International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

412

Original  Article
Improving the safety of hospital complexes in modern conditions

Vaulin Vladimir Ivanovich1, Singeev Sergey Aleksandrovich1

Abstract
Background: The article presents the results of a study of ensuring fire safety in medical 
and preventive institutions (LPI) on the example of the central city hospital. Objectives: 
Research is aimed at improving the fire safety of hospital complexes and hospitals in 
modern conditions. Materials and Methods: The study used the methods of system analysis 
of scientific research and statistical data on ensuring fire safety, methods of structural 
analysis of the practice of ensuring fire safety of hospital complexes, mathematical 
methods for calculating the evacuation of people from a building and the spread of a 
fire in a building, methods for calculating the economic efficiency of means of support 
fire safety. Results and Discussion: Based on the analysis of fire statistics in healthcare 
facilities in Russia, it is concluded that it is advisable to improve the fire safety of hospitals 
and hospital complexes in modern conditions. The point of view is expressed that along 
with the fact that fire safety in hospitals is observed, the analysis indicates the existing 
problems in the practice of implementation. Conclusion: In order to increase the level of 
fire safety, it is possible to introduce: a modern fire alarm system; video of control systems 
and monitoring of safety of objects on the territory of the medical facility; installation of 
automatic fire extinguishing systems in fire-hazardous premises; installation of additional 
emergency lighting and reflectors indicating the direction of evacuation in case of fire 
and smoke; carrying out organizational and practical measures to ensure the safety of 
patients in a medical institution in an emergency situation (ES), namely, it is proposed to 
develop a memo of actions for patients in the hospital complex on inpatient treatment in 
case of an emergency with a list in the instruction log; provision of medical facilities with 
individual rescue equipment and provision of hospitals and hospital complexes with high-
rise buildings with modern evacuation means.
Keywords: fire safety system, improving the fire safety of hospitals and hospital 
complexes in modern conditions, fire alarm system, video control and monitoring system 
for the safety of facilities, automatic fire extinguishing system in fire-hazardous premises, 
individual rescue equipment, modern means evacuation.

Correspondence to: Vaulin Vladimir Ivanovich, Department of “Engineering disciplines”, Branch of 
FSBEI HE “Samara State Technical University” in Syzran, Russia.

International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page : 412-417
DOI: http://dx.doi.org/10.31344/ijhhs.v5i4.350  

Introduction. According to the statistics of 
the Ministry of civil defense, emergencies and 
elimination of consequences of natural disasters 
of the Russian Federation for 2012-2016, an 
average of 140 fires occurred in medical and 
preventive institutions per year 1. Data analysis 
shows that every 2nd fire in a health facility occurs 
in stationary facilities. The first cause of fires is 
the “human factor”.

On average, about 3 million people are treated 
in hospital every day in 8400 hospitals, 1502 
polyclinics, 106 clinics of research institutes 
and universities and other medical institutions 
in our country, and about 130 thousand patients 
are treated in day hospitals. Up to 250 thousand 
patients a day in the country are being treated in 
hospitals in a helpless state for health reasons, 
add to this figure patients in nursing homes and 

1. Vaulin Vladimir Ivanovich
2. Singeev Sergey Aleksandrovich

Department of “Engineering disciplines”, Branch of FSBEI HE “Samara State Technical Universi-
ty” in Syzran, Russia.



413

International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

boarding schools. The main share of fires (58%) 
falls on medical and preventive institutions 
(LPU). At the same time, characteristic conditions 
that contribute to the death of people in fires are: 
a state of alcoholic intoxication (53%), a state of 
sleep (18%) and non-transportability of victims 
(14%). The most common causes of fires at these 
facilities were: careless handling of fire (30%), 
violation of the rules for the installation and 
operation of electrical equipment and household 
appliances (24%) and carelessness when Smoking 
(16%) 2. These facts are evidence of the relevance 
of considering the issue of improving fire safety in 
health care facilities in modern conditions.
Modern medical facilities are equipped with a 
large number of complex diagnostic equipment, 
which increases the risk of fire and fire load on the 
premises. In operating rooms, in addition to a large 
amount of electronic equipment, oxygen is also 
provided, which will accelerate the development 
of a fire and may lead to an explosion.
Thus, in all the above cases, a fire can occur in 
almost any room of the health care facility where 
people can be located-from wards to utility rooms. 
Therefore, any medical facility is an object of 
increased fire danger – and this danger is combined 
with the constant presence of a large number of 
people. The combination of dangerous factors 
and fire conditions requires improvement of the 
fire safety system 3. This approach is the basis for 
searching for solutions to a scientific problem.
Materials and methods.
Experimental method. The study used methods of 
system analysis research and statistics on fire safety, 
methods of structural analysis practices ensuring 
fire safety of hospital complexes, mathematical 
methods of calculation of evacuation of people 
from buildings and spread of fire in the building, 
methods of calculation of economic efficiency of 
means of maintenance of fire security.
Results
Theoretical foundations (theory and calculations). 
It should be noted that from the point of view of 
the law, fire safety of medical institutions ensures 
their work, but there are a number of features that 
require detailed consideration from the point of 
view of practice.
The analysis of fire safety on the example of 
the medical institution of the SBU “syzranskaya 
TSGB” shows that as shown by the calculations, the 
main building structures meet the requirements of 
regulatory documents on fire resistance indicators. 

However, the examination of the internal layout of 
the hospital buildings has significant drawbacks.
Since the building OF the SBU “syzranskaya 
TSGB” was designed and built in 1977, it is 
necessary to improve the fire extinguishing 
system, evacuation signs, fire evacuation signs, 
doors with expanded passageways, alarm systems 
and video surveillance systems that meet modern 
requirements.
The modern fire protection system should no longer 
be focused on the elimination of the intended focus 
and should become adaptive. The implementation 
of this approach is the use of a modular wireless 
fire extinguishing system that interacts with the 
heat field of the fire 4. In the domestic industry, 
several types of wireless fire extinguishing 
systems are produced: “GARANT-R” and “TRV-
GARANT-R” 5 .
It is possible to note the advantages of this alarm 
system: extinguishing a fire in the initial period 
is much easier and cheaper; the problem of 
extinguishing spills of liquids is eliminated; the 
reliability of the automated fire protection system 
is significantly increased; the effectiveness of the 
automatic extinguishing system is monitored. 
Analysis of fire statistics at such facilities indicates 
that the rapid spread of fire over the area of the 
building, the average annual damage is quite large. 
Therefore, the possibility of introducing a wireless 
fire extinguishing system can reduce damage and 
is economically feasible.
We will justify the approach by calculating two 
options for protecting premises: the first, without 
BSPT, when the object is protected by outdated 
fire protection equipment; the second option, 
when there is a BSPT to the existing protection. 
The main performance indicators are: capital 
investment K1 and К2, rub.; operating expenses C1 
and C2, rub. / year; fire damage У1 and У2, rub. / 
year. Analysis of fire statistics for 5 years on 40 
existing similar institutions (N=40) that are not 
equipped with BSPT (table 1).
Table 1: Distribution of the number of fires and 
damage by year 6

Years Тi Number of 
fires ni

Damage Yi,, thousand 
rubles

2013 223 (14885340) 3920283
2014 192 (18246565) 347419
2015 171 (22461847) 294012
2016 153 (13418423) 510372
2017 164 (13767378) 513751
2018 211 (15517156) 89231



International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

414

Based on the method of calculating the damage 
assessment7, the calculation of direct fire damage 
over six years is:

          

5675068 тыс.руб./ 1114= 5094
thousand rubles / year (1)

Calculations also show8 that the average fire 
damage for building structures is 17.5 thousand 
rubles., and for equipment 82.5 thousand rubles. 
Thus,
Y п.э

 = 0,12 ∙ 17,5 + 0,15 ∙ 82,5 = 14,47 thousand 
rubles  (2)

The total average annual damage for the first 
option will be

YI  = 5094 + 14.47 = 425,73 thousand rubles / 
year. (3)

Calculations of indicators for the second option 
indicate that the capital investment for the BSPT 
device is approximately K2 = 25 thousand rubles. 
We will determine the economic effect of 
the options, in accordance with the standard 
methodology. 
We determine the listed costs by options: 

I var. P1 = Y I/cр = YI =19 thousand rubles / year, 
(4)

II var. P2=K2EN+C2+ Y2 = 
25•0,15+2,825+6,24=12,815 thousand rubles / 

year. (5)
The annual economic effect of using a wireless fire 
extinguishing system at one facility will be 412.9 
thousand rubles, which indicates the feasibility of 
implementing a new fire extinguishing system.
The evacuation system also needs to be improved. 
For example, “SBUZ SO syzranskaya TSGB” 
has 736 round-the-clock beds in 34 profiles, 2 
polyclinic therapeutic departments with a capacity 
of 375 visits per shift, a women’s consultation for 
200 visits per shift, a trauma center and oncological 
Department of the clinic, diagnostic, paraclinical 
and auxiliary units. The hospital staff consists 
of 1,172 employees, including: 160 doctors, 549 
average medical workers, 258 Junior doctors, and 
205 others. More than 25,000 patients are treated 
in our hospital’s inpatient beds every year. 85% 
of them are emergency patients. The obstetric 
observational Department and the neonatal 
Department are equipped with modern equipment 
purchased after reconstruction and received 
within the framework of the PRP “Health”. Every 
year, the maternity hospital accepts about 2500 
deliveries9.
In the event of a fire, fire extinguishing actions are 

organized simultaneously with the evacuation of 
people and the protection of escape routes.
Calculations indicate that 10 minutes after the fire 
occurred, the fire reached the walls of the room, 
will take a rectangular shape:

S P2 = a · L 2 = 4 ·10 = 40 m
2 (6)

1. Perimeter of a fire in a semicircular 
development:

P P2 = 2( a + L 2) = 2(4+10) = 28 m (7)
1. The growth rate of square fire:
V s2 = S P2/ t svr2 = 40/10 = 4 m

2 / min (8)
Calculations show a high level of danger to the 
medical facility in the event of a fire.
Various variants of calculations of smoke in the 
event of a fire indicate that, depending on the size 
of the premises and combustible materials, the 
room can be filled with smoke in the event of a fire 
from 30 seconds to 4-5 minutes in the corridors. 
In the event of an evacuation, the emergency exit 
lights located at a height of more than 2 meters 
may not be visible. Signs located at a height of 
1.5 m in a poorly lit corridor may not be visible. 
At objects with a mass stay of people, the head 
of the organization ensures the availability of 
serviceable electric lights at the rate of 1 lamp 
for 50 people. Since patients act independently in 
case of fire, we suggest using photoluminescent 
evacuation plans. Schemes of this type have the 
characteristics of the material due to their physical 
and mechanical properties, allowing you to 
solve the problem of orientation as effectively as 
possible, even in complete darkness. They make it 
easier to evacuate the building at night, as well as 
in the presence of a dense wall of smoke.
Every year, more than 25,000 patients are treated 
in inpatient beds at the Syzran Central hospital. 
Analysis of training plans for emergency signal 
with evacuation of patients from the premises of the 
hospital complex indicates that they are held once 
a half-year. Quantitative analysis of the number of 
annual treatment of patients in hospitals of medical 
institutions shows that their number significantly 
exceeds by 6-8 times the number of hospital beds 
in the hospital, therefore 2-3% of the contingent of 
patients undergoing instruction on actions in case 
of emergency are not included. Therefore, it is 
necessary to organize the development of memos 
for patients and instructions on fire safety in 
accordance with current legal acts with a signature 
about familiarization in the instruction log.
The presence of a large number of patients who 
are not able to leave the hospital complex on their 

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415

International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

own requires improving the means of evacuation 
of patients (new fire escape systems, external 
evacuation devices for bedridden patients, training 
incoming patients).
We will calculate the time of evacuation10 from 
the hospital, provided that the fire occurred in the 
afternoon and the fire is located on the third floor in 
one of the wards. The building has 1 (A) main exit 
and 2 evacuation (B, C). the hospital Building is a 
three-story building of II degree of fire resistance 
and has dimensions in terms of 100x50m. The 
calculations are summarized in table 2.

Analyzing the results obtained during the 
calculation, it is possible to formulate a final 
conclusion that the estimated time of evacuation 
from exits A, B, and C corresponds to fire safety 
standards. However, a big problem is providing 
fire safety for people who are not mobile (people 
who are unable to move independently – non-
transportable), unable to evacuate themselves, the 
number of which in hospitals reaches dozens of 
people.
These people include weakened elderly citizens, 
bedridden patients admitted to a hospital ward 
after surgery, as well as disabled people with 
musculoskeletal disorders. It is extremely difficult 
to carry non-mobile people on stretchers (and 
based on the number of medical staff and their 
physical capabilities), it is advisable to suggest the 
use of an individual means of rescue – a travois, 
an evacuation mattress, an evacuation pad, an 
evacuation chair.
Travois-used for evacuation and rescue of disabled 
people in hospitals and nursing homes by medical 
staff. They are suitable for rooms and passages 
with limited dimensions and hard-to-reach places. 
Evacuation travois are stored in a collapsed state 
and in the event of a fire or other emergency 
(emergency), they are quickly deployed11.
The evacuation mattress is used for emergency 
evacuation of bedridden patients, including those 
with a large weight, in case of fire and emergency 
by medical personnel. Movement is performed 
by sliding on the floor and stairs. The mattress 
is flexible and not wide, which allows you to 
evacuate patients through standard doorways, 

corridors and fire escapes.
Evacuation substrate – safety, simplicity, economy 
and efficiency. it is Used for emergency evacuation 
of bedridden patients in case of fire and emergency 
by medical staff. In case of increased fire, it will 
be a means of rapid and simple movement of 
bedridden patients. Movement is performed 
by sliding on the floor and stairs. The mattress 
does not require lifting the patient, and the nylon 
material supports have a low degree of resistance, 
which allows a physically untrained person to 
transport the patient.
The evacuation substrate consists of a single 
cross-shaped web, has four slings that form two 
transverse belts for fixing and two slings that form 
longitudinal traction loops to ensure movement. 
In the corners diagonally located elastic straps 
for attaching the substrate to the mattress. On the 
sides there are four pockets for storing cross belts, 
with which the patient is fixed on the mattress. 
The cross belts are connected by buckles with a 
length adjustment function.
Evacuation chair-provides easy access to the stairs 
for people with limited mobility in case of fire and 
emergency12. The evacuation chair can be easily 
moved up the stairs. This is important for children 
with disabilities and people with limited mobility, 
who can quickly move from their strollers to a 
chair.
It is advisable to provide high-rise hospital 
complexes with modern means of evacuation. 
Inclined rescue sleeve13. This system can quickly 
and reliably provide a safe mass evacuation 
of people from buildings. A special feature is 
the ease of bringing the device into working 
condition, which allows you to use it to rescue 
children, women, the elderly and people with 
disabilities before the arrival of the rescue service 
or firefighters.
 Discussion and conclusion
Scientists have studied various aspects of fire 
safety: in the works Legasov V. A., Topol’s’ke N. 
G., H. H. Brushlinskii, A. K. Mikeev discusses 
the creation of a doctrine or concept of fire safety, 
improve the legal framework for the activities of 
the fire service; andresearch scientists Borodin, 
D. A., Yershova, K., Vasiliev V., Titkova, V., 
etc. – are considered fire safety as a specific fire-
technical work. Rudakov P. G., Smirnova O. Ya., 
Khartofilakas A. C., Kamlet Kh. y., Krundyshev B. 
L., Stepanov V. K., Molotkova E. G. investigated 
the design of a comfortable and safe living 

Table 2: Evacuation time 250 people
Number of people Exit The evacuation time

170 А 5 min 21 sec
40 В 1 min 33 sec
40 С 48 seconds 



International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

416

environment for the disabled and elderly.
Authors: Koshmarov Yu. a., Ryzhov Yu. a., 
Dekterev A. A. and others devoted their works 
to modeling the spread of fire hazards. These 
developments were used in calculating the spread 
of the hospital fire model.
The works of V.V. Kholshchevnikov14, R.N. 
Istratov, V. M. predtechenskiy, D. A. Samoshin, E. 
E. kiriukhantsev, E. T. Shurin, A. B. Apakov, and 
others were devoted to modeling the processes 
of evacuation of people, including the study 
of evacuation of people with disabilities. The 
achievements were used in calculations and search 
for solutions to evacuate patients from a hospital 
building in the event of an emergency.
Foreign scientists D. Dreidel15 and others-
studied modeling of the spread of fire hazards; A. 
Schadschneider [16], W. Klingsch, H. Kluepfel, 
T. Kretz, C. Rogsch, A. Seyfried, E. Kuligowsky, 
D. Peacock R. and others – studied modeling of 
evacuation processes.
Serebrennikov E. A., Chupriyan A. P., Kopylov 
N.P. and others investigated fire safety and modern 
directions of its improvement17; Ivanova L.P., 
Sukhonina M.A., Tikhonova N.V.18 considered 
the issues of fire safety in buildings of medical 
institutions. These aspects contributed to the 
definition of measures to improve fire safety in 
modern conditions. 
Scientists Khairil Idham Ismail, Haniza Mohd 
Yusof, Ahmad Faidi MZ, Basri I. Have considered 
the importance of fatigue management for 
healthcare workers19.
Scientific achievements of scientists allowed us to 
complete the research tasks.
Conclusion.
Thus, the analysis of the security system of the 
GBUZ WITH “TSGB” indicates that the existing 
system ensures compliance with the requirements 
of documents. However, practical activities require 
improvement. In order to improve the level of fire safety 
possible implementation: advanced alarm systems for 

fire, video monitoring system and security monitoring 
facilities on the territory of SBME; the installation 
of automatic fire suppression systems in fire areas 
(warehouse, laboratory, canteen, etc.); setup of external 
devices and evacuation of the sick; the installation of 
additional emergency lighting and reflectors indicating 
the direction of evacuation in case of fire and smoke; 
set individual elements of pointers on the floor 
covering with reflectors or lyuminestsentnym coating, 
which will allow you to specify the path of evacuation; 
conducting organizational and practical measures to 
ensure the safety of patients of medical institutions in 
emergency situations, namely, it is proposed to develop 
a memo of action patients located in a hospital complex 
for inpatient treatment in case of emergency with the 
painting in the journal of instruction; provision of health 
facilities by individual means of salvation (scrapers of 
various types, evacuation mattresses, evacuation of the 
substrate, evacuation chairs) and provision of hospitals 
and hospital complexes, high-rise modern means of 
evacuation (rescue sloping arms).
Funding 
The study was carried out in the absence of 
funding. 
Conflicts of Interest 
“The authors state that there is no conflict of 
interest.” 
Ethical purity:
During the development of the article, copyright 
is not violated. The article in this version has not 
been published in magazines.
Authors’ contribution:
In the course of work on the article, the author 
Vaulin Vladimir Ivanovich prepared the idea 
of   the study, reviewed the statistical materials, 
clarified the calculations, made conclusions, and 
completed the design of the article.
The author of the article Singeev Sergey 
Aleksandrovich checked the calculations, 
clarified the authors of the discourse, and detailed 
the conclusions. In general, the authors jointly 
checked the quality of the article.



417

International Journal of Human and Health Sciences Vol. 05 No. 04 October’21

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