Key Takeaways
- RACE is the fire response sequence: Rescue patients in immediate danger, Alarm (activate fire alarm), Contain the fire (close doors), Extinguish if safe
- PASS is the fire extinguisher technique: Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side
- Patient rescue priority moves patients closest to fire first, with ambulatory patients assisted before non-ambulatory
- Closing doors and windows during a fire is critical to contain fire and smoke spread
- Never use elevators during a fire - use stairwells for evacuation
Fire Safety (RACE/PASS)
Healthcare facilities contain numerous fire hazards including oxygen, electrical equipment, and flammable materials. The NCLEX tests your ability to respond correctly and safely during fire emergencies.
RACE: Fire Response Sequence
When a fire is discovered, follow the RACE sequence in order:
| Step | Action | Details |
|---|---|---|
| R | RESCUE | Remove patients/people from immediate danger |
| A | ALARM | Activate the fire alarm; call 911 or fire code |
| C | CONTAIN | Close all doors and windows to limit fire/smoke spread |
| E | EXTINGUISH | Attempt to extinguish only if safe to do so |
Detailed RACE Steps
R - Rescue
- Rescue those in immediate danger first (same room as fire)
- Move patients to safety behind closed doors
- Priority: Patients closest to fire, then those in fire zone
- Ambulatory patients can be directed to safe area
- Non-ambulatory patients may need wheelchair, stretcher, or blanket drag
A - Alarm
- Activate the nearest fire alarm pull station
- Call the facility emergency number or 911
- Announce location and type of fire
- Stay on the line until released by emergency personnel
C - Contain
- Close all doors and windows on the unit
- Closed doors slow fire spread and can save lives
- Turn off oxygen and electrical equipment if safe
- Do NOT open doors that are hot to touch
E - Extinguish
- Attempt to extinguish only if:
- The fire is small (contained to a wastebasket or similar)
- You have a clear escape route
- You know how to use the extinguisher
- If in doubt, evacuate and let fire department handle it
PASS: Fire Extinguisher Technique
If you need to use a fire extinguisher, remember PASS:
| Step | Action | Details |
|---|---|---|
| P | PULL | Pull the pin (breaks the tamper seal) |
| A | AIM | Aim the nozzle at the BASE of the fire |
| S | SQUEEZE | Squeeze the handle to discharge the agent |
| S | SWEEP | Sweep from side to side at the base of the fire |
Critical Points for PASS
- Aim at the BASE - The base is where the fuel is burning; spraying at flames is ineffective
- Stand 6-8 feet away from the fire
- Sweep side to side until fire is out
- Back away while watching for re-ignition
- Extinguishers typically last only 8-10 seconds - use quickly
Fire Extinguisher Types
Know which extinguisher to use for each fire class:
| Class | Fire Type | Extinguisher |
|---|---|---|
| A | Ordinary combustibles (paper, wood, cloth) | Water, ABC dry chemical |
| B | Flammable liquids (oil, gas, grease) | ABC dry chemical, CO2, foam |
| C | Electrical equipment | ABC dry chemical, CO2 |
| D | Combustible metals | Special dry powder |
| K | Kitchen (cooking oils/fats) | Wet chemical |
Exam Tip: Most healthcare facilities use ABC dry chemical extinguishers because they work on most common fire types.
Evacuation Procedures
Horizontal Evacuation
- Move patients to the next smoke compartment on the same floor
- Stay behind closed fire doors
- Faster and safer than vertical evacuation for most patients
Vertical Evacuation
- Used when horizontal evacuation is not possible
- Never use elevators - use stairwells only
- Move to a floor below the fire (fire travels upward)
- Patients may need to be carried or slid on blankets
Evacuation Priority
- Ambulatory patients - Can walk with direction
- Patients in wheelchairs - Move with assistance
- Patients with equipment - Disconnect non-essential equipment
- Non-ambulatory patients - May need multiple staff members
Special Considerations
Oxygen Safety
- Oxygen supports combustion (makes fires burn faster)
- Turn off oxygen if fire is in the area (if safe to do so)
- Never allow smoking near oxygen
- Post "Oxygen in Use" signs
Electrical Safety
- Unplug equipment if fire involves electrical source
- Do not use water on electrical fires
- Report frayed cords, overloaded outlets
Door Management
- Feel the door before opening - if hot, do not open
- Keep doors to patient rooms closed
- Fire doors automatically close when alarm activates
- Never prop fire doors open
Fire Prevention
| Prevention Measure | Rationale |
|---|---|
| No smoking on campus | Eliminate ignition source |
| Regular equipment inspection | Identify electrical hazards |
| Proper storage of flammables | Reduce fuel sources |
| Clear exits and hallways | Enable evacuation |
| Staff training | Ensure proper response |
| Fire drills | Practice response procedures |
Documentation After Fire
Document:
- Time fire discovered
- Location and type of fire
- Actions taken (RACE steps)
- Patients affected and their status
- Injuries, if any
- Equipment damaged
- Staff involved in response
On the NCLEX
Common testing points:
- Correct order of RACE steps
- When to use PASS technique
- Priority actions during fire emergency
- Understanding that rescue comes before alarm
- Knowing never to use elevators during fire
Exam Strategy: RACE always starts with Rescue - patient safety is the priority. Only attempt to extinguish if the fire is small and you have an escape route.
A nurse smells smoke and discovers a fire in a patient room. What is the FIRST action the nurse should take?
When using a fire extinguisher, the nurse should aim the nozzle at which part of the fire?
During a fire evacuation, which action is most important for limiting fire and smoke spread?