Fire Safety

When a fire alarm sounds on your unit, your first action isn't grabbing an extinguisher — it's rescuing the patient closest to danger. Getting RACE and PASS backward costs lives.

Hospital fire response follows two sequential mnemonics. RACE governs the overall response: Rescue anyone in immediate danger, Activate the alarm (pull the nearest fire alarm and call the operator), Contain the fire by closing all doors and windows, and Extinguish or Evacuate only after the first three steps are complete. PASS governs extinguisher use: Pull the pin, Aim at the base of the fire (not the flames), Squeeze the handle, and Sweep side to side. The sequence matters — rescue always comes first, even before pulling the alarm. Close doors to compartmentalize smoke and fire spread; horizontal evacuation (same-floor movement away from the fire zone) is preferred over vertical evacuation because it's faster and safer for immobile patients. Oxygen supports combustion, so all O2 in the immediate fire area must be shut off. Electrical equipment is unplugged or powered down. Ambulatory patients evacuate first, then wheelchair patients, then bedbound patients — this maximizes the number of people moved in the least time.

Key Distinctions

Students confuse the order: Rescue comes before Activate. Pulling the alarm first while a patient is in the fire's path is the wrong priority. Don't confuse RACE (the macro plan) with PASS (extinguisher technique only) — RACE tells you what to do overall; PASS tells you how to operate one piece of equipment. Horizontal evacuation is attempted before vertical; stairs are a last resort, not a first move.

Clinical Pearl

RACE before PASS — rescue the patient, then fight the fire. And always aim at the base, never the top of the flames.