Course Introduction

Hyperbaric Fire Fighting And Fire Prevention Procedures Peter Manz

In 1997 a review reported 35 incidents resulting in 77 human fatalities over almost 70years of HBOT use, and also in 1997 a fire in a multiplace hyperbaric chamber in Milancaused the death of 10 patients and a nurse, apparently due to a malfunctioning firesuppression system.1, 15 Again, prevention strategies are of utmost importance, especiallywhen choosing and maintaining the equipment1Fire PreventionTo prevent fires a good knowledge of why they start is important2It is generally accepted that if the pressure is below 3 atm abs and duration of treatment is less than 120 minutes, HBOT is safe. The most common fatal complication of HBOT is due to fire, which can be catastrophic in the confined space of a chamber. Fires are generally causedby prohibited sources of ignition brought in by the patient.An analysis of such fires for the period 1927 to 1996 identified 77 human fatalities in 35 hyperbaric fires.11 In 1997, a fire in a chamber in Milan, Italy killed ten patients and a nurse. Ten years previously in Naples, a spark from a toy gun brought into a single place chamber by a four year-old child caused afatal fire.Just recently a Monoplace Unit in Florida US for reasons to be yet determined (most likely electrical) killed both occupants.The Fire TriangleFuelOxygenIGNITIONFIREA FIRE REQUIRESPLUS A FOOL TO PUT THEM TOGETHERFIRE

OOOPS3Ignition may be fromElectrical, electrostatic or break arcHot surface, friction spark or heated wireHeated gases independent of surfaces, generated by adiabatic compression or jets of hot gasExothermic chemical reactionMechanical source of friction heating and particle impactLaser sources4Ignition sources in chambersMatchesLit cigarettesCigarette lighters, pocket warmersElectrical items, radios, torches, batteries,Hand Phone. MP3 PlayersHeat packs, or chemicalsFriction toys, welders spark gunLighting5Speed of burn increases as oxygen level and or pressure increasesThis process begins at any increase over 21 % oxygen by volume at 1 ATABurn rate starts to accelerate considerably after 23.5% oxygen by volume.Therefore at no time will any chamber oxygen level be over 23.5 %If this is not known, consideration should be given to aborting the treatment 6

Cook DiagramCook Diagram7The effect of oxygen and pressure on burn ratesWhen pressure and or oxygen levels increase burns rates also increase (Cook Diagram). These changes also effect ignition temperature, which decreases, significantlyTherefore the friendly HBOT system atmosphere is unfortunately well suited to easier ignition and faster burning of fire 8Flame propagation Is determined by available oxygen and fuel

Control of fuel and oxygen is fundamental in fire management

Low oxygen, low fuel, slow / low spread of flame9Fuel sources in chambersMattressPillowsSheetsClothing, NO POCKETSPaper, books magazinesNewspapers?If hot enough and O2 then almost anything will burn

10Minimum hot plate ignitionCotton sheeting NFPA Ch 19 table 5.3.2.8

This shows that increasing oxygen levels combined with raised pressure, lowers the ignition temperature11Is chamber gas homogenous?All occupied chambers must have some pockets of differing gas, Heterogeneous (not well mixed)Therefore it is possible that the measured oxygen concentration may be high in pocketsSheffield showed that this may be minimalPP Curve disperses gas quickly, but possibly not quite evenlyNew evidence suggests that oxygen may collect near or under the floor plates

12Are Hyperbaric Fires Controllable?We should only have A Class material in a chamberIf careful control of all material in a chamber is taken (NO POCKETS)Use fire retardant products (seating materials etc)A Class material is effectively controlled by using waterAlso Fires need time to become established13Exclude ignition!!This must be possibleNo electricityNo matches, lighters (NO POCKETS)Nothing should be taken in.Only have what is allowed in the chamber.

14Fire prevention is best If a fire starts water must be availableRegular system tests, tx pre tests, and bi annual full tests, must be fastidiously carried out, and the results carefully loggedNo deaths have occurred, in any chamber when water is quickly available, and the oxygen level is less than 23.5%this is a very achievable goal, and it NEEDS TO BE COMPLIED WITH !!15Fire SystemWater is best medium to fight hyperbaric FiresIt must be available quicklyWater storage.Water pressurecontrolsdelivery

Fire SystemsNFPAIndependent Air SourceDeluge and Hand Held HosesMinimum Flow for 60 seconds (one minute)How often do you test?Do you record the results?German DIN 13256-213Italian ISPESL14UKBHA- British Hyperbaric Association 15French Decree dated march 28 199016Australian AS 4774.217 (refers NFPA99)South Africa SABS 037718EU prEN 149316

19Actions in a fireAll occupants on BIBS, protect your own airway FIRSTImmediately deluge with water.Inform all of the TeamStart an emergency ascentThese actions should be almost simultaneousPrepare to assist occupants on surfacingFire may re-ignite on door opening20

In Europe, it was only after the drama, which happened in Milan (1997) that fire inside hyperbaric chambers was looked differently upon.In 1998 a series of tests were done in HBU to determine the effectiveness of hand held and deluge systems21

22Emergency ProceduresAll events that may occur in a hyperbaric chamber should be considered and planned for.Normal procedures and those that deviate from Normal are should be covered in the Units Standard Operational Procedures ManualAll procedures need to be practiced - regularlyThese should include the emergency ones23HBO Personnel shall be knowledgeable in and have a written procedure for:Technical EmergenciesMedical EmergenciesFire EmergenciesGeneral Emergencies24Technical EmergenciesLoss of pressurizing gas airLoss of primary oxygenRapid Increase in chamber pressureRapid decrease in chamber pressureLoss of back up pressurizing gasLoss of back up oxygen sourceContaminated breathing gas either source or chamber environmentLoss of communicationsLoss of power 25Medical EmergenciesManagement of Seizures CNS Oxygen toxicityCardiac arrest, including defibrillationBarotraumas during descent/ ascentClaustrophobia and acute anxietySuspected pneumothoraxAggressive or violent patient

26Fire and General EmergenciesFIREFire inside the HTS (Chamber)Fire in the room, adjacent areaAccidental fire deluge activationGENERALOmitted decompression.Incapacitation of the technicianIllness of the attendantEmergency entry of the outside assistantRequesting help in the chamber areaEmergency decompression.27Prohibited Items /Contraband!!Sources of Ignition: Matches, Lit cigarettes, Cigarette lighters, pocket warmers, Electrical items, radios, torches, batteries, Heat packs, or chemicals, Friction toys, welders spark gun, Unsuitable clothing (Synthetics and pockets)

Sources of contamination: Oil, Smell, HP Cylinders, Other Gases, Mercury (Thermometers, BP Devices), some ointments.Sources of additional fuel: Newspapers, Extra Magazines, Bedding, Unsuitable clothing (Synthetics and having pockets), oily materials, Bandages and ointments.Documentation and Procedures

ONLY TAKE IN ESSENTIAL APPROVED MATERIALS, NOTHING ELSE !!!

Are Hyperbaric Fires Controllable?We should only have A Class material in a chamberIf careful control of all material in a chamber is taken (NO POCKETS)A Class material is effectively controlled by using waterAlso Fires need time to become establishedSafe Gas Handling, Fire Chamber EnvironmentPotential ProblemsFire hazard from high oxygen concentrationsPotential explosion of badly handled cylindersDepletion of oxygen supplyHP CylindersThe compressed energy of a HP gas cylinder is enormousIt will kill, destroy buildings if allowed toAlways firmly fix cylinders when storedlarge ones upright, small ones on sideAlways use a cart for larger cylinders (fix to cart)Never leave standing up unless it is firmly fixedSNIFT before connectingAlways turn on slowly, only use correct pressure rated equipment

Where does oxygen come from?The atmosphereBy fractional distillation Produces very pure gasDecanted, compressed further into HP cylindersAssures qualityAbsorption swing system, less pure oxygen Fractional distillation processDraws in airRemoves CO2, dust, OilCompressed, cooled to turn gas, air into a liquid. (-196 deg K at ~ 600kPa)Distilled storedCompressed evaporated into cylindersHP pure gas ready for useAll gasses have colour codesOxygen here is Green (Same as USA), Germany it is blue, UK/ Australia Black with white topBe sure of your gasAnalyze is best to be surebe careful when traveling

Safe Gas HandlingHP Gas storage cylindersOxygen manufactureOxygen hazardCalculating gas supply duration/ needsHyperbaric oxygen environment (fire risk)

Oxygen Fire HazardOxygen supports combustionHigh oxygen concentrations accelerates burn rateAlways ventilate the areaNever have exposed flame etc, no smoking where oxygen is being usedOxygen is odorless colorless. It can be present in large dangerous quantities, without being aware of it

USE NO OIL

ONLY YOU CAN PREVENT FIRES & ACCIDENTSExisting Chamber Facilities

Singapore General HospitalHyperarichealth.com43All HH chambers are medically managed.(This means trained physicians say who goes in and for how long, not us).All units are IDAN Compliant. IDAN stands for International Diver Alert Network.Are regularly visited by Hyperbaric Health staff.Almost all our units are Twin Lock systems, rated to 5.5 bar.

1 ATA3 ATA

Air465 0 C385 0 C

Oxygen360 0 C340 0 C