Fire Hazard in Neonatal Units in India: Let’s Make a Start

Abstract

Sir,The commentary [1] in November issue of Indian Journal ofPediatrics on fire safety in neonatal units was long overdue.The authors have critically analyzed the issue and havecome up with comprehensive guidelines. A number of fireaccidents in neonatal units throughout India have occurredin recent times, the most horrific being the fire in a Patialabased hospital [2].The neonatal units are generally vulnerable for fire acci-dents in the hospitals due to the presence of oxygen andinflammable substances like alcohol. The existence of largenumber of heavy electrical equipment makes it additionallysusceptible than any other place in the hospital. The guide-lines offered in the commentary [1] are wide-ranging andhave looked at the issue as a whole. In India, despiteincreasing awareness about the issue, these guidelines mayremain largely unimplemented, primarily due to the lack ofresources.While it is extremely important to implement theseguidelines as a whole, we also know it may not happen inmost neonatal units in India because of lack of resources.But instead of waiting for the “right amount” of resources,we urgently need to make a start with whatever we have.Here are some simple, reasonable and low cost interven-tions, which may not be complete but would still help inreducing the risk of fires in neonatal units in India.1. Keep an alternate and functional exit. Most of the neo-natal units keep only single entry and exit point in orderto restrict the entry of people.2. The regular maintenance of equipments, especiallyoverhead warmers. In almost all cases the fire seemsto start from faulty electrical equipment.3. Heavy electrical wiring. The electrical wiring in thenursery is usually done as for the rest of the hospital.Consequently it is insufficient to bear the load of largenumberofelectricalequipmentsandheatersandbecomesa vulnerable point.4. Increasing the number of electrical points. In the ab-sence of sufficientnumber of electrical points, extensionboards are frequently used which becomes potentialsparking point.5. Direct observation. Many nurseries in India still runwith the nursing station outside. This puts the infantsat grave risk as they remain unattended and at the sametime early signs of the disaster may be missed.6. Training of the entire staff and the presence ofevacuation plan in the event of fire. Lack of stafftraining and its consequences were amply demon-strated during another fire accident in Kolkata re-cently [3].References