Many of your patients’ homes present fire hazards.  According to the National Fire Protection
Association, more than 400,000 home fires take place annually.  Some patients are at a special risk.  Those age 80 or
older are three times more likely to die in a fire.  Patients with disabilities
Are also vulnerable.

That’s why your agency has a fire safety program to help protect you and your patients.  The fire safety program, aimed at
preventing fires in patient’s homes and at the office, must comply with standards set by local fire ordinances.


It takes four elements to make fire:  oxygen, fuel, heat, and the resulting chemical reaction when they combine to ignite a

  • Oxygen is always present.  Fire needs it to ignite.  You need it to live.  Your job is to keep the other two ingredients
    – heat and fuel – away from each other.
  • Heat is present in many sources, including stoves, appliances such as toasters, fireplaces, lighted cigarettes and
    damaged electrical wiring.
  • Fuel is anything combustible – that is, anything that will burn when exposed to heat.  Cloth, paper, wood, upholstery,
    gasoline, and kerosene are all fuels.
  • A chemical reaction occurs when the right amount of oxygen, fuel, and heat are present and generates a fire.  
    Interrupt that chain reaction by removing any or all of the elements and the first can’t sustain itself.

Alert families should keep combustibles a safe distance from any source of heat and to be cautious around oxygen


There are five types of fire.  Fires are categorized by the types of heat sources and combustibles that cause them.
In homes, most fires start due to unattended cooking, unattended candles, dryer fires, cigarettes. Here’s how they can be

  • Class A fires:  Use proper housekeeping.  Keep trash and clutter from piling up.
  • Class B fires:  Store cleaning fluids, paints, solvents, oils, and similarly flammable gases and liquids far away from
    any heat source.
  • Class C fires, or electrical fires:  Keep appliances in working order.  Replace or repair old or worn out wiring.  Don’t
    overload extension cords or electrical cords under rugs.  If any appliance starts to smoke or puts out an unusual
    smell, unplug and stop using it until it is repaired.
  • Class K fires:  When using the stove, never leave an active burner unattended.  Since most homes don’t have Class
    K rated fire extinguishers, clients need to know how to extinguish a fire on the stove.  Oil and grease fires cannot be
    put out with water.  They need to be smothered.


According to a study by the US Fire Administration, the older a dwelling is, the greater the likelihood of fire.  But the fact is
that no home is safe from fire.

  • Kitchen:  Cooking accidents are the leading cause of fire-related injuries for the elderly.
  • Bedroom:  Electrical fires most commonly occur here from space heaters placed too close to flammables, or misused
    or damaged electric blankets.
  • Utility room, basement, garage:  Here or wherever household heat is generated are risk areas.  The risk increases
    in rooms where space heaters are used.
  • Clothes dryers:  Lint build up and lack of proper ventilation can increase the risk of fire.
  • Older homes:  Outdated electrical wiring systems and overloaded sockets pose risks.

Fires are most often started by people due to:

  • Carelessness, such as unsafe smoking habits.
  • Forgetfulness, such as leaving food unattended on the stove.
  • Negligence, as in letting children play around matches, cooking flames or other fire hazards.


Assess a home’s fire safety on your first visit.

Start outside.

  • Locate all exits.
  • Identify the construction material of the house.
  • Make sure the address is clearly marked and visible to the fire department.

Move inside.

  • Locate all exits.
  • Determine whether there is electricity and how the home is heated.
  • Look for a circuit breaker or fuse box and make sure the right-sized fuses are used.
  • Make sure space heaters have three feet of clearance around them.
  • Make sure kerosene heaters have three feet of clearance around them.  Check for adequate ventilation to avoid the
    danger of carbon monoxide poisoning.
  • Make sure fireplaces or wood stoves are cleaned to avoid chimney fires caused by creosote buildup.  Check for use
    of fireplace screens.  Flammable items must be kept well away.
  • Next, look for the following fire safety equipment.
  • At least one smoke detector on each level, especially near bedrooms.  The detector should be tested and cleaned
    monthly.  Batteries should be changed twice yearly – for example, when Daylight Savings Time starts and stops.
  • A working flashlight in every bedroom, since smoke creates darkness and electricity may go off.
  • A portable fire extinguisher in the kitchen and any other room at risk for fire.  Make sure everyone knows how to use

Proper Use of Fire Extinguishers

Fire extinguishers are categorized by the type of fire they put out:  a Class A, B, or C fire.  ABC
Extinguishers can be used to fight Class A, B, or C fires. Class K extinguishers are mainly used in commercial kitchens, so
most homes will not have them, but they are available for home use.  For best overall protection in the kitchen, use a multi-
purpose, dry chemical extinguisher rated for Class A, B, and C fires.

Proper use is critical.  Make sure everyone can P-A-S-S the test.

Pull the pin.
Aim the nozzle at the base of the flame, since the pressure of spraying directly into the fire may spread the burning
Squeeze the trigger while holding the canister upright.
Sweep side to side to cover the fire area with the extinguishing agent.

Take the time to assess your own home for fire safety.


Here are some fire safety tips for your homebound patients:
  • Keep phones within easy reach so patients can call the fire department.  Place a portable phone at the bedside if
    possible.  If a cell phone is available, make sure there is an entry or speed dial set for emergency responders.  
    Always keep the cell phone charged.  Identify an alternative method to reach the fire department if no phone is
    available.  If the patient has a remote emergency button, make sure it is within reach at all times.
  • Post emergency numbers at each phone and teach everyone to use them.
  • Alert the fire department to any disabled persons who may need evacuation help.  Obtain special safety tips.
  • Use smoke detectors with a strobe light or vibrator for hearing-impaired people.
  • Never smoke or bring open flame near oxygen equipment, since oxygen quickly feeds the fire’s growth.  Be careful
    around oxygen.
  • Always sleep on the first floor near an exit, if disabled, to aid escape; avoid sleeping upstairs.


Fire is fast.  In less than 30 seconds, a small flare-up can blaze out of control.  In less than five minutes, a home can be
consumed in flames.  To respond quickly, every family needs a written escape plan that shows at least two ways out of
each room, usually a doorway and a window.  Upstairs, the plan should include an Underwriter’s Laboratory-approved
collapsible ladder to aid escape.

Review these guidelines with your families:
  • Know the plan for every room and practice it, including when blindfolded or in darkness.  Most fire deaths occur
    between 2 am and 6 am.  Smoke turns familiar rooms dark and deadly even in daylight.
  • Practice using the quick-release feature of any security bars at doors or windows to avoid getting trapped inside.
  • Keep escape routes such as hallways, stairways and doorways clear and free of clutter.
  • Sleep with bedroom doors closed to hold back heat and smoke.
  • Feel the door with the back of the hand before opening it.  If a door is hot, don’t open it.  Instead, use the alternate
    escape route.
  • Have a prearranged spot to meet outside the home such as a tree or spot on the sidewalk.  Don’t go back in under
    any circumstances!
  • Call the fire department from a neighbor’s home.  Tell them if someone is missing.  Firefighters are trained to
    perform safe rescues.


Fire spreads quickly.  Heat and smoke can become lethal in no time.  You must race against these dangers.  Heat is more
threatening than flames.  Since heat rises, it can be 200 degrees at floor level and 600 degrees at eye level – hot enough
to scorch your lungs and melt your clothes to your skin.  The air can soon become hot enough to ignite every combustible
in the room - a phenomenon known as flashover.

  • Poisonous gases that kill.  Fire eats up oxygen.  Breathing in even small amounts of smoke and toxic gases can
    leave you drowsy and disoriented.  Fumes can lull you to sleep before flames reach you.  The elderly, whose
    reaction time may be slowed by medications or disabilities, are especially at risk.  Smoke and fumes rise initially.  
    That’s why every home should have smoke detectors that work.
  • What you do in the first one to three minutes of a fire is critical to protect lives and property.  It’s a RACE to safety:
  • Rescue.  Assist the elderly and disabled first.  Follow pre-planned escape routes.  Remember to stay low and crawl
    beneath the heat and smoke.
  • Activate the Alarm.  Alert others in the home to move to safety.  Call the fire department and emergency responders.
  • Confine the blaze.  Close doors and windows to keep it contained.
  • Extinguish.  If small and confined to its area of origin, the fire can be smothered with a pillow, blanket or heavy
    towel.  You can use a fire extinguisher, following the “pull, aim, squeeze and sweep techniques.  Since fire
    extinguishers’ contents lasts only about 20 seconds, get out if you can’t extinguish.
  • Evacuate the family.  Stay calm.  Give clear, exact directions.

For non-ambulatory patients, use a wheelchair if available or even a wheeled bed.  If someone can assist you, use the
“swing carry” to form a cradle with your arms behind a patient’s arms and knees.  Use the “blanket drag” to move a patient
to safety by yourself.  If a patient’s clothing catches fire, use a blanket to smother the flames or initiate the “stop, drop, and
roll” technique and move to safety while staying low to the ground beneath the smoke.

Once everyone is moved to safety, administer first aid.  Get medical help to the scene if needed.  Keep all people out of
the home until the fire department says it is safe to re-enter.


Teach your families to prevent fire hazards.  You can’t insist on safety measures in someone else’s home, but you can
point out potential hazards.  Here are some ideas to improve risky situations:

  • Carry a large spoon from the kitchen as a reminder that food is on the stove if the telephone or doorbell rings while
  • Avoid wearing loose, dangling sleeves than can catch fire when cooking.
  • Never put metal dishes in a microwave.
  • Never smoke in bed or near oxygen sources.  Careless smoking habits are the leading cause of fire deaths.  
    Smoker should use a large, wide-mouthed ashtray, and then douse its contents with water.
  • Be alert to and correct hazards such as dangerous use of space heaters, piled up trash, or flammables near heat
  • Set up medical equipment safely.  Use proper electrical hookup, place equipment well away from any heat source
    and follow any special safety considerations.
  • Educate families about home safety checklists, seasonal heating tips or holiday fire prevention.


Fire can also be a threat in the office.  Follow your fire safety guidelines.  Here are some general rules:

Good housekeeping

  • Get rid of waste promptly and property
  • Keep combustibles – including dust – away from lights and machinery
  • Never block exits, fire alarms, or sprinkles

Flammables precautions

  • Use only in ventilated areas away from heat
  • Handle properly to prevent spills and vapor release
  • Keep flammable liquids in closed, airtight metal containers
  • Discard oily rags in lidded metal containers.  Empty daily

Oxygen cylinder use

  • Never handle with oily hands or gloves
  • Never store near combustible materials
  • Move carefully on hand trucks.  Don’t drag, roll, or bump

Electrical equipment safety

  • Remember, workplace fires are most often electrical
  • Don’t over load circuits, motors, or outlets
  • Avoid running unattended equipment or machinery overnight
  • Maintain equipment properly to prevent fires

Fight fire with awareness

  • Attend all drills and safety meetings.  Know your role.
  • Smoke only where permitted.  Fully extinguish smoking materials.
  • Know the location of fire alarms and fire extinguishers, and how to use them.
  • Sound the alarm at the first suspicion of fire.  Call the fire department and emergency services.  Post emergency
    numbers near phones.
  • Know designated escape routes.
  • Help evacuate everyone safely.


Remember to assess homes for fire hazards and teach families how to prevent them.  Make sure you know and follow your
agency’s fire safety drills, programs and policies.  You could help prevent dangerous fires and save lives.

    Revised 12/2/2016
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