The Safety Net

Clinical Risks For Fire Safety for Persons with Developmental Disabilities

The week of October 6 –12, 2002 is Fire Prevention Week.

The month of October is Fire Safety month. There will be a lot of publicity and awareness activities in publications like the newspaper and within local communities. With awareness increased, this is a good opportunity to integrate some clinical issues for fire safety risk in any consulting or training that you might do. There are risks that are unique to consumers with developmental disabilities. If a consumer also has other conditions such as mobility impairment or hearing loss, then the risks are greater. Sometimes direct support staff can benefit from a discussion of possible concerns that might arise in the event of a fire.

The majority of fatal fires occur during the night. A consumer who requires adaptive equipment may not have access to it and may require two people for lifts and transfers. This person is an example of one who must have a well thought out plan of exit in the event of a fire. Chances are if he lives in a licensed home, there is a fire plan, but what if he lives with his parents? Here are some high risk issues that should trigger a risk plan for fire evacuation and a few suggestions for inclusion in those plans.

 First remember that all homes should have functioning smoke detectors. This is the single biggest reason for persons being able to escape a fire.

 Hearing loss –Needs an alarm with flashing lights in his bedroom

 Blind – May need some tactile cues that are located near the floor such as raised carpet tacks along the wall that leads to the exterior door, since people will generally be advised to crawl outside if there is smoke. If the person uses a cane, it should be near her bed so she may exit independently, if that is an option.

 Drowsiness from medication – It is important for staff to recognize who may be so drowsy that they may not recognize danger or be able to react to it.

 Respiratory disease – These individuals may be at risk for smoke related problems sooner than others due to their already compromised condition. They may require a bedroom near an exit or recognition from staff that this is the first person taken outside. If oxygen is in use, there needs to be a clear plan of what to do about oxygen in an emergency.

 Stamina – Some individuals may be extremely sedentary and not able to move quickly. Obesity may also be a contributing factor that makes crawling extremely difficult or impossible. It may be necessary for a wheelchair to be positioned near the bed. In a dire emergency, blankets may be used to drag the person out of the building to safety. Sometimes a stretcher or similar device may hung on a wall in the hall for use in an emergency.

 Cognitive impairments – Repeated practice is the best method to teach safe exit from a fire. Fire drills are necessary even in private homes. The more practice, the more likely that there will be a smooth exit if the worst happens.

 Behavioral challenges – Conducting a simulated situation such as a fire drill after people are asleep, will give you a better idea of how a person may react. Being prepared for someone who may become hysterical or aggressive can save a life.

Other Safety Considerations:
Smoking is the leading cause of fatal fires. In a home where some people smoke, there needs to be careful attention to disposal of ashes and vigilance at the locations where smoking occurs.
Everyone has the right to chose where they live, but it is safer for some people to be on the first floor and maybe even near an exit. Helping an individual to understand the choices is important.
Having a telephone near sleeping areas can speed assistance to persons who are in need.
A working flashlight in the night stand may also be a lifesaver. It might help someone find his way out or it might help rescuers find him.

Planning ahead and practicing are good strategies for fire safety.

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