Fire and more fire: On hospital ICU fires, patient safety

India must treat hospital fire safety (अस्पताल की अग्नि सुरक्षा) as an issue of criminal accountability (आपराधिक जवाबदेही)

Cuttack is not an anomaly (विसंगति, असामान्यता). It is the latest entry in a ledger of preventable deaths in Indian hospital ICUs. In 2016, 22 people died in a fire at a private hospital ICU in Bhubaneswar, which did not have the mandatory (compulsory, obligatory, binding, essential) fire safety clearance (स्वीकृति, अनुमति). Following (के बाद, उपरांत) this tragedy (त्रासदी), fire safety audits (अग्नि सुरक्षा निरीक्षण) were made compulsory for such facilities (सुविधा, संस्थान). Last year, the Odisha government allocated (आवंटित करना, बाँटना) about ₹320 crore for fire safety improvement across hospitals in the State. But this did not prevent the fire at the government SCB Medical College and Hospital, Cuttack, apparently (जाहिरा तौर पर) caused by a short circuit (a faulty connection or abnormal flow of electric current in a circuit that bypasses the normal load, often causing overheating or fire) in the ICU of the trauma care unit. Some reports suggest (संकेत देना, इंगित करना) the fire may have started in a ventilator (a medical device that provides mechanical assistance to a patient’s breathing by delivering air into the lungs; respirator, life-support machine), which was later found heavily charred (झुलसाना, जला देना). The accident, which occurred in the early hours of Monday, claimed 12 of the 23 ICU patients. Although the hospital had a firefighting unit (अग्निशमन दल), its personnel (staff, employees, workforce, workers) arrived after more than 30 minutes, reportedly (supposedly, allegedly, reputedly, ostensibly) because staff did not alert (notify, inform) them early. Additionally (furthermore, moreover, besides, also), the fire hydrants (an upright water pipe, especially one in a street or building, with a nozzle to which a fire hose can be attached; water plug, emergency water outlet) could not be operated by staff. Nevertheless (in spite of that; nonetheless, however, yet, still), water is not the right medium (substance) to fight electric fires, which are best extinguished (put out, douse, smother, quench) using carbon dioxide (a colourless, odourless gas used in fire extinguishers to displace oxygen and smother electrical fires; CO2, extinguishing gas, non-flammable gas, fire-suppressant agent), a method that requires trained personnel. Last October, six patients were killed in an ICU fire in Rajasthan. In 2024, newborns (a child that has recently been born; infant, baby, tot) died in an ICU fire in Jhansi, Uttar Pradesh. Two similar accidents were reported in Maharashtra in 2021. An audit (inspection, review, evaluation, assessment) in Jhansi revealed (disclose, uncover, expose, bring to light) hazards including exposed wiring (electrical cables or wires that are not properly covered or insulated, posing a risk of electric shock or fire; bare wires, uninsulated cables, open electrical lines), inadequate earthing (the process of connecting electrical equipment to the ground to prevent electric shocks and fires) and electrical circuits not matching power load (the amount of electrical energy consumed by the devices and equipment connected to an electrical circuit) requirements — the last being a leading (most important; primary, main) cause of electrical fires in India.

ICUs have intrinsic safety risks, as their oxygen-rich (containing a high concentration of oxygen, which significantly increases flammability and fire risks; highly oxygenated, oxygen-dense) environment (surroundings, setting, atmosphere, conditions) can turn even a spark into an inferno (a large fire that is dangerously out of control; conflagration, blaze, firestorm, raging fire). ICUs are also packed with electrical equipment, and the personnel are not always well trained in their safe handling (the process of operating or managing dangerous equipment or materials in a manner that prevents accidents or harm; secure operation, careful management, proper usage). State-of-the-art (modern, cutting-edge, advanced, ultra-modern) medical equipment comes with (feature, include, possess, bear) advanced electronics (technologically sophisticated, modern digital, high-tech, complex electronic) and variable frequency drives (a type of motor controller that drives an electric motor by varying the frequency and voltage of its power supply) that generate what are called “harmonic currents (an unwanted electrical current generated by non-linear loads that distorts the normal power supply and can cause dangerous overheating in circuits)”. These currents flow within circuits and typically have no safety devices such as circuit breakers (an automatic electrical safety switch designed to protect an electrical circuit from damage caused by overcurrent or short circuit; safety switch, trip switch, fuse). Harmonics (unwanted electrical frequencies that cause distortion in voltage and current waveforms, often leading to equipment overheating and fire hazards; frequency distortions) create silent, persistent (continuous, unrelenting, constant, unending) overheating and insulation (protective covering, shielding) degradation and are a severe fire hazard (a material, condition, or situation that increases the likelihood of a fire starting or spreading; fire risk, flammability threat, combustion danger, fire peril). Today’s electrical practice lays down that every time a new ventilator is wheeled into an ICU, the wiring, protection and load capacity (the maximum amount of electrical current that a system can safely handle; electrical limit, maximum load, carrying capacity, power threshold) must be re-evaluated (reassess, review, reconsider, re-examine). Older facilities need an electrical upgrade (the process of modernizing or improving an electrical system to safely handle increased power demands or new equipment; power system enhancement, wiring modernization, circuit improvement) before cutting edge equipment can be installed. As patients in ICUs are often sedated (tranquillize, calm, put to sleep, medicate), intubated, and connected to machines, staff must be trained to ensure their safe evacuation (the action of emptying or clearing a place, especially of people in a dangerous situation; clearing, emptying, removal, withdrawal). Until India treats hospital fire safety as a matter of (an issue or question of a specific kind; an issue of, a question of, a case of, a subject of) criminal accountability rather than (instead of, in place of, as an alternative to, opposed to) bureaucratic paperwork (clerical work, documentation, record-keeping, administration), the fires will keep burning and the bodies will keep mounting (increase, accumulate, pile up, multiply).

Courtesy: The Hindu

Important Word List With Meaning

1.hospital fire safety (noun)

Hindi Meaning - अस्पताल की अग्नि सुरक्षा
English Meaning - the set of practices, protocols, and equipment implemented within a healthcare facility to prevent, manage, and protect patients and staff from fire hazards.

2.criminal accountability (noun)

Hindi Meaning - आपराधिक जवाबदेही
English Meaning - the legal responsibility and liability of individuals or entities to face prosecution and penal consequences for negligent or unlawful actions resulting in harm or death; penal responsibility, legal liability, culpability.

3.accountability (noun)

Hindi Meaning - जवाबदेही, उत्तरदायित्व
English Meaning - responsibility, liability, answerability, culpability.

4.anomaly (noun)

Hindi Meaning - विसंगति, असामान्यता
English Meaning - abnormality, exception, irregularity, aberration.

5.clearance (noun)

Hindi Meaning - स्वीकृति, अनुमति
English Meaning - official authorization or permission; approval, sanction.

6.fire safety clearance (noun)

Hindi Meaning - अग्नि सुरक्षा स्वीकृति
English Meaning - an official certification or approval granted by authorities indicating that a building complies with all mandated fire prevention and safety regulations; fire safety certification.

7.following (preposition)

Hindi Meaning - के बाद, उपरांत
English Meaning - coming after or as a result of an event; subsequent to, succeeding, in the aftermath of, trailing.

8.tragedy (noun)

Hindi Meaning - त्रासदी
English Meaning - disaster, catastrophe, calamity, misfortune.

9.fire safety audit (noun)

Hindi Meaning - अग्नि सुरक्षा निरीक्षण
English Meaning - a comprehensive and systematic evaluation of a building’s premises and operations to identify fire hazards and ensure compliance with safety standards.

10.facility (noun)

Hindi Meaning - सुविधा, संस्थान
English Meaning - a place, amenity, or piece of equipment provided for a particular purpose; establishment, institution, centre, premises.

11.allocate (verb)

Hindi Meaning - आवंटित करना, बाँटना
English Meaning - assign, allot, distribute, designate.

12.apparently (adverb)

Hindi Meaning - जाहिरा तौर पर
English Meaning - seemingly, evidently, ostensibly, outwardly.

13.suggest (verb)

Hindi Meaning - संकेत देना, इंगित करना
English Meaning - indicate, imply, propose, point to.

14.char (verb)

Hindi Meaning - झुलसाना, जला देना
English Meaning - burn, scorch, sear, blacken.

15.firefighting unit (noun)

Hindi Meaning - अग्निशमन दल
English Meaning - an organized team of trained personnel equipped to extinguish fires and handle emergencies within a facility or area; fire brigade, fire department, rescue squad.

16.personnel (noun)

English Meaning - staff, employees, workforce, workers.

17.reportedly (adverb)

English Meaning - supposedly, allegedly, reputedly, ostensibly.

18.ledger (noun)

English Meaning - record book, register, log, archive.

19.mandatory (adjective)

English Meaning - compulsory, obligatory, binding, essential.

20.short circuit (noun)

English Meaning - a faulty connection or abnormal flow of electric current in a circuit that bypasses the normal load, often causing overheating or fire.

21.trauma care (noun)

English Meaning - specialized medical treatment provided to patients suffering from severe or life-threatening physical injuries; emergency treatment, critical care, injury management.

22.trauma (noun)

English Meaning - severe injury, physical damage, shock, wound.

23.ventilator (noun)

English Meaning - a medical device that provides mechanical assistance to a patient’s breathing by delivering air into the lungs; respirator, life-support machine.

24.claim (verb)

English Meaning - kill, take, end.

25.firefighting (noun)

English Meaning - the activity or profession of extinguishing fires; fire control, fire suppression, emergency response, hazard mitigation.

26.alert (verb)

English Meaning - notify, inform.

27.additionally (adverb)

English Meaning - furthermore, moreover, besides, also.

28.(fire) hydrant (noun)

English Meaning - an upright water pipe, especially one in a street or building, with a nozzle to which a fire hose can be attached; water plug, emergency water outlet.

29.nevertheless (adverb)

English Meaning - in spite of that; nonetheless, however, yet, still.

30.medium (noun)

English Meaning - substance.

31.extinguish (verb)

English Meaning - put out, douse, smother, quench.

32.carbon dioxide (noun)

English Meaning - a colourless, odourless gas used in fire extinguishers to displace oxygen and smother electrical fires; CO2, extinguishing gas, non-flammable gas, fire-suppressant agent.

33.newborn (noun)

English Meaning - a child that has recently been born; infant, baby, tot.

34.audit (noun)

English Meaning - inspection, review, evaluation, assessment.

35.reveal (verb)

English Meaning - disclose, uncover, expose, bring to light.

36.hazard (noun)

English Meaning - a danger or risk; danger, risk, peril, threat.

37.exposed wiring (noun)

English Meaning - electrical cables or wires that are not properly covered or insulated, posing a risk of electric shock or fire; bare wires, uninsulated cables, open electrical lines.

38.inadequate (adjective)

English Meaning - insufficient, deficient, poor, substandard.

39.earthing (noun)

English Meaning - the process of connecting electrical equipment to the ground to prevent electric shocks and fires.

40.power load (noun)

English Meaning - the amount of electrical energy consumed by the devices and equipment connected to an electrical circuit.

41.leading (adjective)

English Meaning - most important; primary, main.

42.cause (noun)

English Meaning - reason.

43.intrinsic (adjective)

English Meaning - inherent, innate, built-in, essential.

44.oxygen-rich (adjective)

English Meaning - containing a high concentration of oxygen, which significantly increases flammability and fire risks; highly oxygenated, oxygen-dense.

45.environment (noun)

English Meaning - surroundings, setting, atmosphere, conditions.

46.turn into (phrasal verb)

English Meaning - transform, convert, change into, alter.

47.spark (noun)

English Meaning - a small fiery particle thrown off from a fire, alight in ashes, or produced by an electrical fault; flicker, flash, ignition, ember.

48.inferno (noun)

English Meaning - a large fire that is dangerously out of control; conflagration, blaze, firestorm, raging fire.

49.pack with (phrasal verb)

English Meaning - fill, cram, stuff, load.

50.well trained (adjective)

English Meaning - skilled, proficient, qualified, competent.

51.safe handling (noun)

English Meaning - the process of operating or managing dangerous equipment or materials in a manner that prevents accidents or harm; secure operation, careful management, proper usage.

52.state-of-the-art (adjective)

English Meaning - modern, cutting-edge, advanced, ultra-modern.

53.come with (phrasal verb)

English Meaning - feature, include, possess, bear.

54.advanced electronic (adjective)

English Meaning - technologically sophisticated, modern digital, high-tech, complex electronic.

55.variable frequency drive (noun)

English Meaning - a type of motor controller that drives an electric motor by varying the frequency and voltage of its power supply.

56.harmonic current (noun)

English Meaning - an unwanted electrical current generated by non-linear loads that distorts the normal power supply and can cause dangerous overheating in circuits.

57.circuit breaker (noun)

English Meaning - an automatic electrical safety switch designed to protect an electrical circuit from damage caused by overcurrent or short circuit; safety switch, trip switch, fuse.

58.harmonics (noun)

English Meaning - unwanted electrical frequencies that cause distortion in voltage and current waveforms, often leading to equipment overheating and fire hazards; frequency distortions.

59.persistent (adjective)

English Meaning - continuous, unrelenting, constant, unending.

60.overheating (noun)

English Meaning - thermal overload, excess heat, superheating.

61.insulation (noun)

English Meaning - protective covering, shielding.

62.degradation (noun)

English Meaning - deterioration, decay, breakdown, degeneration.

63.fire hazard (noun)

English Meaning - a material, condition, or situation that increases the likelihood of a fire starting or spreading; fire risk, flammability threat, combustion danger, fire peril.

64.lay down (phrasal verb)

English Meaning - stipulate, prescribe, mandate, dictate.

65.wheel into (phrasal verb)

English Meaning - push, roll, move, transport.

66.load capacity (noun)

English Meaning - the maximum amount of electrical current that a system can safely handle; electrical limit, maximum load, carrying capacity, power threshold.

67.re-evaluate (verb)

English Meaning - reassess, review, reconsider, re-examine.

68.electrical upgrade (noun)

English Meaning - the process of modernizing or improving an electrical system to safely handle increased power demands or new equipment; power system enhancement, wiring modernization, circuit improvement.

69.cutting edge (adjective)

English Meaning - pioneering, state-of-the-art, advanced, forefront.

70.sedate (verb)

English Meaning - tranquillize, calm, put to sleep, medicate.

71.intubate (verb)

English Meaning - catheterize, cannulate, ventilate, insert a tube into.

72.evacuation (noun)

English Meaning - the action of emptying or clearing a place, especially of people in a dangerous situation; clearing, emptying, removal, withdrawal.

73.a matter of (phrase)

English Meaning - an issue or question of a specific kind; an issue of, a question of, a case of, a subject of.

74.rather than (phrase)

English Meaning - instead of, in place of, as an alternative to, opposed to.