Oxygen systems to be audited, says Maharashtra Covid Task Force after Ahmednagar hospital fire

Charred remains at the ICU of Civil Hospital after a fire broke out in Ahmednagar. Pic/PTI

After the Ahmednagar Civil Hospital fire that saw 11 casualties, the State Covid Task Force held an emergency meeting on Sunday to discuss suggestions on forming guidelines and preventing such episodes in future. While a preliminary probe found the firefighting equipment inadequate, fire experts have not ruled out the fact that rich oxygen supply can be one reason why these facilities are prone to fire.

So far, at least 51 lives have been lost in fire in Covid facilities in Maharashtra in the past 14-15 months. "It has been a cause of concern seeing a series of fire incidents happening in Covid-19 facilities. With the Ahmednagar Civil Hospital fire, this emergency meeting was held on Sunday afternoon to discuss the way forward and how to prevent such episodes," said a doctor who is part of the task force.

The task force has, in its recommendation, emphasised the need to investigate oxygen fires to identify causes and take lessons from the same to improve prevention and preparedness strategies, and routinely disseminating findings to hospital personnel.

Oxygen and cooling may be reasons

"We opined that an audit of Covid-19 facilities has to be done on priority basis. It is important to know what kind of cooling and what kind/quality of oxygen supply is there in these facilities," said another member of the task force. Talking about the areas of concern, the member said, "Covid-19 treatment can lead to elevated oxygen concentrations in the ambient air of the wards, so the combustibility of materials increases." He added that higher electrical loads on electrical power supplies may also increase risk of fires due to overloading.

"Poor maintenance or increased wear of equipment from unexpected high usage of equipment (eg, ventilators) can create hot spots in the absence of air cooling, or make contact sparking more likely," he said. Among the important checklist of managing oxygen risk, the task force member said it is important to identify hospital locations and procedures where oxygen hazards may be present, and to implement a risk management strategy commensurate with the level of risk.

"Monitoring oxygen levels in the atmosphere with appropriately located gas detection systems, that give off alarms or even activate ventilation systems when oxygen concentrations are elevated, will play a key role in curtailing such incidents in future," said the doctor. Saturday's fire at Ahmednagar had broken out in the intensive care unit (ICU) where Covid-19 patients were admitted.

Dr Shashank Joshi, member of the state Covid task force, said, "All Covid ICUs are potential fire hazards because of air conditions and cooling, electrical wiring and a lot of oxygen and flammable sanitisers. Also in the pandemic, we had many makeshift ICUs. Lot of gadgetisation has happened in ICU along with placement of flammable sanitisers. Therefore fire safety audits have to be more in detail."

Some key recommendations

He said a strict fire audit has to be followed especially in the makeshift ICUs along with use of fire retardant material for curtains and clothes. "Particular care has to be taken of laptop and phone charging points and fire retardant material used for clothes and curtains. It should be ensured that the oxygen, electrical points, gadgets and machines are in compliance," Dr Joshi said.

Another recommendation by the task force included raising awareness of oxidisation hazards among all levels of management and all areas of operation including administration, medical personnel, admissions, maintenance and housekeeping staff.

It also advised enhancement of air flow in oxygen therapy rooms. For enhancing the air flow, the task force suggested use of high flow ventilation systems or opening windows in adjacent rooms or corridors. It added that bed linen and clothing should also be ventilated for at least 15 minutes after use to allow dispersion of any excess oxygen.

11
No. of fires at Covid facilities in India

42
No. of fires at Covid facilities across the globe