IRLF 
 
 SB 272 
 
 Fire Prevention and 
 Fire Protection 
 
 f T . 
 Hospitals 
 
 By OTTO R. EICHEL, M. D 
 
A MANUAL 
 
 OF 
 
 FIRE PREVENTION 
 
 AND 
 
 FIRE PROTECTION 
 
 FOR 
 
 HOSPITALS 
 
 BY 
 
 OTTO R. EICHEL, M.D. 
 
 Director, Division of Sanitary Supervisors 
 New York State Department of Health 
 
 NEW YORK 
 JOHN WILEY & SONS, INC. 
 
 LONDON : CHAPMAN & HALL, LIMITED 
 1916 
 
/ 
 
 ^ 
 
 Copyright, 1916, by 
 OTTO R. EICHEL 
 
 PUBLISHERS PRINTING COMPANY 
 207-217 West Twenty-fifth Street, New York 
 
PREFACE 
 
 IT is the purpose of this manual to pro- 
 vide in convenient form an outline of the 
 principles of fire prevention and protection 
 with indications for their application in 
 institutions housing the sick. It is planned 
 for use not only by superintendents and 
 boards of managers, but also by inspectors, 
 architects, builders, and others who have 
 occasion to consider the fire problem hi 
 hospitals. 
 
 As has been pointed out by high authority, 
 the extent to which the subject generally is 
 neglected by many institutions is hardly less 
 than criminal. Indeed, in many hospitals 
 only a merciful Providence seems to pre- 
 vent unspeakable disasters. The author's 
 
 personal observation and study of this 
 iii 
 
 359272 
 
IV PREFACE 
 
 condition have resulted in the preparation 
 of this manual, which, it is hoped, will meet 
 a real need. 
 
 The author is much indebted to Dr. 
 Hermann M. Biggs, New York State Com- 
 missioner of Health, for permission to pub- 
 lish this work; to his Deputy, Dr. Linsly 
 R. Williams, for the suggestion to prepare 
 it; to Mr. Franklin H. Wentworth, Secretary 
 of the National Fire Protection Association, 
 for valuable suggestions, and to Dr. Willard 
 J. Denno, Secretary of the New York State 
 Board of Medical Examiners, for criticism 
 of the manuscript. 
 
 OTTO R. EICHEL, M.D. 
 Albany, N. Y., 
 April, 1916. 
 
CONTENTS 
 
 PAGE 
 
 PREFACE iii 
 
 PART A. INTRODUCTORY i 
 
 I. Definitions and Abbreviation .... i 
 
 II. General Considerations 5 
 
 III. Recommendations 10 
 
 PART B. COMMON HAZARDS IN HOSPITALS AND 
 
 THEIR SAFE-GUARDING 15 
 
 I. Lighting Hazards 15 
 
 II. Heating Hazards 20 
 
 III. Exposure Hazards . 25 
 
 IV. Miscellaneous Hazards 28 
 
 PART C. FIRE APPLIANCES AND SAFEGUARDS . . 33 
 
 I. Chemical Extinguishers 33 
 
 II. Other Hand Extinguishers 37 
 
 III. Other Appliances 43 
 
 PART D. MISCELLANEOUS PRECAUTIONS .... 51 
 
 PART E. HOSPITAL FIRE DEPARTMENT .... 55 
 
HOSPITAL FIRE MANUAL 
 
 PART A INTRODUCTORY 
 
 I 
 
 DEFINITIONS AND ABBREVIATIONS 
 
 For the purpose of this book the following 
 abbreviations are used: 
 
 N. B. F. U. The National Board of Fire 
 Underwriters is an association of practically 
 all the fire insurance companies in the 
 United States. Through its committees it 
 promotes legislation, suppresses arson, col- 
 lects statistics, and makes scientific studies 
 of fire origins and means of prevention and 
 protection. Has branch offices in many 
 cities. Main office, 76 William Street, New 
 York City. 
 
2 > SOSPITAL FIRE MANUAL 
 
 N. F. P. A. The National Fire Protec- 
 tion Association includes nearly all the 
 associations, companies, bureaus, and in- 
 stitutions interested in fire prevention and 
 fire protection in the United States and 
 Canada. It has a world-wide subscribing 
 membership. It promotes fire prevention 
 and protection in every possible way. Its 
 work is broader in scope than that of the 
 N. B. F. U., which is one of its members. 
 It prepares many valuable publications on 
 fire matters, one of the most useful being 
 its " Field Practice." It does educational 
 work and establishes standard rules, re- 
 quirements, and specifications regarding 
 hazards and their safeguarding, fire equip- 
 ment, etc. Its standards are adopted by 
 the N. B. F. U. and its laboratories, and 
 are universally recognized as authoritative. 
 Address, 87 Milk Street, Boston, Mass. 
 
HOSPITAL FIRE MANUAL 3 
 
 U. Lab. The Underwriters' Laboratories, 
 Inc., are under direction of N. B. F. U. 
 They make examinations and tests of fire 
 devices, materials, and apparatus under 
 standards recommended by the N. F. P. A., 
 and publish a list of manufacturers of 
 such appliances, which is revised semi- 
 annually. 
 
 National Electrical Code. This code con- 
 tains recommendations for reducing the 
 hazards of electricity. It is promulgated by 
 the N. B. F. U. from recommendations 
 made by the N. F. P. Association's 
 Electrical Committee, formerly known as 
 the Underwriters' National Electric Asso- 
 ciation. The code is generally accepted as 
 standard. 
 
 Fire Hazard. A condition which may 
 cause fire. 
 
 Fire Prevention. Concerns fire hazards, 
 
4 HOSPITAL FIRE MANUAL 
 
 educational and private administrative mea- 
 sures, and legislation. 
 
 lire Protection. Concerns control by 
 means of construction features, fire appli- 
 ances, and safeguards against hazards. 
 
II 
 
 GENERAL CONSIDERATION 
 
 Prevention and Protection. It is a not- 
 able fact that hospitals often approach the 
 fire problem from the view-point of protec- 
 tion rather than prevention; and occasionally 
 with regard chiefly to protection of property 
 instead of human lives. This is unfortu- 
 nate, as it results in the neglect of attention 
 to those common hazards which cause the 
 majority of fires, and the installation, in- 
 stead, of expensive appliances, the proper 
 use of which may be neither practised nor 
 understood. It is of primary importance 
 to detect and safeguard the simple hazards, 
 and to provide adequate protection for 
 
 lives first. 
 
 5 
 
6 HOSPITAL FIRE MANUAL 
 
 Hospital Fires. Although in the past the 
 loss of life in hospital fires has been com- 
 paratively small, the aggregate loss in 
 property has been large. Fires in hospitals 
 are by no means so infrequent as one might 
 suppose. While making a survey of certain 
 tuberculosis hospitals in New York State, 
 the author found that during a brief period 
 of time they had suffered from a number of 
 incipient fires: two from electric flat-irons, 
 three from gas appliances, two from defec- 
 tive flues, two from kitchen ranges, four from 
 adjoining woodlands, two from incinerators, 
 and in two more instances large frame 
 buildings were entirely destroyed. Such 
 accidents are not rare in hospitals generally. 
 The publicity given these incidents was very 
 limited, probably because no lives were lost. 
 However, it should not remain for a hospital 
 holocaust corresponding with the Iroquois 
 
HOSPITAL FIRE MANUAL 7 
 
 Theatre fire to awaken hospital authorities 
 to the gravity of the fire risk in which, only 
 too often, they house the bed-ridden sick. 
 The hospital is virtually a large residence. 
 Fires of the residence class, of both known 
 and "unknown origin," are usually due to 
 such common and easily preventable causes 
 as electrical or gas hazards, or defective 
 flues and chimneys. 
 
 The Cost of Fires. The importance of the 
 matter may be further emphasized by view- 
 ing it in the light of the problem generally. 
 Experience has shown the danger to life to 
 be greater in buildings where people live 
 than in those where they work or play. It 
 is believed probable that more lives are lost 
 in residence fires than in factories, theatres, 
 and schools combined. The popular mind 
 entertains the obverse conception of the 
 facts, probably because only the fire which 
 
8 HOSPITAL FIRE MANUAL 
 
 destroys many lives receives wide publicity. 
 Fire causes an average annual property loss 
 in the United States of $250,000,000 
 $30,000 per hour, or $500 per minute; an 
 annual per capita fire tax of $2.50. This 
 enormous loss is especially deplorable as 
 most fires are readily preventable. Eco- 
 nomic conditions are necessarily affected by 
 such large losses. They must be met by 
 the insurance companies from their collec- 
 tions, which are practically an assessment 
 on all the people. 
 
 The Fundamental Evil. It is not only of 
 primary importance to prevent fires by 
 safeguarding the common hazards, but also 
 by obviating such fundamental causes as 
 the carelessness, indifference, and negligence 
 of the average citizen. It has long been 
 recognized by fire experts that to these are 
 due the much greater prevalence of fires in 
 
HOSPITAL FIRE MANUAL 9 
 
 this country than in Europe. This can be 
 accomplished in a democratic state only by 
 education, and to some extent by enforced 
 legislation. 
 
Ill 
 
 RECOMMENDATIONS 
 
 Below are enumerated certain general 
 recommendations for all hospitals. These 
 are an application to the conditions found 
 in hospitals, of well-established facts and 
 principles regarding fire prevention and fire 
 protection: 
 
 1. That there be strict compliance with 
 existing local or state laws regulating fire- 
 hazards, e.g., regarding explosives, matches, 
 motion-picture machines, building codes, 
 fireworks, chimneys and flues, inflammable 
 liquids, etc. 
 
 2. Cooperation and consultation with the 
 local fire department within whose district 
 
 the hospital may be located. 
 10 
 
HOSPITAL FIRE MANUAL 11 
 
 3. Consultation with the Fire Under- 
 writers and compliance with their sugges- 
 tions in every instance where they have 
 jurisdiction. 
 
 In every case where it is possible without 
 conflict with results of the foregoing steps, 
 it is further recommended: 
 
 4. That hi every hospital where any of 
 the fire hazards described hi Part B below 
 exist such steps as are outlined be taken to 
 safeguard against them. 
 
 5. That each hospital have a minimum 
 fire apparatus of "small size" (1^2 gallons) 
 or of the "one quart size" chemical hand 
 extinguishers as described on page 34, an 
 adequate number to be distributed on each 
 floor of each building. That the standard 
 size (2^4 gallons) extinguisher be discon- 
 tinued where patients and women and 
 children may be obliged to handle them. 
 
12 HOSPITAL FIRE MANUAL 
 
 The use of chemical extinguishers on wheels 
 to be optional. They are expensive but 
 valuable for isolated hospitals. That fire 
 pails be used as secondary equipment. 
 That for garage, electrical machinery, and 
 hazardous fluids the one-quart chemical hand- 
 extinguisher and pails of sand, as described 
 on page 37, be used. That dry powder and 
 grenade type extinguishers be abolished. 
 
 6. That appliances described on pages 43 
 and 45 (fire-doors, escapes, and ladders) be 
 used where the fire safety could be greatly 
 improved within the limitations outlined. 
 
 7. That appliances described on pages 43 
 and 44, such as paints, hose, faucets, and 
 alarm box, be adopted so far as possible. 
 
 8. That the water supply be given atten- 
 tion as described on pages 51-52. 
 
 9. That all the miscellaneous precautions 
 described in Part D regarding valves, hy- 
 
HOSPITAL FIRE MANUAL 13 
 
 drants, gravity and pressure tanks, and locked 
 doors, be observed in all hospitals to which 
 they may apply. 
 
 10. That private fire departments be estab- 
 lished in all hospitals, with rules, organiza- 
 tion, drill, and inspection service based on 
 the general outlines given in Part E and 
 within such limitations as may be necessary. 
 
 11. That educational work be done in fire 
 prevention and protection, as outlined on 
 page 66, within such limitations as may be 
 necessary. 
 
 12. That so far as possible no fire devices, 
 materials, apparatus, or other appliances be 
 purchased except such as are approved in 
 the latest list issued by the U. Laborato- 
 ries, and that other safeguards and means 
 of protection comply with the standard 
 rules, requirements, and specifications of 
 the N. F. P. A. 
 
PART B COMMON HAZARDS IN 
 
 HOSPITALS AND THEIR 
 
 SAFEGUARDING 
 
 I 
 LIGHTING HAZARDS 
 
 1. Candles. The use of candles presents 
 a constant danger, as they are very com- 
 bustible, easily dropped or tipped over, can 
 fall into small openings, present an un- 
 guarded flame, may continue to burn after 
 being dropped, and the wick may glow after 
 flame is extinguished. There is practically 
 no instance in which they could not be 
 abolished. The small electric hand torch is 
 much safer and should be used instead. 
 
 2. Gas Jets. These present a constant 
 fire hazard if located very near to walls, 
 
 15 
 
16 HOSPITAL FIRE MANUAL 
 
 ceilings, shelves, attic roofs or rafters; or 
 where open doors may come in contact. 
 Where inflammable material may touch the 
 jets, as in storerooms and closets, the jets 
 should be entirely removed or, in some 
 cases, lengthened and the lights protected 
 by wire bonnets. Movable jets should not 
 be used. 
 
 3. Gas Lamps. They should have broad 
 bases and no inflammable trimmings, and 
 only non-inflammable connections. They 
 should not be used if electric lights are 
 available. All gas hose of flexible tubing 
 contains rubber, and therefore will burn, 
 although some types have metallic covers. 
 Rigid installations should be secured wher- 
 ever possible. 
 
 4. Kerosene Lamps. The danger from 
 this common cause of fires needs no em- 
 phasis. Their use should not be permitted, 
 
HOSPITAL FIRE MANUAL 17 
 
 but if essential they should be of metal 
 and of broad base design, or of non-cap- 
 sizable construction. 
 
 5. Lanterns. These present the same 
 conditions, and the same general precau- 
 tions should be observed as in the case of 
 kerosene lamps. If they are essential, only 
 good safety lanterns, should be used of the 
 type used by watchmen and railroad em- 
 ployees (broad base and protected with wire 
 fenders). The lantern having a removable 
 bottom for oil should not be used such bot- 
 toms may become loose and drop out. 
 
 The electric hand torch is to be preferred 
 wherever possible. 
 
 N. B. If much kerosene is needed, as 
 for lamps, lanterns, heaters, stoves, etc., 
 only high test oil should be used, as required 
 by the U. S. A. specifications, or as used 
 by the railroad companies. Such kerosene 
 
18 HOSPITAL FIRE MANUAL 
 
 is said to be superior also in other respects 
 to the ordinary kind. 
 
 6. Alcohol Lamps. Their use can usually 
 be limited to the laboratory, and even there 
 they should be abolished, if possible, and 
 stationary gas flame used instead. Benzine 
 and gasoline should be kept away, especially 
 if kept in bottles which may be mistaken 
 for alcohol bottles. 
 
 7. Electric Lamps. Especially if old, in- 
 candescent lamps become very hot, and will 
 char paper or cloth if in contact with them, 
 and have even been known to ignite wood. 
 Usually paper and cloth shades should not 
 be used on electric lamps. 
 
 Incandescent lamps should be stationary, 
 wherever possible, and not in contact with 
 combustible material; movable lamps should 
 be equipped with wire-bonnets or similar 
 protective device; cords should not be hung 
 
HOSPITAL FIRE MANUAL 19 
 
 over non-insulated places, as pipes, nails, 
 hooks, etc., and should not have knots tied 
 in them. 
 
 Electric lighting systems, their use and 
 changes and extensions in them, should be 
 in accordance with the requirements of the 
 National Electrical Code. Injuries to the 
 system, or its disturbance by storms, etc., 
 should usually be corrected by expert 
 electricians. 
 
 8. Acetylene Systems. The hazards of 
 these systems may be safeguarded by ob- 
 serving the " Standard Rules and Require- 
 ments" of the N. F. P. A. 
 
II 
 
 HEATING HAZARDS 
 
 1. Fireplaces. The chief precautions 
 necessary are proper construction, to have 
 the flooring about the fireplace of non- 
 combustible material, and to protect against 
 flying sparks or rolling logs by good and- 
 irons and screens. The latter to be of such 
 size and design as to completely cover the 
 front of the fireplace and not tip over easily. 
 The one-piece screen with curved top is 
 usually to be preferred. (See N. F. P. A. 
 suggested Municipal Ordinances). 
 
 2. Stoves. (a) Coal There is but slight 
 danger from coal stoves if properly installed 
 and cared for. They should be erected on 
 metal legs; stand on zinc, sheet iron, or 
 
 asbestos base; and be placed at a safe 
 20 
 
HOSPITAL FIRE MANUAL 21 
 
 distance from walls or inflammable matter 
 unless latter are protected. Ash receptacles 
 of metal only. 
 
 (V) Gas. Gas stoves, ranges, plates, burn- 
 ers, and water heaters should be connected 
 with the gas supply line by rigid iron piping; 
 the soft rubber and other inflammable con- 
 nections are among the most dangerous 
 common fire causes, and should positively 
 not be used. Practically all flexible gas 
 hose contains rubber and will burn, although 
 some types have metallic covers. 
 
 These gas appliances, as well as coal 
 stoves, should be properly mounted on zinc 
 or asbestos, and be safely clear from walls 
 and combustible matter, unless the latter 
 are protected by metal or asbestos. 
 
 (c) Electric. Electric stoves, heaters, and 
 plates are comparatively safe and much to 
 be preferred to coal, gas, oil, and alcohol 
 
22 HOSPITAL FIRE MANUAL 
 
 appliances. There is danger in their use, 
 however, if circuits are overloaded or if 
 near combustible matter, and general wire 
 dangers are always present where any electric 
 current is used. These hazards are reduced 
 to a negligible minimum by proper installa- 
 tion (as required by the National Electrical 
 Code). 
 
 N. B. The electric flat-iron offers the 
 greatest and most prevalent electrical hazard 
 of the day, and has been the cause of numer- 
 ous fires. These have invariably resulted 
 from carelessness, as leaving the current on 
 when not in use. This may be ^avoided by 
 having a small red pilot light on the irons 
 or in the same circuit to indicate when the 
 current is on. They should never be al- 
 lowed to stand on inflammable material 
 when the current is on, only well insulated 
 cord should be used, and this should not be 
 
HOSPITAL FIRE MANUAL 23 
 
 tied or knotted, and should be kept clear 
 from hooks, nails, piping, and other non- 
 insulated places. 
 
 3. Furnaces. The chief danger is in over- 
 heating. This can be obviated by careful 
 attention to fires and by proper construction 
 and installation. 
 
 4. Stove-Pipes. If they pass through 
 closets, unused rooms, blind attics, or enter 
 chimneys out of sight, present a constant 
 fire danger. Stove-pipes should not be 
 passed through floors, roofs, ceilings, walls, 
 partitions, or sides of buildings, unless pro- 
 tected by metal ventilated thimbles having 
 a 6-inch clearance. 
 
 5. Steam-Pipes. These may constitute 
 a source of danger, especially if improperly 
 installed. Wood may spontaneously ignite 
 after being charred by contact with over- 
 heated steam-pipes. This possibility has been 
 
24 HOSPITAL FIRE MANUAL 
 
 proven by both observation and labora- 
 tory experiment. Floors and walls should 
 be protected from such pipes by metal 
 collars; the pipes should be insulated with 
 asbestos or non-combustible packing where 
 they pass close to walls, ceilings, or floors, 
 and in the latter instance properly supported 
 or suspended. Oil waste, coal dust, and 
 other highly inflammable material should be 
 kept away from steam-piping. 
 
 6. Chimneys. If poorly constructed, 
 cracked, overheated, or used as supports for 
 flooring, timbers, etc., may be a potent source 
 of fire danger. This is especially true if an 
 ordinary chimney is used as a support, ow- 
 ing to the loosening of the chimney and 
 subsequent ignition of the wood. This is a 
 fairly common cause of fire, especially in 
 rural frame buildings. (See the N. F. P. A. 
 suggested Municipal Ordinances.) 
 
Ill 
 
 EXPOSURE HAZARDS 
 
 A 7 ". B. These exist where buildings are 
 adjacent to risks, such as other buildings or 
 forests, or in parts of buildings apt to be 
 exposed to extending fires, or to adjacent 
 risks connected by corridors, etc. An ex- 
 tending fire is naturally a very serious 
 menace to the rest of a building. (See 
 also paragraph 7 on page 32.) Protection 
 against it may be afforded by mill construc- 
 tion, wired-glass windows, fire shutters and 
 doors, and by fire-walls after the Porter 
 plan, as carried out in some of the New 
 York City Hospitals. For instance, sky- 
 lights should contain wired glass, corri- 
 dors may be protected by fire-doors or 
 shutters, etc. 
 
 25 
 
26 HOSPITAL FIRE MANUAL 
 
 1. Forests. If near buildings they con- 
 stitute an important fire hazard. If they 
 are extensive the construction of a fire-line 
 through them at some distance from the 
 buildings should be considered, as has been 
 done at the New York State Tuberculosis 
 Hospital at Raybrook. Sufficient spades, 
 shovels, and axes should always be available, 
 so that several men may instantly attack 
 a forest- or brush-fire. The one who will 
 be responsible for the direction of the fight- 
 ing should be familiar with the various 
 means of controlling forest-fires. During 
 times of drought special precautions should 
 be taken to protect forests (see State and 
 United States Government bulletins, etc.). 
 
 2. Buildings. Adjacent to other struc- 
 tures constitute a danger. Each case will 
 require separate study. Where frame cor- 
 ridors connect buildings a slow-burning con- 
 
HOSPITAL FIRE MANUAL 27 
 
 struction of corridors, fire-doors, and hy- 
 drants suitably located, may be advisable. 
 
 3. Sparks. From power-house stacks, 
 chimneys (especially from fireplaces), and 
 passing locomotives are dangerous. Where 
 such conditions are possible wood-shingle 
 roofs should be replaced with fireproof 
 roofing (see the N. F. P. A. paper on " The 
 Evil Shingle Roof"). 
 
 4. Automobiles. Obviously endanger 
 buildings in which they are housed. They 
 should not usually be stored in barns and 
 never in structures occupied by people or 
 live stock, or for the storage of valuable 
 material, nor in the non-fire-resisting struc- 
 tures which are themselves large and ex- 
 pensive, or which by their location endanger 
 near-by property. 
 
IV 
 
 MISCELLANEOUS HAZARDS 
 
 1. Coal. If improperly stored may spon- 
 taneously ignite, and under certain condi- 
 tions coal-dust may explode. For details 
 of preventive measures, see " Field Prac- 
 tice," of the N. F. P. A., and Freitag on 
 " Fire Prevention and Fire Protection." 
 
 2. Chemicals, Paints, Oils, Inflammable 
 Volatiles, and Explosives. For preventive 
 measures see the " Field Practice" men- 
 tioned above; and in safeguarding hazards 
 from the storage, handling, and use of such 
 materials, the " Standard Rules and Re- 
 quirements" of the N. F. P. A. should be 
 carefully observed. These rules also cover 
 the details of construction and installation 
 of Acetylene Machines, Gas and Gasoline 
 
 28 
 
HOSPITAL FERE MANUAL 29 
 
 Engines, Valves, Lighting Machines, Oil 
 Storage, etc. 
 
 3. Smoking. This prevalent cause of 
 fires needs hardly any emphasis. Some fire 
 experts believe it to be the commonest 
 cause of all fires. In certain places smok- 
 ing or the carrying of lighted cigars, pipes, 
 or cigarettes should be strictly forbidden 
 under severe penalty, and the rule should 
 be rigidly enforced, as in barns, paint shops, 
 carpenter rooms, storerooms, garages, etc. 
 As most cigarettes burn until they are en- 
 tirely consumed, their use in certain in- 
 stances should be entirely prohibited. 
 
 4. Lightning. This is a fairly common 
 cause of fire, especially in frame buildings. 
 It seldom strikes a steel frame building, but 
 is said to strike residences and rural frame 
 structures much oftener than is generally 
 believed. 
 
30 HOSPITAL FIRE MANUAL 
 
 Good rods of correct design, placed on all 
 spires and projecting points, furnish the best 
 protection. 
 
 Where cattle are enclosed with wire 
 fences every sixth or eighth post should be 
 grounded in an effective manner the ground 
 rod terminating with a copper plate bedded 
 in charcoal. 
 
 Lightning protection should be in ac- 
 cordance with the standard rules and re- 
 quirements of the N. F. P. A. During 
 electric storms and after any building is 
 struck by lightning, there should be a care- 
 ful inspection to ascertain the existence or 
 possibility of fire from injured electric wires, 
 chimneys, etc. 
 
 5. Holiday Celebrations. Independence 
 Day and Christmas Day celebrations have 
 been a prolific source of fires, owing to the 
 use of fireworks, inflammable decorations, 
 
HOSPITAL FIRE MANUAL 31 
 
 defective temporary wiring, candle illumina- 
 tions, etc. 
 
 When preparing for such celebrations the 
 " Holiday Bulletins " of the N. F. P. A. 
 should be consulted. These are issued an- 
 nually, preceding July 4 and December 25, 
 and contain valuable suggestions for fire 
 prevention and protection. 
 
 6. Ashes, Rubbish, Sweepings, Inflam- 
 mable Refuse, etc. The careless disposal of 
 these materials is a common cause of fires, 
 although plainly enough they should be 
 kept away from stoves, fires, hot steam- 
 pipes, or other places where ignition is pos- 
 sible by contact, should not be allowed to 
 accumulate, and the receptacles used should 
 be of metal. Especially ashes and oil or 
 cotton-waste always should be disposed of 
 in metal cans. 
 
 (See the U. Lab. list of manufactures of 
 
32 HOSPITAL FIRE MANUAL 
 
 approved types of safety cans and waste 
 cans, tanks, fire pails, etc.) 
 
 7. Fires. Fires themselves, naturally, of- 
 fer a great hazard because of the possibility 
 of apparently extinguished fires continuing 
 to burn in concealed places or to smoulder 
 and blaze forth later. (See also N. B. to 
 Sec. Ill, of Part B.) 
 
 " Make sure it's out," where there is 
 smoke there is apt to be fire. If the fire 
 has burned in concealed places (between 
 walls, under roofs and cornices, or in inac- 
 cessible places), it may be well to leave a 
 guard until it is certain that the fire is com- 
 pletely out. All fires should be immediately 
 followed by a careful investigation to as- 
 certain the extent of possible damage to 
 electric wiring, chimneys, flues, etc. con- 
 ditions which themselves may be very 
 dangerous. 
 
PART C FIRE APPLIANCES AND 
 SAFEGUARDS 
 
 N. B Consult also the U. Lab. list of ap- 
 proved " Fire Appliances," which contains a 
 list of manufacturers. The list also gives 
 brief descriptions of the standard articles. 
 
 I 
 
 CHEMICAL EXTINGUISHERS 
 
 i. Chemical Extinguishers on Wheels, 
 33 Gallons. " These appliances are effective 
 on fires where water or solutions containing 
 large percentages of water are effective. 
 Their use on electric arcs or wiring carrying 
 high voltages may be dangerous on account 
 of the conductivity of the liquid. They are 
 
 33 
 
34 HOSPITAL FIRE MANUAL 
 
 of limited service in hazardous fluid fires. 
 They must be protected from freezing." 
 (U. Lab.) 
 
 These extinguishers are valuable for hos- 
 pitals not readily accessible to a municipal 
 fire department, for the fighting of fires 
 beyond the incipient stage. 
 
 2. Chemical Hand Extinguishers. (a) 
 The standard size, 2.5 gallons, is useful on 
 incipient fires within the limitations de- 
 scribed above for wheel extinguishers. It 
 is highly efficient but heavy and difficult 
 for women and children to handle. 
 
 (b) The small size, 1.5 gallons, is preferable 
 in most instances, as it is " intended pri- 
 marily for use by women and children" 
 (U. Lab.). 
 
 N. B The chemicals used in the "wheel," 
 "standard," and "small size" extinguishers 
 are sodium bicarbonate and sulphuric acid. 
 
HOSPITAL FIRE MANUAL 35 
 
 (c) The one-quart size hand extinguisher 
 utilizes special liquids, the chief ingredient 
 of which is said to be carbon tetrachloride. 
 These hand extinguishers have the great 
 advantages of being so small that they can 
 be handled by women, children, and am- 
 bulant patients; one person can carry 
 several of them at one time; they are effec- 
 tive on incipient fires in hazardous fluids, 
 cotton, and fabrics, rapidly burning mate- 
 rials, and in fires not easily extinguished by 
 water (as volatile liquids and oils); they 
 can be used on electric arcs or wiring carry- 
 ing high voltages without danger to the 
 users; will not freeze; and the liquids used 
 will not usually damage fabrics and other 
 ordinary articles. They are especially ser- 
 viceable for garage and automobile use, and 
 about electric machinery and arcs. " They 
 are not recommended for service on fires in 
 
36 HOSPITAL FIRE MANUAL 
 
 freely burning material (such as wood) of 
 any considerable quantity." (U. Lab.) 
 
 N. B. Chemical hand extinguishers 
 should be readily available on each floor 
 of a building, including cellar and attic, in 
 very accessible places, preferably in hall- 
 ways and near red lights. They should be 
 inspected, tested, and refilled as often as 
 necessary, and bear tags giving dates of 
 refilling in ink, typewriting, or stamped. 
 See the U. Lab. list for manufacturers of 
 approved types of extinguishers. 
 
II 
 
 OTHER HAND EXTINGUISHERS 
 
 i. Pail Type. Made in 8, 10, 12, and 14- 
 quart sizes. Pails of water are the best 
 and cheapest fire extinguishers known for 
 most of the ordinary beginning house fires. 
 Everybody understands their use and al- 
 most anybody can use them. Their use is, 
 of course, limited to fires in which water is 
 effective, and which can be easily reached 
 by water thrown from a pail. They are of 
 little use on oils and inflammable liquids, 
 and are dangerous on electrical arcs and 
 machinery, and on high-voltage wires. In 
 such places pails filled two-thirds full of 
 clean, dry sand, containing scoops for throw- 
 ing it, are useful accessory means of protec- 
 tion. More valuable, however, for this 
 
 37 
 
38 HOSPITAL FIRE MANUAL 
 
 purpose, are the one-quart size hand ex- 
 tinguishers mentioned above. 
 
 The smaller pails are preferable for hos- 
 pitals, as they can be more easily used by 
 women, children, and patients. They should 
 be made of iron, steel, or fibre; have rounded 
 bottoms so they cannot easily be used for 
 other purposes or misplaced; should be 
 painted red and marked with the words 
 "Fire" or "For Fire Only" in black letters, 
 2^ or more inches high; should be suspended 
 from brackets or placed on shelves containing 
 pail-holes, and never on window-sills, work- 
 tables, stock-shelves, or other places not in- 
 tended for them; the tops of the pails should 
 not be over 5 feet above the floor and the 
 bottoms not less than 2 feet above it; they 
 should be refilled once weekly with clean 
 water, and one person held responsible for 
 their care; when exposed to low tempera- 
 
HOSPITAL FIRE MANUAL 39 
 
 tures the contents should be protected 
 against freezing by the addition of 2 pounds 
 of common salt, or preferably 2 pounds of 
 calcium chloride, to each pail, with thorough 
 stirring to dissolve (see " Freezing Preven- 
 tives for Fire Pails " and " Water Barrels 
 and Pails," by N. F. P. A.). As a general 
 rule there should be two or more pails for 
 each 1000 square feet or fraction thereof; 
 this will necessarily vary where the floor 
 area is not continuous but divided into 
 room space, halls, etc.; the various small 
 areas may not be so accessible as one large 
 area, and may therefore require more pails 
 in proportion; the pails should be located 
 near the most vulnerable points, hi plain 
 sight, and in no manner covered or ob- 
 structed. 
 
 It is advisable to use such pails only as 
 are listed by the U. Lab. 
 
40 HOSPITAL FIRE MANUAL 
 
 2. Dry Powder Hand Extinguishers. 
 These are the least reliable and most in- 
 efficient extinguishers known. Unfortu- 
 nately they are also very widely used, and 
 can be found in many hospitals. The writer 
 has seen one hospital which contained no 
 other equipment except stand - pipes and 
 hose. The extinguishers could not be opened 
 by jerking or pulling, and readily sustained 
 1 80 pounds weight; the hose attached to 
 the stand-pipes was so large that with a 
 full stream it could have been handled only 
 by trained firemen or strong men. The 
 dry powder extinguisher proved to be worse 
 than useless in the famous Iroquois Theatre 
 fire. 
 
 This type of extinguisher usually contains 
 bicarbonate of soda, a small amount of 
 coloring-matter, and some starch or clay to 
 prevent caking. 
 
HOSPITAL FIRE MANUAL 41 
 
 They are of very slight value in a certain 
 class of fires as first-aid accessories where 
 the temperatures are very low, in museums, 
 libraries, on inflammable liquids, and elec- 
 trical machinery, and where water itself 
 may be as bad as fire. Even so, they still 
 present difficulties in opening and scattering 
 the contents, owing to the metal caps and 
 tubular shape. Pails of sand are very much 
 better. 
 
 Furthermore, considering their extremely 
 limited utility, general inefficiency, and 
 cheap construction and contents, they can- 
 not be regarded as inexpensive when sold 
 for several dollars apiece. 
 
 (They are not mentioned in the U. Lab. 
 list of approved fire appliances.) 
 
 3. Grenade Type. This type, usually 
 consisting of bottles containing fluids, a 
 large percentage of which is water, is of 
 
42 HOSPITAL FIRE MANUAL 
 
 so little value as to be practically worthless. 
 The false sense of security which may result 
 from their presence, and the time lost in 
 attempting to quench a fire with them, 
 may be very dangerous. They are hardly 
 equivalent in value to a pitcherful of water. 
 (They are not mentioned in the U. Lab. 
 list of approved fire appliances.) 
 
Ill 
 
 OTHER APPLIANCES 
 
 1. Fire Doors and Shutters. The use of 
 
 these in corridors connecting adjacent build- 
 ings, or to close openings in fire walls, or 
 for walls which are partially fire-proof, 
 should be carefully considered and, in many 
 instances, is very advisable. The U. Lab. 
 have listed a large number of firms which 
 supply approved types of fire doors, shutters, 
 etc. 
 
 2. Fire Retardant Paints. These are val- 
 uable, as they retard the spread of fire. 
 There are many places in hospitals in which 
 they can, and should be used. Wherever 
 possible they should be used instead of 
 shellac, varnish, and oil, especially as the 
 latter are more inflammable than ordinary 
 
 43 
 
44 HOSPITAL FIRE MANUAL 
 
 paints. Many uncoated wood surfaces could 
 advisedly be covered with fire retardant 
 paint. (See the U. Lab. list of manufactur- 
 ers of approved paints.) 
 
 3. Fire Hose and Faucets. Hose should 
 be rubber lined or unlined linen, made in 
 accordance with the standard specifications, 
 and passed by U. Lab. (See their list of 
 approved appliances for names of manu- 
 facturers.) 
 
 It should be of sufficient length to reach 
 all enclosed places and not less than 2^2 
 inches diameter; tested at stated intervals, 
 and bear a tag giving dates of inspections 
 and tests; and always be connected with 
 stand-pipe, ready for emergency use. 
 
 Faucets. Some or all of the ordinary 
 water taps should be threaded for the attach- 
 ment of garden hose, which can be of ser- 
 vice as supplementary fire equipment. Such 
 
HOSPITAL FIRE MANUAL 45 
 
 hose can be handled by women and children, 
 whereas the regular fire hose (2^ inches or 
 more) requires one or more strong men or 
 trained firemen. 
 
 4. Fire-escapes and Ladders. Many of 
 the numerous types of fire-escapes are not 
 suitable for hospitals and some should not 
 even be considered. Among these are es- 
 capes consisting in part, or entirely, of 
 vertical ladders, which end in a locked door, 
 or any part of which is not protected by 
 railing, or is not of sufficiently substantial 
 design to inspire confidence. Fire-escapes 
 should usually extend to the roof, especially 
 if the latter contains skylights or other exit 
 facilities. If improperly located or con- 
 structed they may be both dangerous and 
 useless. Escapes should be tested from 
 time to time, and repainted sufficiently often 
 to prevent rusting. They should be kept 
 
46 HOSPITAL FIRE MANUAL 
 
 clean in winter if covered with snow or 
 ice they may be useless when needed, or 
 cause fatal accidents. 
 
 One or more extension ladders may be 
 valuable in fighting advancing fires. 
 
 5. Fire-Alarm Box. Every hospital which 
 is reasonably accessible to a municipal fire 
 department should endeavor to have a fire- 
 alarm box installed to signal the department- 
 headquarters, and arrange for response to 
 hospital alarms. The Rochester, N. Y., 
 Fire Department has gladly extended this 
 assistance to " lola," the Monroe County 
 Tuberculosis Hospital, situated a short dis- 
 tance beyond the Rochester City Line. 
 (See also page 61.) 
 
 6. Sprinkler Systems. These are, briefly, 
 appliances for the spraying of water over 
 the area of an incipient fire. The heat of 
 the fire to be extinguished automatically 
 
HOSPITAL FIRE MANUAL 47 
 
 frees the water by acting upon the valves 
 or " heads" of the sprinkler system. They 
 usually give adequate protection if properly 
 installed, and carefully supervised and 
 maintained. 
 
 The sprinkler appliance may be of value 
 in large hospital buildings whether they are 
 fire-resisting or not, if they contain large 
 untenanted portions, and especially if such 
 portions contain much inflammable material. 
 Each hospital, however, may present a 
 separate problem, and the question must 
 be studied with regard to the fire problem 
 as a whole. 
 
 A hospital planning to install a sprinkler 
 system should act only upon the advice of 
 a competent fire-prevention engineer. It is 
 further advisable for the sprinkler system, 
 if adopted, to be installed in accordance with 
 the rules and regulations of the N. F. P. A. 
 
48 HOSPITAL FIRE MANUAL 
 
 The successful operation of a sprinkler 
 system necessarily depends upon adequate 
 water-supply and -pressure and immediate 
 automatic opening of the sprinkler-heads. 
 The system should be inspected at definite 
 intervals, usually not less often than once 
 monthly, so that deterioration, obstruction, 
 etc., may be prevented. For instance, 
 
 1. Dust and dirt should not be allowed 
 to accumulate on the heads. 
 
 2. The heads should not be painted, 
 nor covered with oils, polish, whitewash, 
 wax or other coatings, except when first in- 
 stalled,, and then only with an anti-corrosive 
 coating recommended by a reliable expert. 
 
 3. Shelves, stored material, etc., should 
 not be permitted even temporarily to ob- 
 struct the heads. 
 
 4. Heads which appear to be injured 
 should be promptly replaced. If several 
 
HOSPITAL FERE MANUAL 49 
 
 appear spoiled, that part of the system 
 should be tested. 
 
 5. Extra sprinkler-heads should always be 
 on hand, ready for use. Various employees 
 should be informed as to their place of 
 storage. 
 
 6. After a fire the open heads should be 
 immediately replaced and valves opened 
 promptly. 
 
 7. Valves should always be open, except 
 when temporarily closed for repairs, etc. 
 
 8. Check up, with a list on file, all sprink- 
 ler gate-valves, noting those which are not 
 open and strapped, reasons therefor, etc. 
 
 9. Repairs, when necessary, should be 
 made immediately, and only by a mechanic 
 who thoroughly understands such work. 
 
 10. Pressure gauge should be noted and 
 report made to Superintendent and Chief 
 Engineer if too low. 
 
50 HOSPITAL FIRE MANUAL 
 
 11. Attention should be given to all con- 
 ditions mentioned in Part " D " on water 
 supply. 
 
 12. These duties should usually be made 
 a part of the regular required duties of one 
 or more regular employees, and not second- 
 ary to other tasks. 
 
PART D MISCELLANEOUS 
 PRECAUTIONS 
 
 1. Water-Supply. The adequacy of the 
 water-supply and water-pressure for fire 
 fighting should be determined. This is 
 especially important in large buildings. It 
 is advisable, preferably in the Spring and 
 Autumn, when the hydrants are flushed, to 
 place the entire system under pressure to 
 ascertain the soundness of the piping, valves, 
 hose, etc. 
 
 2. Valves. All valves, especially in base- 
 ments, engine-rooms, closets, or concealed 
 places, which may be used to shut off water- 
 supply from buildings or sections of build- 
 ings, should be painted a bright red, and 
 have securely attached to them (with wire) 
 tags stating in typewriting or ink the exact 
 
 51 
 
52 HOSPITAL FIRE MANUAL 
 
 building or part of same which they control. 
 This is especially important if they control 
 a separate water-supply to stand-pipes or 
 risers, such valves and others, closed only 
 when making repairs, should be locked 
 open to prevent tampering with them. 
 
 Valves which must be kept closed should 
 be tested weekly by giving them a quarter 
 turn. They should not be closed too tightly. 
 The writer has visited hospitals in which 
 important valves could be opened only with 
 great difficulty. 
 
 3. Hydrants should be opened and flushed 
 thoroughly in the Spring and Autumn, tested 
 from time to time, always kept free from 
 obstructions, and protected against freezing 
 during the winter. 
 
 4. Gravity and Pressure - Tanks should 
 be carefully inspected from time to time. 
 Hoops, telltales, and glass -gauge valves 
 
HOSPITAL FIRE MANUAL 53 
 
 should be kept in good condition. Air-pres- 
 sure and water-level should always be prop- 
 erly maintained. During the Winter care 
 should be taken to prevent the formation 
 of ice in gravity-tanks. Pressure-gauges 
 should be inspected frequently. 
 
 5. Locked Doors. Any door which is 
 kept locked all or part of the time, which 
 may be needed as an emergency-exit, should 
 have placed near or upon it a fire axe, or 
 the door-key in a glass-faced box, or should 
 be locked with padlock having brittle shackle, 
 or should be equipped with all of these, de- 
 pending upon the circumstances. The pad- 
 lock with brittle shackle is an excellent 
 means of locking doors, hose-boxes, etc., 
 where an appearance of security is desired 
 without preventing easy access. (Refer to 
 the U. Lab. list of manufacturers of ap- 
 proved appliances.) It must not be for- 
 
54 HOSPITAL FIRE MANUAL 
 
 gotten that the door which can be readily 
 broken open by a kick or body pressure 
 exists chiefly in drama and fiction; even 
 ordinary doors cannot be opened easily in 
 this way, and many will resist the combined 
 efforts of several strong men. Such locked 
 doors have caused the loss of many lives. 
 
PART E HOSPITAL FIRE 
 DEPARTMENT 
 
 Although in many hospitals only the in- 
 cipient fire can be controlled, it is neverthe- 
 less necessary to have an adequate organiza- 
 tion, drill, and equipment in order to retard 
 an extending fire, and thus afford tune for 
 the safe removal of all occupants and valu- 
 able contents. Practically every hospital 
 should have a private fire department 
 planned along the lines described below. 
 
 i. Rules. These should be as few as 
 possible, and clearly and concisely worded. 
 The general rules must also meet the peculiar 
 needs of each hospital. They will usually 
 forbid the use or possession, or both, of 
 matches, candles, tobacco, lamps, alcohol, 
 heating devices, the accumulation of waste, 
 
 55 
 
56 HOSPITAL FIRE MANUAL 
 
 papers, etc., except by written permission of 
 the superintendent; they will forbid tam- 
 pering with fire appliances, and will direct 
 what to do if fire is discovered as reporting 
 to nurse in charge of floor or building, or to 
 superintendent, etc. (such person being in 
 each instance the nearest officer in author- 
 ity). Special rules will be required to safe- 
 guard certain hazards, as in barns, garage, 
 storerooms, attic, kitchen, laundry, etc. 
 The storing of automobiles, motor-cycles, 
 and hazardous fluids except in places desig- 
 nated should be forbidden. The rules pre- 
 scribing the duties of each employee (see 
 also pages 60 and 65) will include a clear 
 definition of their responsibilities in the 
 event of fire, and from time to time separate 
 instructions may be given to selected pa- 
 tients. The plan of fire organization should 
 be included in the rules, or posted separ- 
 
HOSPITAL FIRE MANUAL 57 
 
 ately; if a location alarm is established the 
 location signals should be conspicuously 
 posted. It is usually best to post the general 
 fire rules in conspicuous places, possibly to 
 print them in red, on a buff-colored card- 
 board or paper, and plainly headed " FIRE 
 RULES." The penalty for their infraction 
 should be stated and usually strictly en- 
 forced. 
 
 2. Organization. The type of hospital 
 buildings, classes of patients treated, num- 
 ber of employees of each sex, etc., must 
 govern the manner of organization. The 
 objects to be accomplished may be mapped 
 out in their order of importance, the most 
 difficult first. For instance, lives are more 
 important than property, the children and 
 bed patients will require more assistance 
 than ambulant patients and employees, and 
 the office contents are more important than 
 
58 HOSPITAL FIRE MANUAL 
 
 patients' personal effects. Usually the fire 
 is discovered in its incipiency when only 
 few fire-fighters are needed, but a number 
 of attendants may be needed immediately 
 to remove the children and bed patients. 
 In this there must be no delay, as incipient 
 fires often spread and destroy lives and prop- 
 erty with unbelievable rapidity. Therefore 
 some form of organization on the following 
 lines is necessary 
 
 Inspector Chief Messengers. 
 
 Asst. 
 
 Chief. 
 
 Floor Captains. 
 
 Rescue Company Fire Company Salvage Company 
 
 Stretcher men Extinguisher men Any persons avail- 
 Exit guards Pail men able after rescue 
 Stair guards Hose men work is finished. 
 Hall guards Ladder men 
 
 Engineer 
 
 Asst. to engineer 
 
HOSPITAL FERE MANUAL 59 
 
 The chief should be the chief resident 
 officer, the assistant chief the next in au- 
 thority; and the floor or pavilion captains 
 should be the nurses in charge. The in- 
 spector may be the night-watchman, and 
 the messengers will be any patients or boys 
 who may not be strong enough or suffi- 
 ciently skilled to assist with rescue work 
 or fire fighting. The rescue company should 
 consist of a sufficient number of able-bodied 
 men or women to remove the children and 
 bed patients. Guards may be needed to 
 prevent crowding and accidents in hall- 
 ways, fire-escapes, and doors. The engineer 
 should usually have no other duties than to 
 attend to the engine-room. Usually also 
 he will need one assistant or fireman, espe- 
 cially if one or more fire-pumps are in use. 
 The extinguisher, pail, and hose men will 
 preferably be employees, who can be trained 
 
60 HOSPITAL FIRE MANUAL 
 
 to handle the fire appliances with rapidity 
 and effectiveness. The salvage company 
 will include any able-bodied and available 
 persons not required for fire apparatus or 
 rescue work, to save such property as can 
 be readily removed from the buildings. 
 The hose men should be strong, as a fire 
 hose stream cannot be easily handled by 
 any others at least two men are usually 
 necessary. 
 
 3. The Fire Drill. The object of the drill 
 is twofold, viz.: (i) to train the employees 
 and others to effectively man the fire ap- 
 paratus, and (2) to prevent panic by teach- 
 ing patients and employees self-control and 
 by training them in orderly and rapid 
 methods of exit. 
 
 The signal apparatus may consist of a 
 fire-whistle or electric bells or gongs (see 
 N. B. F. U. approved list). An alarm 
 
HOSPITAL FIRE MANUAL 61 
 
 should be selected which is loud, but of soft 
 tone to prevent unnecessary excitement. 
 Two signals should be arranged for one 
 for drill and one for real fire. The fire-signal 
 may be so given that the actual location of 
 the fire is also indicated by a succession 
 of gong-strikes, bell-rings, or whistles. 
 
 Immediately upon the drill signal being 
 given all persons shall report to the sta- 
 tions assigned to them, and immediately 
 prepare to perform the duties required of 
 them by the rules. The stretcher men and 
 guards will report to rooms or wards con- 
 taming bed patients and children, to remove 
 them under the direction of the nurse in 
 charge, who acts as floor captain. After 
 all have been presumably removed these 
 men shall report to the floor captain for 
 further duty. The extinguisher men and 
 pail men will immediately report at the site 
 
62 HOSPITAL FIRE MANUAL 
 
 of the fire, bringing the appliances in their 
 charge. The hose men will man the hose 
 at the site of the fire. These will work 
 under the personal direction of the chief 
 or his assistant. The engineer must start 
 the fire-pump immediately upon hearing 
 the drill alarm, raise the water-pressure, 
 stoke fires, etc., without awaiting further 
 orders. The salvage company will take 
 orders from the chief or his assistant, and 
 their work may be organized on the ground 
 after the alarm is given. In small hospitals 
 this company may be incorporated with the 
 fire company. The inspector and the mes- 
 senger will perform such duties as may be 
 assigned them, the latter being prepared to 
 render personal service to the chief, carry 
 messages, etc. The inspector may be used 
 to attend to the hose lines, signal to others, 
 etc. As a general rule the chief and his 
 
HOSPITAL FIRE MANUAL 63 
 
 assistant should alternately direct the fire 
 and the rescue companies, so that they will 
 become equally proficient in the work of 
 supervision. 
 
 The ladder and hose men should become 
 proficient in the use of their apparatus 
 especially the latter should become accus- 
 tomed to the " recoil " and " weight " of the 
 hose. This is exceedingly important, es- 
 pecially where a high-pressure stream is 
 used, as it is not only difficult to manage, 
 but may cause fatal injuries to those whom 
 it might strike. 
 
 Hose practice should include the connect- 
 ing of hose to hydrants, leading it into 
 buildings, and directing full stream upon 
 roofs, etc. General drill for efficiency and 
 speed in handling does not require water 
 being turned on. Special care must be 
 taken to prevent kinks and twists in hose; 
 
64 HOSPITAL FIRE MANUAL 
 
 these must be removed before water is 
 turned on, otherwise hose may burst; burst- 
 ing may also occur if hose is twisted or 
 kinked after water is on. Hose containing 
 short bends near nozzle is difficult to hold, 
 and may recoil only easy curves should be 
 permitted. 
 
 Drill should be held at regular intervals, 
 preferably once monthly, and without no- 
 tice, with an occasional night drill. The 
 hospital managers should personally review 
 some or all of the drills. A record should 
 be kept of the time required for drills, and 
 special work done, as connecting of hose to 
 hydrants, time for bringing apparatus, etc., 
 and all concerned encouraged to maintain 
 records, within such limitations as provide 
 for their personal safety. The entire drill 
 should be developed to a degree of military 
 precision and discipline. 
 
HOSPITAL FIRE MANUAL 65 
 
 4. Inspection Service. The work of in- 
 spection should be usually divided between 
 the engineer and the night watchman, with 
 a general inspection from tune to time, 
 especially during the Winter, by the super- 
 intendent and the managers. The engineer's 
 rules should require that he make a daily 
 inspection of the buildings, noting the con- 
 dition of the valves, pipes, tanks, gauges, 
 telltales, stand-pipes (obstructions, etc.), 
 escapes, emergency pumps, water supplies, 
 etc. In the instance of water-intakes lo- 
 cated at lakes, ponds, brooks, or enclosed 
 springs at some distance, the inspection, 
 providing the service is usually satisfactory, 
 need be made but once or twice monthly. 
 
 The night-watchman's rules should require 
 that he note the condition and location of 
 the fire appliances and safeguards, and daily 
 report any defects, losses, or misplace- 
 
66 HOSPITAL FIRE MANUAL 
 
 ments, apparent violations of the fire rules, 
 special hazards observed, or other observa- 
 tions he may make concerning fire matters. 
 He should be provided with an approved 
 watchman's clock (see U. Lab. list) and the 
 stations so placed that his rounds will in- 
 clude the locations of fire appliances and 
 of possible hazards (kitchens, engine, and 
 dynamos, furnace rooms, etc.). He should 
 have definite instructions as to his duties 
 in any emergency. 
 
 5. Miscellaneous Considerations. (a) 
 Hospital Fire Association. The plan of a 
 private fire association as worked out by 
 several corporations is worthy of adoption 
 by the larger hospitals, as it has considerable 
 merit. The scheme includes a regular or- 
 ganization of all who are concerned in the 
 hospital fire department, having a constitu- 
 tion, by-laws, regular meetings, etc. Mem- 
 
HOSPITAL FIRE MANUAL 67 
 
 bership can be made a matter of merit, 
 educational work can be done among the 
 patients and employees, and the hospital 
 morale improved to no small degree. Its 
 work may be developed to include " Fire 
 Day," with lectures, moving pictures, con- 
 tests, etc. 
 
 (b) Cooperation. Neighbors residing with- 
 in hearing distance of the fire signal may 
 be invited to respond to it. Such co- 
 operation may be mutually valuable and 
 advantageous. 
 
 Where arrangement has been made with 
 a local municipal fire department to respond 
 to calls, it should be given supreme charge 
 immediately upon its arrival. However, no 
 time should be lost awaiting such assistance, 
 as even in cities the average time for a 
 good fire department to arrive is several 
 minutes, and minutes are hours for fire. 
 
68 HOSPITAL FIRE MANUAL 
 
 Furthermore, in rural buildings fires are 
 seldom controlled after spreading beyond 
 the incipient stage. (See also page 46.) 
 
 N.B. In recent years, owing to the in- 
 creased magnitude of the American Fire 
 Problem, the study and practice of fire pre- 
 vention and protection have become a dis- 
 tinct engineering specialty. Extensive lit- 
 erature has grown up about the subject, and 
 treatises can be found on almost any of its 
 phases. Those who wish to become better 
 informed than is possible from this brief 
 manual may find the following works useful: 
 
 " Field Practice," by N. F. P. A. 
 
 " Fire Prevention and Fire Protection," 
 by J. K. Freitag (J. Wiley & Sons, New 
 York City). 
 
 "A Cyclopedia of Fire Prevention and 
 Insurance," which includes chapters by 
 many fire specialists. 
 
HOSPITAL FIRE MANUAL 69 
 
 "The Prevention of Fire in Old Build- 
 ings Housing the Insane/ 5 by J. Allen Jack- 
 son, N. Y. Medical Journal, March 25, 1916. 
 
 Reports on tests of materials, building 
 construction, etc., by the United States 
 Geological Survey. 
 
 " Standard Rules and Requirements for 
 Safeguarding Hazards," by N. F. P. A. 
 
 " State Laws and Municipal Ordinances 
 for Regulating Fire Hazards," by N. F. P. A. 
 
 " Standard Rules and Requirements for 
 Fire Protection," by N. F. P. A. 
 
 Educational pamphlets by N. F. P. A. 
 
5 
 
 1 5 J? 
 
359272 
 
 UNIVERSITY OF CALIFORNIA LIBRARY