Fire Extinguishers in an ASC

Q: We have a 1400 square foot ambulatory surgical center (ASC). In the plans there are only 5 Fire Extinguishers throughout the facility. I looked at 2012 Life Safety Code and the referenced NFPA 10-2010 but still not sure. What are the locations and how many fire extinguishers should be in this 3 operating room 1400 square foot ASC?

A: The placement of portable fire extinguishers is determined on the length of travel distance to get to a fire extinguisher…. It is not determined by the total square footage of the facility. According to NFPA 10-2010, the maximum travel distance to get to a fire extinguisher is dependent on the classification of the fire extinguisher, the capacity of the fire extinguisher, and the potential level of hazard from the fire.

Class A fire extinguishers are for normal combustibles, such as paper, wood, plastic and linens. The maximum travel distance to get to a Class A extinguisher is 75 feet for all capacities of Class A extinguishers, and all potential levels of hazard from the fire. That means you need a Class A extinguisher within 75 feet of all paper, wood, plastic and/or linen. Since paper, wood, plastic and linen are nearly everywhere in a healthcare facility, you will need a Class A fire extinguisher within 75 feet of everywhere inside the facility.

Class B fire extinguishers are for flammable liquids, such as alcohol, alcohol-based hand-rub (ABHR) solution, and xylene. The maximum travel distance to get to a Class B extinguisher is either 30 feet or 50 feet, depending on the capacity of the Class B fire extinguisher, and the level of hazard of the potential flammable liquid fire. The capacity of a Class B extinguisher is pre-determined by the manufacturer, and is identified on the extinguisher label. Usually, it is determined by the ability of the extinguisher to extinguish a fire, so the quantity of the product in the extinguisher is a factor. According to Table of NFPA 10-2010, where the level of the potential hazard is low, a 5-B extinguisher is only permitted a 30-foot travel distance, but a 10-B extinguisher is permitted a 50-foot travel distance. Similarly, if the level of potential hazard is moderate, then a 10-B extinguisher is permitted a 30-foot travel distance, and a 20-B extinguisher is permitted a 50-foot travel distance.

Class C fire extinguishers are for electrical fires. An electrical fire is started by electricity, but the actual substance that burns is either Class A (normal combustibles) or Class B (flammable liquids). Therefore, where potential electrical fires are expected, then a Class C extinguisher is needed, based on the maximum travel distance to get to the extinguisher on either Class A or Class B standards.

Class D fire extinguishers are for combustible metals such as magnesium, zirconium, and potassium, which a typical healthcare facility does not have. Therefore, Class D extinguishers are not required if you do not have any of the combustible metals.

Class K extinguishers are for fires from cooking appliances that involve combustible cooking media (vegetable or animal oils and fats). These are found in kitchens and the maximum travel distance to get to a Class K extinguisher is 30 feet.

The determination of the level of hazard for a Class B potential fire is subjective and could vary depending on the surveyor and authority having jurisdiction (AHJ). For a healthcare facility, a low level of hazard would be areas where individual (or low quantities) of ABHR dispensers or bottles are located, and low levels of alcohol or xylene are located. A potential hazard of flammable liquids is moderate where larger quantities of flammable liquids are stored. But be careful: Based on the information in NFPA 10-2010, you would need Class B extinguishers with a 10-B rating with a maximum travel distance of 50 feet to cover potential fires from ABHR dispensers. This is often overlooked by designers when they are placing portable fire extinguishers in new facilities. Instead of the usual 75 maximum travel distance to get to a Class A extinguisher, you will need to place the Class B extinguishers with a maximum 50-foot travel distance to cover potential fires from ABHR dispensers.

There are fire extinguishers that have the rating to fight Class A, Class B, and Class C fires all in one extinguisher. These are typically ABC dry powder extinguishers, but there are other media types, such as clean agent extinguishers that can achieve an ABC rating. But dry powder extinguishers are not desirable in operating rooms where the possibility of infection is high if the dry powder extinguisher is activated. Therefore, many healthcare facilities rely on water-mist Class A:C extinguishers and a carbon dioxide (CO2) Class B inside the operating room. But you would have to make sure the water-mist extinguishers are charged with distilled water and nitrogen to prevent the growth of pathogens.

Other healthcare facilities do not use water-mist extinguishers in the operating room and rely on the sterile water in a bowl in the sterile field to extinguish any Class A fires that may occur. They then find Class B:C extinguishers to cover Class B and Class C potential fires. Keep in mind, there is no requirement that portable fire extinguishers have to be located inside each operating room. The fire extinguishers just have to be located within the maximum travel distance permitted for each classification of extinguisher, capacity of the extinguisher, and the level of hazard for the potential fire. But be careful: Some operating rooms are rather large, and it might be more than 30 feet to travel from the far corner of the operating room, to the Class B extinguisher in the hallway.

Class K extinguishers are required in kitchens, and the maximum travel distance to get to a Class K extinguisher is 30 feet. A placard needs to be installed above the Class K extinguisher that informs the staff to activate the kitchen hood suppression system first, before using the Class K extinguisher.

Mechanical Room Fire Extinguishers

Q: What are your thoughts on using CO2 extinguishers in an HVAC mechanical room, instead of an ABC type?

A: It likely would be a situation where you would be non-compliant with NFPA 10-2010, and therefore you would not be compliant with the 2012 LSC. A CO2 extinguisher carries a BC rating, meaning it is classified for use on flammable liquid fires and electrical fires. But what about fires in your mechanical room that are caused by normal combustibles (paper, cardboard, plastic, linen, etc.)? I’ve yet to see a mechanical room that did not have some level of combustibles stored in the room (filters, boxes of spare parts, trash bags, etc.).

I would recommend ABC fire extinguishers for all mechanical rooms, and the dry powder type is the most common and affordable to use. However, if the mechanical room has sensitive electronic equipment, then perhaps a Clean Agent ABC type extinguisher would be more appropriate.

CO2 extinguishers have a limited value, and should only be used in areas where you have flammable liquids in use and storage, such as laboratories, pharmacies, and perhaps a grounds garage.

Fire Extinguishers in Vehicles

Q: What is the standard on fire extinguishers in work vehicles? We have them in our transit vans to our home health nurses. Do we need them inspected and retagged every year like our buildings? Also do they need a monthly check as well?

A: I am not aware of any NFPA code or standard that requires portable fire extinguishers inside vehicles used/owned/leased by healthcare organizations. If there is a requirement to have them, it may come from your insurance provider.

However, the expectation is once you have them, you must maintain them. So that would mean you need to inspect them monthly, and provide maintenance service on an annual basis.

Fire Extinguishers

Q: Are portable fire extinguishers required in business occupancies?

A: Yes… Section 38.3.5 of the 2012 Life Safety Code says portable fire extinguishers must be provided in every business occupancy in accordance with Section references NFPA 10 for installation, inspection, and maintenance of portable fire extinguishers.

Strange Observations – Part 33

Continuing in a series of strange things that I have seen while consulting at hospitals…

Equipment rooms can be a major source of findings for surveyors.

Mostly because equipment rooms are often out-of-sight / out-of-mind. And because often times no-one is assigned to maintain the equipment rooms in safe condition.

Here we have a trash cart and a water machine obstructing access to electrical panels and a fire extinguisher.

Fire Extinguisher Signs

Q: I was wondering if there was a specific regulation that states exactly where fire extinguisher signs need to be located. Is there a difference between patient area and staff area? Looking over the new Life Safety Code regulations I have not been able to get a specific answer on where signage location is mandatory.

A: The only thing I can find is section of NFPA 10-2010, which says where visual obstructions of fire extinguishers cannot be completely avoided, means shall be provided to indicate the extinguisher location. The Annex section says acceptable means of identifying the fire extinguisher locations include arrows, lights, signs, or coding of the wall or column.

 So, while there is no direct requirement to install signs over fire extinguishers, you may do so. However, be aware: Some AHJs will expect signs identifying the locations of all extinguishers once you start using signs. Their logic is, if you use signs to identify the location of some extinguishers, then your staff will expect to see signs for all extinguishers.

The AHJs do have the right to interpret the code as they see fit. I suggest you ask your AHJs to see if they would require all of the extinguishers have signs.

Strange Observations – Part 32

Continuing in a series of strange things that I have seen while consulting at hospitals…

I get it… I understand that many people like to decorate their work area to help brighten up the day for everyone.

I like those people… They are the happy, cheerful, positive, encouraging type of individuals.

But keep an eye on them, as they will eventually start decorating features of Life Safety that will get you in trouble.

Still another reason to do frequent rounding inspections (i.e. monthly) in all areas.

4-Inch Corridor Projection

Q: With the adoption of the new 2012 Life Safety Code by CMS, we had a discussion about projections from the corridor wall. Since the LSC only allows projections to be 4 inches, the question that came up was in regards to fire extinguishers mounted to the wall and not recessed as they project out from the wall about 7 inches. Will we be required to recess them or will they be allowed? The same question was raised about wall mounted telephones?

A: Actually, the 2012 LSC allows a 6-inch projection into the corridor [see], but CMS’ Final Rule published May 4, 2016 said they will enforce the more restrictive 4-inch maximum projection into the corridor, based on the Americans with Disabilities Act (ADA). For all healthcare facilities that receive Medicare & Medicaid funds, they must comply with CMS’ exception to the 2012 LSC.

To answer your question, there are no exceptions to the 4-inch maximum projection rule. So, anything projecting more than 4 inches into the corridor, including fire extinguishers and telephones, would likely be cited by a surveyor or inspector.

I read a survey report just the other day where the surveyor cited the hospital for having an ABHR dispenser that projected into the corridor by 4 1/4 inches. So, AHJs are citing anything that projects more than 4-inches into the corridor, including fire extinguishers.

This may be a good opportunity to consider oval-shaped fire extinguishers that do not project more than 4 inches into the corridor. Take a look at these compliant fire extinguishers from Oval brand:


Strange Observations – Part 13

Continuing in a series of strange things that I have seen when consulting at hospitals…

Believe it or not, there is a fire extinguisher buried behind all of the trash on the carts.

If a fire were to occur, how fast would the staff be able to find the extinguisher?

Fire Extinguishers in Chute Rooms?

Q: Our hospital is wondering if it is a requirement to have fire extinguishers in our linen/trash chute room? If so where can I find the code reference?

A: No… it is not a requirement to have portable fire extinguishers inside the trash/linen discharge room, or the trash collection room. However, it is a requirement to have a properly classified fire extinguisher within the maximum travel distance for that extinguisher and the level of hazard it is intended to handle from everywhere in the facility, which would include the trash collection room. The extinguisher would have to be a Class A:B and located within the maximum travel distance for a Class A:B (probably 75 feet).