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Life Safety Code® (NFPA 101) and other NFPA codes relevant to Healthcare

NFPA's Life Safety Code® (NFPA 101) covers a host of topics related to reducing the spread of fire in buildings and providing means of egress from buildings when necessary. The code includes different requirements for different types of buildings such as hotels, homes, and hospitals.

Means of Egress
These requirements comprise three major components:

  • Exit access, defined as the portion of the means of egress leading to an exit. This includes corridors and aisles.
  • Exit, defined as the portion of a means of egress that is separated from all other spaces of a building by construction and provides a protected way of travel to the exit discharge. This may include exit doors, protected stairways, and landings.
  • Exit discharge, defined as the portion of a means of egress between the end of the exit and a public way, such as a sidewalk open to outside air.

Building Features
Three other major areas covered by NFPA 101 are:

  • Construction features such as smoke barriers and interior finish.
  • Building service and fire protection features such as utilities, heating, air conditioning, smoke control, elevators, rubbish, chutes, detection systems, and fire extinguishment systems.
  • Operating features such as furnishing and fire exit drills.

Detection and Extinguishment Systems
Methods of detecting smoke, heat, and fire have been developed, as have systems that can suppress and extinguish fires. The two systems often are integrated.

Detection Systems
Standards exist for fire detection systems addressing performance, installation, and suitability for different applications. The systems are viewed as consisting of two parts:

  • Detector. This part senses heat, smoke, flame, gas, or anything else that would indicate a fire. Criteria have been established on performance, modes of operation, location and mounting, and testing (see NFPA 13, 72).
  • Control/Indicator. This part provides notification in some form to individuals, signaling them to take appropriate action. Standards and recommendations have been developed for a variety of these systems based on their complexity and intended use. Criteria cover equipment and electrical circuit specifications, operation, maintenance and testing, and other requirements. Addressed are: protected premises fire alarm systems, auxiliary fire alarm systems, remote supervision station fire alarm systems, proprietary supervisory systems, and alarm systems for central station service (see NFPA 72).

Fire Extinguishment Systems
Standards and recommendations have been developed for two types of extinguishment systems used at health care facilities: water and chemical.

  • Water. Separate standards exist for sprinkler type and standpipe type water systems. For sprinklers, standards cover design and installation, activation mechanisms, and maintenance. Standpipe provisions cover installation, acceptable configurations and equipment, appropriate uses of different types of systems, inspection and maintenance, and testing. Standards also exist on the selection, installation, and maintenance of fire pumps that may be necessary to pump water to such systems (see NFPA 13, 25).
  • Chemical. Five different types of chemical systems typically are used at health care facilities: carbon dioxide (NFPA 12), Halon 1301 (NFPA 12A), dry chemical (NFPA 17), wet chemical (NFPA 17A), and foam (NFPA 11). NFPA standards cover the installation, testing, use, and limitations of each

Protecting Building-Wide Systems
Building-wide systems for heating, cooling, lighting, detecting, communicating, extinguishing, and collecting may be affected by, or have an effect on, fire safety. Several codes, standards, and recommendations have been issued addressing these systems.

Environmental Air Building-Service Systems
Systems that provide heating, cooling, ventilation, or exhausting are covered by NFPA documents addressing three areas:

  • Fuels. Safeguards for handling fuels such as oil and gas once on site, including standards for gas piping, have been developed (NFPA 31, 54).
  • Heaters. Codes exist for a variety of heating systems, including equipment such as boilers and furnaces that burn gas, oil, fuel oil, and natural gas (NFPA 31, 54, 8501; also, American National Standards Institute standards ANSI Z21.13 and ANSI Z83.3).
  • Air Movers. Provisions exist to restrict smoke, heat and fire spread through air ducts, and for various methods of smoke control (NFPA 90A, 90B, 92A, 92B).

Electrical Systems
NFPA has addressed electrical systems in terms of installation of wiring and provisions for emergency power.

  • Installation of Wiring. The National Electrical Code® (NFPA 70) is the most comprehensive document on electrical construction and installation. It provides criteria on wiring, design, methods, material, and installation. Specific criteria exist for electrical systems in health care facilities under Article 517 of the code.
  • Emergency electrical power. Criteria exist for the power generation system needed to supply electrical power in the event that the normal supply fails, how such a system should be connected to the normal supply, and what circuits, outlets, or functions are to be connected to the system (NFPA 37, 99, 110).

Specific Building-Service Systems
Different NFPA documents address various building-wide systems that perform a specific, more limited function, including:

  • Piped gas systems (NFPA 45, 54, 99; also, NFPA Fire Protection Handbook).
  • Piped vacuum systems (NFPA 99; also, NFPA Fire Protection Handbook).
  • Chutes (NFPA 82, 101).
  • Elevators (NFPA 101; also, ANSI/AMSE A17.1).
  • Fans (NFPA 91).

Protecting Fixed, Localized Systems
Localized activities that take place in health care facilities such as surgical procedures, X-rays, treatment clinics, and immobilizing patients, as well as computer operations, cooking, storing, and disposal, are covered by various codes and standards. Generally these activities can be divided into two major groups: areas where storage primarily occurs, and areas where some ongoing activity takes place.

Storage Areas
NFPA documents provide criteria for a variety of storage activities, including:

  • General storage, for which criteria exist for a broad range of combustibles and address arrangement, building construction, fire protection, and safety practices (NFPA 231).
  • Rack storage, which can be considered a subset of general storage but presents some unique hazards (NFPA 231C).
  • Data storage, in print or electronic form (NFPA 232, 232AM(manual)).
  • Flammable liquids (NFPA 30, 45, 99).
  • Flammable and nonflammable medical gas storage (NFPA 99).
  • Flammable and nonflammable laboratory gas (NFPA 45, 99).
  • Nuclear material storage (NFPA 801).

NFPA also has developed criteria for identifying the relative fire hazard of various hazardous materials using labeling methods designed to enable quick identification by firefighters (NFPA 704).

On-Going Activities
Special NFPA provisions exist that address the following specific on-going activities:

  • Inhalation anesthetizing locations, including criteria for electrical wiring (NFPA 70, 99), isolated power system and line isolation monitors (NFPA 70, 99), conductive flooring (NFPA 99), piped gases (NFPA 45, 54, 99), and piped vacuum (NFPA 99).
  • Patient care areas of hospitals, including anesthetizing locations, comprising criteria for electrical wiring (NFPA 70, 99) and isolated power system and line isolation monitors (NFPA 70, 99).
  • Hyperbaric and hypobaric facilities, including criteria on housing and fabrication, ventilation, illumination, fire protection, and electrical systems (hyperbaric: NFPA 99; hypobaric: NFPA 99B).
  • Laboratories, including criteria for fire protection, electrical receptacles, fume hood protection, and ventilation (NFPA 45, 99).
  • Non-medical areas, including criteria for computer areas (NFPA 75), kitchen areas (NFPA 54, 96), and two types of waste disposals systems - incinerators and waste compactors (NFPA 82).

Emergency Communication Systems
Systems used to notify building occupants of an emergency are covered by various NFPA codes and standards. Requirements exist for speakers used for emergency communications and alarm signals, as well as for mounting and locating audible and visual indicating appliances such as bells, horns, chimes, or strobe lights (NFPA 72, 101).

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