Information
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Conducted on
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Shift:
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Time lapse before response:
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Location:
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Type of incident:
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Was the drill announced or unannounced?
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Individuals associated with the incident / drill:
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Prepared by
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Did responding parties demonstrate organization and appropriate response?
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We're patients, visitors and others removed from the scene?
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Was the alarm activated or simulated?
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Was it reported to the hospital operator for overhead paging (or simulated)?
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Was it reported to off site responders (or simulated)?
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Did the alarm sound in all areas?
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Was the enunciator panel located?
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Were the doors closed appropriately?
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Did the fire smoke doors close appropriately?
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Were the halls and exits cleared of obstructions and equipment?
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Was a fire extinguisher brought to the point of fire?
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Was the proper use of the fire extinguisher demonstrated (or simulated)?
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Was the evacuation plan reviewed and routes identified?
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Was an alternate smoke compartment for horizontal evacuation identified?
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Was the oxygen shutoff valve identified and staff knowledgeable about responsibility to shut off?
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We're patients and visitors reassured (or simulated)?
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Analysis of drill response:
