in india: let’s make a start

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CORRESPONDENCE Fire Hazard in Neonatal Units in India: Lets Make a Start Atul Goel & Anoop Mathew & Tejinder Singh Received: 17 February 2012 / Accepted: 3 August 2012 / Published online: 23 August 2012 # Dr. K C Chaudhuri Foundation 2012 Sir, The commentary [1] in November issue of Indian Journal of Pediatrics on fire safety in neonatal units was long overdue. The authors have critically analyzed the issue and have come up with comprehensive guidelines. A number of fire accidents in neonatal units throughout India have occurred in recent times, the most horrific being the fire in a Patiala based hospital [2]. The neonatal units are generally vulnerable for fire acci- dents in the hospitals due to the presence of oxygen and inflammable substances like alcohol. The existence of large number of heavy electrical equipment makes it additionally susceptible than any other place in the hospital. The guide- lines offered in the commentary [1] are wide-ranging and have looked at the issue as a whole. In India, despite increasing awareness about the issue, these guidelines may remain largely unimplemented, primarily due to the lack of resources. While it is extremely important to implement these guidelines as a whole, we also know it may not happen in most neonatal units in India because of lack of resources. But instead of waiting for the right amountof resources, we urgently need to make a start with whatever we have. Here are some simple, reasonable and low cost interven- tions, which may not be complete but would still help in reducing the risk of fires in neonatal units in India. 1. Keep an alternate and functional exit. Most of the neo- natal units keep only single entry and exit point in order to restrict the entry of people. 2. The regular maintenance of equipments, especially overhead warmers. In almost all cases the fire seems to start from faulty electrical equipment. 3. Heavy electrical wiring. The electrical wiring in the nursery is usually done as for the rest of the hospital. Consequently it is insufficient to bear the load of large number of electrical equipments and heaters and becomes a vulnerable point. 4. Increasing the number of electrical points. In the ab- sence of sufficient number of electrical points, extension boards are frequently used which becomes potential sparking point. 5. Direct observation. Many nurseries in India still run with the nursing station outside. This puts the infants at grave risk as they remain unattended and at the same time early signs of the disaster may be missed. 6. Training of the entire staff and the presence of evacuation plan in the event of fire. Lack of staff training and its consequences were amply demon- strated during another fire accident in Kolkata re- cently [3]. References 1. Venkataseshan J, Pandit S, Saini A. Fire accidents in neonatal nursery: prevention and management. Indian J Pediatr. 2011;78:14046. 2. Five newborns charred to death in Patiala hospital. Indian express, 1st Feb 2009. Last accessed on 16 Feb 2012. Available from: http:// www.indianexpress.com/news/five-newborns-charred-to-death-in- patiala-ho/417604/ 3. 89 dead in Kolkata hospital fire. Hindustan Times, December 09, 2011. Last Accessed 16 Feb 2012. Available from: http:// www.hindustantimes.com/India-news/Kolkata/89-dead-in-Kolkata- hospital-fire/Article1-779821.aspx A. Goel (*) : A. Mathew : T. Singh Department of Pediatrics, Christian Medical College, Ludhiana 141008, India e-mail: [email protected] Indian J Pediatr (March 2013) 80(3):269 DOI 10.1007/s12098-012-0868-8

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CORRESPONDENCE

Fire Hazard in Neonatal Units in India: Let’s Make a Start

Atul Goel & Anoop Mathew & Tejinder Singh

Received: 17 February 2012 /Accepted: 3 August 2012 /Published online: 23 August 2012# Dr. K C Chaudhuri Foundation 2012

Sir,The commentary [1] in November issue of Indian Journal ofPediatrics on fire safety in neonatal units was long overdue.The authors have critically analyzed the issue and havecome up with comprehensive guidelines. A number of fireaccidents in neonatal units throughout India have occurredin recent times, the most horrific being the fire in a Patialabased hospital [2].

The neonatal units are generally vulnerable for fire acci-dents in the hospitals due to the presence of oxygen andinflammable substances like alcohol. The existence of largenumber of heavy electrical equipment makes it additionallysusceptible than any other place in the hospital. The guide-lines offered in the commentary [1] are wide-ranging andhave looked at the issue as a whole. In India, despiteincreasing awareness about the issue, these guidelines mayremain largely unimplemented, primarily due to the lack ofresources.

While it is extremely important to implement theseguidelines as a whole, we also know it may not happen inmost neonatal units in India because of lack of resources.But instead of waiting for the “right amount” of resources,we urgently need to make a start with whatever we have.Here are some simple, reasonable and low cost interven-tions, which may not be complete but would still help inreducing the risk of fires in neonatal units in India.

1. Keep an alternate and functional exit. Most of the neo-natal units keep only single entry and exit point in orderto restrict the entry of people.

2. The regular maintenance of equipments, especiallyoverhead warmers. In almost all cases the fire seemsto start from faulty electrical equipment.

3. Heavy electrical wiring. The electrical wiring in thenursery is usually done as for the rest of the hospital.Consequently it is insufficient to bear the load of largenumber of electrical equipments and heaters and becomesa vulnerable point.

4. Increasing the number of electrical points. In the ab-sence of sufficient number of electrical points, extensionboards are frequently used which becomes potentialsparking point.

5. Direct observation. Many nurseries in India still runwith the nursing station outside. This puts the infantsat grave risk as they remain unattended and at the sametime early signs of the disaster may be missed.

6. Training of the entire staff and the presence ofevacuation plan in the event of fire. Lack of stafftraining and its consequences were amply demon-strated during another fire accident in Kolkata re-cently [3].

References

1. Venkataseshan J, Pandit S, Saini A. Fire accidents in neonatalnursery: prevention and management. Indian J Pediatr. 2011;78:1404–6.

2. Five newborns charred to death in Patiala hospital. Indian express,1st Feb 2009. Last accessed on 16 Feb 2012. Available from: http://www.indianexpress.com/news/five-newborns-charred-to-death-in-patiala-ho/417604/

3. 89 dead in Kolkata hospital fire. Hindustan Times, December 09,2011. Last Accessed 16 Feb 2012. Available from: http://www.hindustantimes.com/India-news/Kolkata/89-dead-in-Kolkata-hospital-fire/Article1-779821.aspx

A. Goel (*) :A. Mathew : T. SinghDepartment of Pediatrics, Christian Medical College,Ludhiana 141008, Indiae-mail: [email protected]

Indian J Pediatr (March 2013) 80(3):269DOI 10.1007/s12098-012-0868-8