Withdraw ‘unscientific’ fire safety directives, or will have to shut down ICUs: AHNA

Strongly opposing notices issued to hospitals and nursing homes by the Ahmedabad Municipal Corporation’s Fire and Emergency Services along with Estate departments, seeking compliance with the Gujarat High Court directives on Intensive Care Units (ICUs) and glass facades, the Ahmedabad Hospitals and Nursing Homes (AHNA) said they would be forced to shut down their ICUs if these “unscientific” directives are not withdrawn.

While hearing a public interest litigation on fire safety on June 30, the Gujarat High Court directed the state “to take immediate steps” to ensure compliance of a order of the court of December 2020 that issued a number of directions to ensure fire safety in “hospitals, especially for the ICUs”.

In the order dated December 15, 2020 in the same PIL, a division bench of the Gujarat HC had issued directions such as servicing of heavy load equipment such as ventilators, air conditioners once a month.

The bench of Chief Justice Aravind Kumar and Justice AJ Shastri had directed that the “ICU should preferably be located only on the ground floor and have alternate exits wide enough to roll the beds out in the event of necessity” and “glass facades to be removed forthwith and staircases shall be fully ventilated above the parapet wall” and that glass facades of hospital buildings “should not be permitted in any event”.

AHNA opposed the move citing scientific reasons and also demanded policies to be framed by a committee of health experts. “Evidence based medical parts have been completely overlooked in this decision… Making ICUs on the ground floor is against scientific reasons as this increases chances of infections among patients… You might save patients from fire but not infections,” said AHNA president Dr Bharat Gadhavi, addressing the media.

The AMC has sought compliance reports from all private hospitals and nursing homes in Ahmedabad. Citing Indian Society of Critical care Medical Experts Committee Consensus Statement on ICU planning and Designing 2020, AHNA stated, “The statement clearly says that ground floor should be avoided and higher floors are suitable if elevators are available close to ICU. ICUs should be in isolated areas of the hospitals. The members of this committee are from reputed Government and private hospitals.”

AHNA members also raised that ICUs have to be closer to the Operation Theatres as well as Cathlabs. Hence almost all hospitals in the country and abroad do not have ICU on the ground floor, Dr Gadhavi said.According to AHNA secretary Dr Viren Shah,“During the monsoon season, there are increased chances of flooding of the ICUs.”

The association has cited studies to claim that major fire incidents in hospitals during Covid were due to 100 per cent occupancy, operating of ACs, ventilators and other equipment, along with presence of more inflammable material such as the PPE kit, oxygen and sanitisers. Regarding glass facades, AHNA stated, “If the glass facades are only on one side, smoke can go out from other sides. Also if they are openable, there is no reason to remove them.”