Inside ASHE - Fall 2017 - 39

extinguisher would be about a 50 percent
greater cost than a multipurpose A-B-C
extinguisher, and the clean agent
extinguisher would be about a 20 percent
increase in cost as compared to a CO2
extinguisher. A water mist extinguisher
would be similar in cost to a multipurpose
dry chemical extinguisher. Overall, cost
variability should not be an issue when
selecting the best protection for the OR.
Regardless of the type of fire
extinguisher that you select for your OR,
keep in mind that the Joint Commission

has begun to ask OR staff during surveys
whether they perform OR fire drills and
whether staff members have been trained
on the use and type of fire extinguishers
present in the OR. A common qualifying
question by a Joint Commission surveyor
is "Can staff articulate the types of
extinguishers you chose and how and
where to use that specific extinguisher?"
The answer the surveyor is really looking
for is that the staff know and use a
method as described in NFPA 99 for fires
in the OR.

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care facilities is a vital step in preparing
the facility to effectively deal with a fire
in its incipient stage. There are special
extinguisher requirements such as
nonferrous fire extinguisher components of
fire extinguishers in an MRI room or area and
Class K extinguishers in kitchens. There is a
need to consider extinguishing agents for
various areas of a facility that are nontoxic,
noncorrosive, and/or nonconductive.
Chapters 5 and 6 and Annex A notes
of NFPA 10, Standard for Portable Fire
Extinguishers, need very careful review.
Annex C, "Fire Extinguisher Selection" and
Annex D, "Operation and Use," of NFPA 10
provide additional valuable guidance.
Annex D specifically mentions ORs.
Per D.4.8 - Water Mist Extinguisher. Fire
extinguishers of this type are available in
2.5 gal (9.5 L) and 1.75 gal (6.6 L) sizes. They
have ratings of 2-A:C. The agent is limited to
distilled water, which is discharged as a fine
spray. In addition to being used as a regular
water extinguisher, water mist extinguishers
are used where contaminants in unregulated
water sources can cause excessive damage
to personnel or equipment. Typical
applications include operating rooms,
museums, and book collections.
Although it can be said that both water
mist and CO2 could be effective on AC
and BC fires, respectively, I recommend
halogenated hydrofluorocarbon
"clean agent" fire extinguishers such
as HFC-236fa as viable hand-held fire
extinguishing protection in ORs. Based on
my years of experience in fire protection
and my knowledge of the differing fire
classifications and effective extinguishing
mediums, the benefits of the clean agent
hand-held fire extinguishers are that
they are A-, B-, C-rated, have better user
operability for marginally trained staff,
controllable discharge, low toxicity, are
non-conductive and non-corrosive, leave
no residue, and reduce the likelihood
of thermal shock to open incisions if
discharged on a patient. In addition, they
are environmentally friendly in that they
do not contain chlorine or bromine and
have zero ozone depletion potential.
Overall, they are the best option for
the protection of the facility and
equipment, patient protection, and rapid
clean-up for OR business continuation
post-fire events. In addition, from a
cost perspective, a similar-sized CO2

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Table of Contents for the Digital Edition of Inside ASHE - Fall 2017

Letter from the president
What’s new
Pop quiz
The measurement of a health care facility manager: How do you define success?
Creating a program to identify and monitor pressure dependent spaces
Critical considerations for specifying a building automation system for health care
Bright ideas: LED renovation at Boulder Community Health
Selecting the right fire extinguisher for operating rooms
Still battling reheat energy in hospitals: Short- and long-term ideas for hospitals’ biggest energy use
The financial impact of variable speed ventilation controls in hospital kitchens
Data driven culture fuels University of Florida Health’s success in energy and operational optimization
Energy management in a critical access hospital: How Barnesville Hospital reduced energy consumption by 39 percent
Value analysis: Improving operating margin through cost savings
Member spotlight
Advertisers’ index
Inside ASHE - Fall 2017 - Intro
Inside ASHE - Fall 2017 - bellyband1
Inside ASHE - Fall 2017 - bellyband2
Inside ASHE - Fall 2017 - cover1
Inside ASHE - Fall 2017 - cover2
Inside ASHE - Fall 2017 - 3
Inside ASHE - Fall 2017 - 4
Inside ASHE - Fall 2017 - 5
Inside ASHE - Fall 2017 - 6
Inside ASHE - Fall 2017 - 7
Inside ASHE - Fall 2017 - 8
Inside ASHE - Fall 2017 - Letter from the president
Inside ASHE - Fall 2017 - What’s new
Inside ASHE - Fall 2017 - 11
Inside ASHE - Fall 2017 - Pop quiz
Inside ASHE - Fall 2017 - 13
Inside ASHE - Fall 2017 - 14
Inside ASHE - Fall 2017 - 15
Inside ASHE - Fall 2017 - 16
Inside ASHE - Fall 2017 - 17
Inside ASHE - Fall 2017 - The measurement of a health care facility manager: How do you define success?
Inside ASHE - Fall 2017 - 19
Inside ASHE - Fall 2017 - Creating a program to identify and monitor pressure dependent spaces
Inside ASHE - Fall 2017 - 21
Inside ASHE - Fall 2017 - 22
Inside ASHE - Fall 2017 - 23
Inside ASHE - Fall 2017 - Critical considerations for specifying a building automation system for health care
Inside ASHE - Fall 2017 - 25
Inside ASHE - Fall 2017 - 26
Inside ASHE - Fall 2017 - 27
Inside ASHE - Fall 2017 - Bright ideas: LED renovation at Boulder Community Health
Inside ASHE - Fall 2017 - 29
Inside ASHE - Fall 2017 - 30
Inside ASHE - Fall 2017 - 31
Inside ASHE - Fall 2017 - 32
Inside ASHE - Fall 2017 - 33
Inside ASHE - Fall 2017 - Selecting the right fire extinguisher for operating rooms
Inside ASHE - Fall 2017 - 35
Inside ASHE - Fall 2017 - 36
Inside ASHE - Fall 2017 - 37
Inside ASHE - Fall 2017 - 38
Inside ASHE - Fall 2017 - 39
Inside ASHE - Fall 2017 - 40
Inside ASHE - Fall 2017 - 41
Inside ASHE - Fall 2017 - Still battling reheat energy in hospitals: Short- and long-term ideas for hospitals’ biggest energy use
Inside ASHE - Fall 2017 - 43
Inside ASHE - Fall 2017 - 44
Inside ASHE - Fall 2017 - 45
Inside ASHE - Fall 2017 - The financial impact of variable speed ventilation controls in hospital kitchens
Inside ASHE - Fall 2017 - 47
Inside ASHE - Fall 2017 - 48
Inside ASHE - Fall 2017 - 49
Inside ASHE - Fall 2017 - 50
Inside ASHE - Fall 2017 - 51
Inside ASHE - Fall 2017 - Data driven culture fuels University of Florida Health’s success in energy and operational optimization
Inside ASHE - Fall 2017 - 53
Inside ASHE - Fall 2017 - 54
Inside ASHE - Fall 2017 - 55
Inside ASHE - Fall 2017 - Energy management in a critical access hospital: How Barnesville Hospital reduced energy consumption by 39 percent
Inside ASHE - Fall 2017 - 57
Inside ASHE - Fall 2017 - Value analysis: Improving operating margin through cost savings
Inside ASHE - Fall 2017 - 59
Inside ASHE - Fall 2017 - Member spotlight
Inside ASHE - Fall 2017 - Advertisers’ index
Inside ASHE - Fall 2017 - 62
Inside ASHE - Fall 2017 - cover3
Inside ASHE - Fall 2017 - cover4
Inside ASHE - Fall 2017 - outsert1
Inside ASHE - Fall 2017 - outsert2
Inside ASHE - Fall 2017 - 70
Inside ASHE - Fall 2017 - 71
Inside ASHE - Fall 2017 - 72
Inside ASHE - Fall 2017 - 73
Inside ASHE - Fall 2017 - 74
Inside ASHE - Fall 2017 - 75
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