Guidelines in Practice: A Safe Environment of Care

Creating a safe environment for performing surgical procedures is essential to achieve successful patient outcomes and protect the perioperative personnel who are providing care. Numerous factors challenge the provision of a safe environment of care and create a complex setting for perioperative nurses to manage. The updated AORN "Guideline for a safe environment of care" provides perioperative nurses with recommendations for establishing a safe environment for both patients and personnel. This article provides an overview of the guideline and discusses recommendations for implementing fire safety protocols, using warming cabinets, and creating a latex-safe environment. It also includes a scenario describing the care of a patient with an unidentified latex allergy who is undergoing a laparoscopic sleeve gastrectomy and hiatal hernia repair. Perioperative nurses should review the guideline in its entirety and implement recommendations as applicable in operative and other procedural settings.

Biomimetic Multifunctional Graphene-Based Coating for Thermal Management, Solar De-Icing, and Fire Safety: Inspired from the Antireflection Nanostructure of Compound Eyes

Due to the ubiquitous and inexhaustible solar source, photothermal materials have gained considerable attention for their potential in heating and de-icing. Nevertheless, traditional photothermal materials, exemplified by graphene, frequently encounter challenges emanating from their elevated reflectance. Inspired by ocular structures, this study uses the Fresnel equation to enhance the photo-thermal conversion efficiency of graphene by introducing a polydimethylsiloxane (PDMS)/silicon dioxide (SiO2) coating, which reduces the light reflectance (≈20%) through destructive interference. The designed coating achieves an equilibrium temperature of ≈77 °C at one sun and a quick de-icing in ≈65 s, all with a thickness of 5 µm. Simulations demonstrate that applying this coating to high-rise buildings results in energy savings of ≈31% in winter heating. Furthermore, the combination of PDMS/SiO2 and graphene confers a notable enhancement in thermal stability through a synergistic flame-retardant mechanism, effectively safeguarding polyurethane against high temperatures and conflagrations, leading to marked reduction of 58% and 28% in heat release rate and total heat release. This innovative design enhances the photo-thermal conversion, de-icing function, and flame retardancy of graphene, thereby advancing its applications in outdoor equipment, high-rise buildings, and aerospace vessels.

Structure of Metal-Organic Frameworks Eco-Modulated by Acid-Base Balance toward Biobased Flame Retardant in Polyurea Composites

Biobased-functionalized metal-organic frameworks (Bio-FUN-MOFs) stand out from the crowd of candidates in the flame-retardant field due to their multipathway flame-retardant mechanisms and green synthesis processes. However, exploring and designing Bio-FUN-MOFs tend to counteract the problem of compromising the flame-retardant advantages of MOFs themselves, which inevitably results in a waste of resources. Herein, a strategy in which MOFs are ecologically regulated through acid-base balance is presented for controllable preparation of Bio-FUN-MOFs by two birds with one stone, i.e., higher flame-retardant element loading and retention of more MOF structures. Specifically, the buffer layer is created on the periphery of ZIF-67 by weak etching of biobased alkali arginine to resist the excessive etching of ZIF-67 by phytic acid when loading phosphorus source and to preserve the integrity of internal crystals as much as possible. As a proof of concept, ZIF-67 was almost completely etched out by phytic acid in the absence of arginine. The arginine and phytic acid-functionalized ZIF-67 with yolk@shell structure (ZIF@Arg-Co-PA) obtained by this strategy, as a biobased flame retardant, reduces fire hazards for polyurea composites. At only 5 wt % loading, ZIF@Arg-Co-PA imparted polyurea composites with a limiting oxygen index of 23.2%, and the peaks of heat release rate, total heat release, and total smoke production were reduced by 43.8, 32.3, and 34.3%, respectively, compared to neat polyurea. Additionally, the prepared polyurea composites have acceptable mechanical properties. This work will shed light on the advanced structural design of polymer composites with excellent fire safety, especially environmentally friendly and efficient biobased MOF flame retardants.

A Gas-Steamed Route to Mesoporous Open Metal-Organic Framework Cages Enhancing Flame Retardancy and Smoke Suppression of Polyurea

Up to now, metal-organic frameworks (MOFs) with open nanostructures have shown outstanding capabilities in trapping smoke particles compared to the original MOFs. However, only a few MOF-based strategies have been reported to synthesize hierarchical porous cages thus far, which are mainly restricted to environmentally unfriendly wet-chemical liquid methods. Herein, as a proof-of-concept, a gas-steamed metal-organic framework approach was designed to fabricate a series of cheeselike open cages with hierarchical porosity. Briefly, zeolitic imidazolate framework-67 (ZIF-67) and phytic acid were employed as precursor and etchant, respectively. Abandoning the conventional wet-chemical method, the coordination bond of ZIF-67 was cleaved by acidic steam, forming an open framework with a high specific surface area and a hierarchical porous structure. The universality of this method was also confirmed by the selection of different etchants. Impressively, they also show outstanding fume-toxic adsorption capability and labyrinth effects based on abundant and complex porous channels. At only 5 wt % loading, Co3O4@open ZIF-67 cage-2 (Co3O4@OZC-2) imparted polyurea (PUA) composites with a 21.2% limiting oxygen index, and the peak of heat release rate, total heat release, and total smoke production were reduced by around 37.5, 25.5, and 40.4%, respectively, compared to neat PUA. This work will shed light on the advanced structural design of polymer composites with high fire safety, especially smoke suppression performance, so as to obtain more feasible applications.

Tailored Catalysis Inducing Exceptionally Fire-Safe and Mechanically Reinforced Epoxy at An Ultralow Loading

An unconventional P/N/Si-free fire safety of epoxy at an ultralow loading with a significantly improved mechanical robustness and toughness via a mere nanocomposite technique is a great challenge. To achieve the goal, a proof of concept is proposed associated with a hierarchical manipulation of catalysis-tailored FexSy ultrathin nanosheets on organic-layered double hydroxide (LDH-DBS@FexSy) toward the formation of porous piling structure via a self-sacrificing conversion of metal-organic framework. A sufficient characterization certified the targeted architecture and composition. A P/N/Si-free ultralow loading of 2 wt % LDH-DBS@FexSy (i.e., 0.6 wt % FexSy) imparted epoxy with UL-94 V-0 rating, a 36.1% reduction of peak heat release rate, as well as a pronounced fire-protection feature. A systematic contrastive investigation evidenced a time-dependent fire-shielding effect induced by a featured catalysis-tailored ultrafast charring behavior at the interface of epoxy and LDH nanosheets. Intriguingly, the tensile strength, impact strength, and flexural strength were simultaneously enhanced by 62.2, 185.4, and 62.9%, respectively, with a 0.6 wt % incorporation of FexSy hierarchy on the basis of a "root-soil"-inspired interfacial "interlocking" structure. In perspective, an integrated manipulation of an interface catalysis-tailored ultrafast charring and hierarchical "interlocking" construction offer an effective balance of the fire safety, mechanical robustness, and toughness of polymers.

Manufacture and Combustion Characteristics of Cellulose Flame-Retardant Plate through the Hot-Press Method

This study focuses on the increased risk of high heat release and asphyxiation (toxic gas poisoning) in the event of a fire involving polyurethane (PU)- and MDF-based building materials, which are commonly used in buildings. Among them, polyurethane (PU) building materials are very commonly used in buildings, except in Europe and some other countries, due to their excellent thermal insulation performance. Still, problems of short-term heat release and the spread of toxic gases in the event of a fire continue to occur. To overcome these problems, researchers are actively working on introducing various flame retardants into building materials. Therefore, in this study, we produced a laboratory-sized (500 mm × 500 mm) plate-like flame-retardant board that can be utilized as a building material with a lower heat release rate and a lower toxicity index. The material was made by mixing expanded graphite and ceramic binder as flame retardants in a material that is formulated based on the cellulose of waste paper, replacing the existing building materials with a hot-press method. According to the ISO-5660-1 test on the heat release rate of the plate-like flame-retardant board, the Total Heat Release (THR) value was 2.9 (MJ/m2) for 10 min, showing an effect of reducing the THR value by 36.3 (MJ/m2) compared to the THR value of 39.2 (MJ/m2) of the specimen made using only paper. In addition, the toxicity index of the flame-retardant board was checked through the NES (Naval Engineering Standards)-713 test. As a result, the test specimen showed a toxicity index of 0.7, which is 2.4 lower than the toxicity index of 3.1 of MDF, which is utilized as a conventional building material. Based on the results of this study, the cellulose fire-retardant board showed the effect of reducing the heat release rate and toxicity index of building materials in a building fire, which reduces the risk of rapid heat spread and smoke toxicity. This has the potential to improve the evacuation time (A-SET) of evacuees in fires. It is also important to show that recycling waste paper and utilizing it as the main material for building materials can be an alternative in terms of sustainable development.

Deep Learning Based Fire Risk Detection on Construction Sites

The recent large-scale fire incidents on construction sites in South Korea have highlighted the need for computer vision technology to detect fire risks before an actual occurrence of fire. This study developed a proactive fire risk detection system by detecting the coexistence of an ignition source (sparks) and a combustible material (urethane foam or Styrofoam) using object detection on images from a surveillance camera. Statistical analysis was carried out on fire incidences on construction sites in South Korea to provide insight into the cause of the large-scale fire incidents. Labeling approaches were discussed to improve the performance of the object detectors for sparks and urethane foams. Detecting ignition sources and combustible materials at a distance was discussed in order to improve the performance for long-distance objects. Two candidate deep learning models, Yolov5 and EfficientDet, were compared in their performance. It was found that Yolov5 showed slightly higher mAP performances: Yolov5 models showed mAPs from 87% to 90% and EfficientDet models showed mAPs from 82% to 87%, depending on the complexity of the model. However, Yolov5 showed distinctive advantages over EfficientDet in terms of easiness and speed of learning.

A High-Efficient DOPO-Based Flame Retardant as a Co-Curing Agent for Simultaneously Enhancing the Fire Safety and Mechanical Properties of Epoxy Resin

Simultaneously enhancing the fire safety and mechanical properties of epoxy resin (EP) remains a persistent challenge. Herein, a high-efficient phosphaphenanthrene-based flame retardant (FNP) is synthesized using 3,5-diamino-1,2,4-triazole, 4-formylbenzoic acid, and 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide. Due to the presence of active amine groups, FNP is employed as a co-curing agent for fabricating EP composites with outstanding fire safety and mechanical properties. EP containing 8 wt% FNP (EP/8FNP) achieves a vertical burning (UL-94) V-0 rating with a limiting oxygen index of 31%. Meanwhile, FNP declines the peak heat release rate, total heat release, and total smoke release of EP/8FNP by 41.1%, 31.8%, and 16.0%, respectively, compared to those of unmodified EP. The increased fire safety of EP/FNP composites is because FNP promotes the formation of an intumescent, compact, and cross-linking char layer for EP/FNP composites, and releases P-containing substances and noncombustible gases in the gas phase during combustion. In addition, EP/8FNP exhibits 20.3% and 5.4% increase in the flexural strength and modulus compared with those of pure EP. Furthermore, FNP enhances the glass transition temperature of EP/FNP composites from 141.6 °C for pure EP to 147.3 °C for EP/8FNP. Therefore, this work is conducive to the future development of fabricating fire-safe EP composites with enhanced mechanical properties.

Pathways to Next-Generation Fire-Safe Alkali-Ion Batteries

High energy and power density alkali-ion (i.e., Li+ , Na+ , and K+ ) batteries (AIBs), especially lithium-ion batteries (LIBs), are being ubiquitously used for both large- and small-scale energy storage, and powering electric vehicles and electronics. However, the increasing LIB-triggered fires due to thermal runaways have continued to cause significant injuries and casualties as well as enormous economic losses. For this reason, to date, great efforts have been made to create reliable fire-safe AIBs through advanced materials design, thermal management, and fire safety characterization. In this review, the recent progress is highlighted in the battery design for better thermal stability and electrochemical performance, and state-of-the-art fire safety evaluation methods. The key challenges are also presented associated with the existing materials design, thermal management, and fire safety evaluation of AIBs. Future research opportunities are also proposed for the creation of next-generation fire-safe batteries to ensure their reliability in practical applications.

Synthesis and Applications of Supramolecular Flame Retardants: A Review

The development of different efficient flame retardants (FRs) to improve the fire safety of polymers has been a hot research topic. As the concept of green sustainability has gradually been raised to the attention of the whole world, it has even dominated the research direction of all walks of life. Therefore, there is an urgent calling to explore the green and simple preparation methods of FRs. The development of supramolecular chemistry in the field of flame retardancy is expanding gradually. It is worth noting that the synthesis of supramolecular flame retardants (SFRs) based on non-covalent bonds is in line with the current concepts of environmental protection and multi-functionality. This paper introduces the types of SFRs with different dimensions. SFRs were applied to typical polymers to improve their flame retardancy. The influence on mechanical properties and other material properties under the premise of flame retardancy was also summarized.

Analysis of Selected Organophosphorus Compounds and Nano-Additives on Thermal, Smoke Properties and Quantities of CO and CO2 of Epoxy Materials

Majority of anthropogenic air pollutants enter the atmosphere as a result of material combustion, industrial production and transport. Fires not only cause air pollution, but also disrupt ecosystems. Knowledge of the flammability parameters and proper flame-retardant modification of materials hinders the origin and spread of a fire, while also protecting against air pollution. The aim of this study was to obtain fire-retardant modifications of the epoxy resin, and then to analyse the effect of the introduced additives on the rate of heat release, the thermokinetic properties and the toxicity of volatile combustible products. The modifiers of the epoxy resin were organophosphorus compounds and aluminium and magnesium hydroxides, with a grain size of 10 nm. The introduced additives were found to be effective flame retardants as they reduced the rate of heat release and the amounts of toxic products of thermal decomposition and combustion. The HRR_max and HRR_av values of all fire-retardant modifications were lower compared to the corresponding HRR values of the unmodified epoxy material.

Organic Phosphoric Acid Doped Polyaniline-Coupled g-C3 N4 for Enhancing Fire Safety of Intumescent Flame-Retardant Epoxy Resin

Two kinds of polyaniline (PANI) coupled graphitized carbon nitride nanosheets doped with different organic phosphoric acids (CP@PA, with phytic acid; CP@NP, with amino trimethyl phosphonic acid) were developed by in situ polymerization. According to the analysis of the section morphology and element distribution of epoxy resin (EP) composites, although CP@PA and CP@NP show completely different morphology, they can significantly enhance the dispersion of graphitized carbon nitride nanosheets in EP. In addition, the different oxidation states of phosphorus contained in the CP@PA and CP@NP lead to varying effects on the fire safety of EP composites. The flame retardancy Index (FRI) was a dimensionless index to evaluate the performance of flame retardants. When used as a flame retardant, CP@NP (FRI = 3.22) is better than CP@PA (FRI = 1.29) in flame retardant, especially in suppressing thermal hazards. As a synergist of intumescent flame retardants, CP@PA (FRI = 26.12) is the most effective in improving the comprehensive fire safety property of epoxy resin and achieved an "Excellent" rating. Therefore, two different flame-retardant mechanisms of CP@PA and CP@NP were summarized by analyzing the combustion behavior of EP composites and the change of condensed phase. In summary, this research may be helpful for the future design of nano synergies for intumescent flame retardant systems. This article is protected by copyright. All rights reserved.

Surface Flame-Retardant Systems of Rigid Polyurethane Foams: An Overview

Rigid polyurethane foam (RPUF) is one of the best thermal insulation materials available, but its flammability makes it a potential fire hazard. Due to its porous nature, the large specific surface area is the key factor for easy ignition and rapid fires spread when exposed to heat sources. The burning process of RPUF mainly takes place on the surface. Therefore, if a flame-retardant coating can be formed on the surface of RPUF, it can effectively reduce or stop the flame propagation on the surface of RPUF, further improving the fire safety. Compared with the bulk flame retardant of RPUF, the flame-retardant coating on its surface has a higher efficiency in improving fire safety. This paper aims to review the preparations, properties, and working mechanisms of RPUF surface flame-retardant systems. Flame-retardant coatings are divided into non-intumescent flame-retardant coatings (NIFRCs) and intumescent flame-retardant coatings (IFRCs), depending on whether the flame-retardant coating expands when heated. After discussion, the development trends for surface flame-retardant systems are considered to be high-performance, biological, biomimetic, multifunctional flame-retardant coatings.

Electric Cable Construction Parameter and Its Potential to Foresee the Cable Fire Properties

A cable parameter related to the volume of effective non-combustible content, Ω, is proposed, which depends on the ratio of non-metallic, non-combustible component volume to non-metallic, combustible component volume, and the effective area of heat transfer within the cable during the combustion process. The correctness of the proposed cable parameter for circular cables is confirmed by tests and the determination of Spearman's correlation. High Spearman's correlation factors (close to -1) were obtained for total heat release and total smoke production as a function of the Ω cable parameter. The Ω cable parameter might be used in selecting cable samples for large geometric-scale fire testing within the same cable family.

Multielement Flame-Retardant System Constructed with Metal POSS-Organic Frameworks for Epoxy Resin

The direct coordination between polyhedral oligomeric silsesquioxane (POSS) and Co forms an assembly of nanoparticles with low specific surface area and leads to a poor dispersion state in the epoxy resin matrix, resulting in unsatisfactory flame-retardant efficiency. Metal-organic frameworks (MOFs), for instance, ZIF-67, provide not only the cobalt element but also the porous framework that endows the nanocomposite of MOFs and POSS with high specific surface area and abundant Co sites in the silica skeleton. Herein, ZIF-67 is hybridized with octacarboxyl POSS, resulting in the removal of the alkaline ligand to form novel metal POSS-organic frameworks (MPOFs). The size differences for organic groups and silica nanocages of POSS vs. micropores of ZIF-67 gave rise to a reverse click reaction, reforming octavinyl POSS isolated on the outer surface of the Co complex, which could be further modified by a phosphorous flame retardant using an addition reaction. The obtained MPOFs-P with 2 wt % loading in epoxy resin could improve the limiting oxygen index value of the composites to 27.0% and pass the V-0 rating in the UL-94 test. Meanwhile, the peaks of the heat release rate and especially the total smoke production were reduced by 46.6 and 25.2%, respectively. The robust char layer reduces the emission of toxic gas CO by 39.8%. The above epoxy product with promising flame retardancy also improved mechanical properties, thanks to the filler with a unique nanostructure. The ingenious work offers enlightenment for the hybridization method of MOFs and POSS to fabricate a multielement flame-retardant system for epoxy resin with high efficacy.

A Fire Incident Case at a Radiodiagnostic Center of a Tertiary Care Hospital: Methods for Reduction in Fatality by Smoke Evacuation

For the general public, healthcare facilities are always a safe and secure place for treatment. Generally, healthcare institutions are equipped to deal with exterior interruptions, but circumstances brought on by internal risks are more serious and frequently require an emergency evacuation of the facility. An incident happened at the radiodiagnostic setup of a tertiary care institute in North India. This fire incident created panic among staff and patients. At the place of casualty, there were around 150 persons, including staff, patients, and their attendants. Immediately after the confirmation of the fire incident, the fire department and security department took action in the form of fire control and smoke evacuation. Though six fire handling staff required minor emergency services for asphyxia due to smoke inhalation and were cured by oxygen support only, none of the patients was affected due to timely smoke evacuation. Most often, smoke management techniques implemented are compartmentation, pressurization, dilution, ventilation, buoyancy, and airflow. So, we concluded that the step of timely smoke evacuation and preventing the spread of smoke by various methods help to reduce fatality due to smoke. The training programs and mock drills give stakeholders the needed knowledge, skills, and practice they need to safeguard patients and employees.

Health, Security and Fire Safety Process Optimisation Using Intelligence at the Edge

The proliferation of sensors to capture parametric measures or event data over a myriad of networking topologies is growing exponentially to improve our daily lives. Large amounts of data must be shared on constrained network infrastructure, increasing delays and loss of valuable real-time information. Our research presents a solution for the health, security, safety, and fire domains to obtain temporally synchronous, credible and high-resolution data from sensors to maintain the temporal hierarchy of reported events. We developed a multisensor fusion framework with energy conservation via domain-specific "wake up" triggers that turn on low-power model-driven microcontrollers using machine learning (TinyML) models. We investigated optimisation techniques using anomaly detection modes to deliver real-time insights in demanding life-saving situations. Using energy-efficient methods to analyse sensor data at the point of creation, we facilitated a pathway to provide sensor customisation at the "edge", where and when it is most needed. We present the application and generalised results in a real-life health care scenario and explain its application and benefits in other named researched domains.

Nanohybrid of Co3O4 Nanoparticles and Polyphosphazene-Decorated Ultra-Thin Boron Nitride Nanosheets for Simultaneous Enhancement in Fire Safety and Smoke Suppression of Thermoplastic Polyurethane

Thermoplastic polyurethane (TPU) is widely used in daily life due to its characteristics of light weight, high impact strength, and compression resistance. However, TPU products are extremely flammable and will generate toxic fumes under fire attack, threatening human life and safety. In this article, a nanohybrid flame retardant was designed for the fire safety of TPU. Herein, Co₃O₄ was anchored on the surface of exfoliated ultra-thin boron nitride nanosheets (BNNO@Co₃O₄) via coprecipitation and subsequent calcination. Then, a polyphosphazene (PPZ) layer was coated onto BNNO@Co₃O₄ by high temperature polymerization to generate a nanohybrid flame retardant named BNNO@Co₃O₄@PPZ. The cone calorimeter results exhibited that the heat release and smoke production during TPU combustion were remarkably restrained after the incorporation of the nanohybrid flame retardant. Compared with pure TPU, the peak heat release rate (PHRR) decreased by 44.1%, the peak smoke production rate (PSPR) decreased by 51.2%, and the peak CO production rate (PCOPR) decreased by 72.5%. Based on the analysis of carbon residues after combustion, the significant improvement in fire resistance of TPU by BNNO@Co3O4@PPZ was attributed to the combination of quenching effect, catalytic carbonization effect, and barrier effect. In addition, the intrinsic mechanical properties of TPU were well maintained due to the existence of the PPZ organic layer.

Experimental Evaluation of Carbon Reinforced TRC with Cement Suspension Matrix at Elevated Temperature

Textile-reinforced concrete (TRC) is a new composite material comprising high-performance concrete and textile reinforcement from textile yarns with a matrix, usually consisting of epoxy resins (ER). The most significant advantage of ER is the homogenization of all filaments in the yarn and full utilization of its tensile potential. Nevertheless, ER matrix is a critical part of TRC design from the perspective of the fire resistance due to its relatively low resistance at temperatures of approximately 120 °C. This work expands the previously performed mechanical tests at normal temperatures with cement suspension (CS) as a non-combustible material for the yarn matrix. Here, the mechanical properties of CS matrix at elevated temperatures were verified. It was found that the addition of polypropylene fibers into HPC negatively affected the mechanical results of CS matrix specimens. Simultaneously, thermal insulation effect of the covering layers with different thicknesses did not significantly influence the residual bending strength of specimens with CS matrix and achieved similar results as reference specimens. Furthermore, all specimens with ER matrix progressively collapsed. Finally, CS as a textile reinforcement of yarn matrix appears to be a suitable solution for increasing the temperature resistance of TRC structures and for substituting synthetic resins.

Precise Control of a Yolk-Double Shell Metal-Organic Framework-Based Nanostructure Provides Enhanced Fire Safety for Epoxy Nanocomposites

Nanomaterials derived from metal-organic frameworks (MOFs) are highly promising as future flame retardants for polymeric materials. The precise control of the interface for polymer nanocomposites is taking scientific research by storm, whereas such investigations for MOF-based nanofillers are rare. Herein, a novel yolk-double shell nanostructure (ZIF-67@layered double hydroxides@polyphophazenes, ZIF@LDH@PZS) was subtly designed and introduced into epoxy resin (EP) as a flame retardant to fill the vacancy of yolk/shell construction in the field. Meanwhile, the interface of the polymer nanocomposites can be further accurately tailored by the outermost layer of the nanofillers from PZS to Ni(OH)₂ (NH), by which hollow nanocages with treble shells (LDH@PZS@NH) were obtained. It is remarkably interesting that LDH@PZS@NH endows the EP with the lowest peak of heat release rate in the cone calorimeter test, but the total heat and smoke releases (THR and TSP) of the nanocomposites are even higher than those of the neat polymer. In contrast, EP blended with ZIF@LDH@PZS shows outstanding comprehensive performance: with 2 wt.%, the limiting oxygen index is increased to 29.5%, and the peak heat release rate is reduced by 26.0%. The impact and flexural strengths are slightly lowered, while the storage modulus is enhanced remarkably compared with that for neat EP. The flame retardant mechanism is systematically explored focusing on the interfacial interactions of different hybrids within the epoxy matrix, ushering in a new stage of study of nanostructural design-guided interface manipulation in MOF-based polymer nanocomposites.

Preparation of Mn2+ Doped Piperazine Phosphate as a Char-Forming Agent for Improving the Fire Safety of Polypropylene/Ammonium Polyphosphate Composites

A piperazine phosphate doped with Mn2+ (HP-Mn), as a new char-forming agent for intumescent flame retardant systems (IFR), was designed and synthesized using 1-hydroxy ethylidene-1,1-diphosphonic acid, piperazine, and manganese acetate tetrahydrate as raw materials. The effect of HP-Mn and ammonium polyphosphate (APP) on the fire safety and thermal stability of polypropylene (PP) was investigated. The results showed that the combined incorporation of 25 wt.% APP/HP-Mn at a ratio of 1:1 endowed the flame retardant PP (PP6) composite with the limiting oxygen index (LOI) of 30.7% and UL-94 V-0 rating. In comparison with the pure PP, the peak heat release rate (PHRR), the total heat release (THR), and the smoke production rate (PSPR) of the PP6 were reduced by 74%, 30%, and 70%, respectively. SEM and Raman analysis of the char residues demonstrated that the Mn2+ displayed a catalytic cross-linking charring ability to form a continuous and compact carbon layer with a high degree of graphitization, which can effectively improve the flame retardancy of PP/APP composites. A possible flame-retardant mechanism was proposed to reveal the synergistic effect between APP and HP-Mn.

Community/Public Health Nurses' Awareness of Residential High-Rise Fire Safety issues

High-rise (HR) building fires remain a tragic cause of preventable injury and death in the United States. Recent incidences of HR building fires have served as high-profile reminders of the persistent threat that HR fires pose to public health. Fire safety is an important aspect of household emergency preparedness addressed by community/public health nurses (C/PHNs). This study aimed to address a gap in the literature regarding C/PHNs' awareness of fire safety for people and families who reside in HR buildings. A descriptive qualitative study using key-informant and focus group interviews was conducted involving C/PHNs (n  =  19) in Honolulu, Hawaii. Qualitative data analysis revealed three main themes related to this issue: (1) C/PHN awareness of HR fire safety issues, (2) C/PHN perceived barriers for HR building occupant fire safety, and (3) C/PHN suggested strategies to address HR fire safety for occupants. Findings highlight how more needs to be done to assure that C/PHNs are adequately prepared to work with occupants of residential HR buildings on matters related to fire safety.

The Fire and Explosion Hazard of Coloured Powders Used during the Holi Festival

During the world-famous Holi festival, people throw and smear each other with a colored powder (Holi color, Holi powder, Gulal powder). Until now, adverse health and environmental effects (skin and eye irritation, air pollution, and respiratory problems) have been described in the available literature. However, the literature lacks data on the flammable and explosive properties of these powders during mass events, despite the fact that burns, fires, and explosions during the Holi festival have taken place many times. The aim of the article is to present the fire and explosion parameters of three currently used Holi dust and cornflour dust types as reference dust. The minimum ignition temperature of the dust layer and dust cloud, the maximum explosion pressure and its maximum rate of growth over time, the lower explosion limit, the limit of oxygen concentration, and the minimum ignition energy were determined. Tests confirmed that the currently available Holi powders should be classified as flammable dusts and low-explosive dusts. The likelihood of a fire or explosion during mass incidents involving a Holi dust-air mixture is high.

Thermal and Mechanical Studies of Perlite Concrete Casing for Chimneys in Residential Buildings

Chimneys are structures designed to convey exhaust gases from heating devices to the outside of buildings. The materials from which they are made have a great impact on their fire safety, as well as on the safety of the whole building. As current trends in the construction industry are moving towards improving the environmental impact and fire safety, changes to building materials are constantly being introduced. This also applies to the development of chimney technology, as there is still a recognised need for new solutions when it comes to materials used in the production of chimney systems. This article presents the findings of tests carried out on a chimney made from innovative perlite concrete blocks. Four different perlite concrete blocks that differed in bulk densities were analysed. The obtained results were then compared with widely used leca (lightweight expanded clay aggregate) concrete blocks. The test results confirmed high insulation properties of the perlite concrete block, from which the innovative chimney casing was made. The fire safety level was maintained even in high temperatures that occur during soot fire (1000 °C). These properties were retained despite there being no additional insulation of the flue duct. Even though the thermal load decreased the compressive strength of the chimney blocks, they still displayed sufficient average strength of 4.03 MPa. Additionally, the test results confirmed the possibility of recovering heat from the chimney with the efficiency of 23–30%, which constitutes a considerable increase compared to chimneys made from leca concrete blocks.

Intelligently Thermoresponsive Ionic Liquid toward Molecular Firefighting and Thermal Energy Management

Hydrocarbon-based phase change materials (PCMs) are accompanied by an inherent fire risk, which is hindering their further application especially in construction. Molecular-firefighting PCMs can be ideal and promising candidates to simultaneously ensure the highly efficient energy management and fire safety of PCMs. In this work, two novel phosphorus/nitrogen-containing ionic liquids ([DP][MI] and [DP][TEA]), composed of imidazole (MI) or triethylamine (TEA) cations and dicetyl phosphate (DP) anion, were synthesized for fire-proofing thermal energy management. The fire risk assessment confirmed that the extinguishing time of prepared [DP][MI] and [DP][TEA] was greatly shortened to 20 s and 3.5 min from 45 min for controlled sample, respectively. Moreover, the thermal enthalpy of [DP][MI] reached about 99.0 J g^-1. In addition, [DP][MI] and [DP][TEA] achieved low supercooling extents of 2.2 and 4.4 °C, separately. Both molecular firefighting and efficient energy management were achieved for [DP][MI] and [DP][TEA]. As applied in wood-plastic composite which is ubiquitous in construction, [DP][TEA] endowed the composite with temperature-regulating capability of about 10 °C in hut test and remarkably suppressed fire hazard of the composite, displaying a potential application value.

Reduction of Load Capacity of Fiber Cement Board Facade Cladding under the Influence of Fire

The paper analyzes the issue of the reduction of load capacity in fiber cement board during a fire. Fiber cement boards were put under the influence of fire by using a large-scale facade model. Such a model is a reliable source of knowledge about the behavior of facade cladding and the way fire spreads. One technical solution for external walls—a ventilated facade—is gaining popularity and is used more and more often. However, the problem of the destruction during a fire of a range of different materials used in external facade cladding is insufficiently recognized. For this study, the authors used fiber cement boards as the facade cladding. Fiber cement boards are fiber-reinforced composite materials, mainly used for facade cladding, but also used as roof cladding, drywall, drywall ceiling and floorboards. This paper analyzes the effect of fire temperatures on facade cladding using a large-scale facade model. Samples were taken from external facade cladding materials that were mounted on the model at specific locations above the combustion chamber. Subsequently, three-point bending flexural tests were performed and the effects of temperature and the integrals of temperature and time functions on the samples were evaluated. The three-point bending flexural test was chosen because it is a universal method for assessing fiber cement boards, cited in Standard EN 12467. It also allows easy reference to results in other literature.

Experimental Evaluation of 79 and 300 GHz Radar Performance in Fire Environments

This paper presents an experimental study of the propagation of mm-wave/low-THz signals in the frequency ranges of 79 and 300 GHz through fire. Radar performance was investigated in various real scenarios, including fire with strong flame, dense smoke and water vapour. A stereo video camera and a LIDAR were used as a comparison with other common types of sensors. The ability of radars to enable the visibility of objects in fire environments was proven. In all scenarios, the radar signal attenuation was measured, and in the case of steam was compared with theoretical calculations. The analysis of the experimental results allows us to conclude that there are good prospects for millimetre wave and Low Terahertz radar in the field of firefighting imaging equipment.

2019 Writing Contest Post-graduate Winner: Fire Safety Behaviors Among Residential High-Rise Building Occupants in Hawai'i: A Qualitative Study

The world's population is rapidly urbanizing. Today, the majority of people live in cities and many live in high-rise buildings. High-rise buildings pose many challenges with regards to occupant safety, including fire prevention and evacuation safety. The purpose of this study was to describe factors that influence fire safety behaviors among residents of high-rise buildings and the strategies that population health nurses can use to support health education for people living in high-rise environments. An exploratory, descriptive qualitative research design with purposive sampling was used. Twelve residents from 8 high-rise buildings in Honolulu, Hawai'i participated in this study. In-depth semi-structured interviews were conducted and recorded, followed by thematic analysis of the interview transcripts. Five key themes emerged from the study: (1) attitudes towards fire safety, (2) building fire safety culture, (3) perceived ability to prepare for fires, (4) intentions to prepare, and (5) occupant fire preparedness behaviors. Gaps in knowledge regarding high-rise building fire safety were identified that contributed to residents' risk and vulnerability. Fire safety is of relevance to all nurses who work with populations. Population health nursing practice addresses the health, safety, and emergency preparedness needs of clients and communities. More research should be done to improve understanding of fire safety behaviors among high-rise residents to help population health nurses and other professionals mitigate the risk of fire in residential high-rise buildings and keep individuals and families safe during actual emergencies.

Nanoflake-Constructed Supramolecular Hierarchical Porous Microspheres for Fire-Safety and Highly Efficient Thermal Energy Storage

The leakage and fire hazard of organic solid-liquid phase change material (PCM) tremendously limit its long-term and safe application in thermal energy storage and regulation. In this work, novel nanoflake-fabricated organic-inorganic supramolecular hierarchical microspheres denoted as BPL were synthesized through the electrostatically driven assembly of poly(ethylene ammonium phenylphosphamide) (BP) decorated layered double hydroxides using sodium dodecyl sulfate as a template. Then the BPL was simultaneously utilized as a porous supporting material and flame retardant for polyethylene glycol to fabricate shape-stabilized PCM (BS-PCM). Benefiting from the structural uniqueness of the BPL microsphere, the BS-PCM possessed a high latent heat capacity of 116.7 J g^-1 and excellent thermoregulatory capability. Moreover, the BS-PCM had no apparent leakage after a 200-cycle heating/cooling process and showed excellent thermal reversibility, superior to similar solid-liquid PCMs reported in recent literature. More interestingly, unlike flammable PEG, BS-PCM showed excellent fire resistance when exposed to a fire source. The unique BPL porous microsphere provided not only a microcontainer with high storage capacity for solid-liquid PCM, but also a fire resistant barrier to PEG, supplying a promising solution for highly efficient and fire-safe thermal energy storage.

Identification of the Destruction Model of Ventilated Facade under the Influence of Fire

Ventilated facades are becoming an increasingly popular solution for external part of walls in the buildings. They may differ in many elements, among others things: claddings (fiber cement boards, HPL plates, large-slab ceramic tiles, ACM panels, stone cladding), types of substructures, console supports, etc. The main part that characterizes ventilated facades is the use of an air cavity between the cladding and thermal insulation. Unfortunately, in some aspects they are not yet well-standardized and tested. Above all, the requirements for the falling-off of elements from ventilated facades during a fire are not precisely defined by, among other things, the lack of clearly specified requirements and testing. This is undoubtedly a major problem, as it significantly affects the safety of evacuation during a fire emergency. For the purposes of this article, experimental tests were carried out on a large-scale facade model, with two types of external-facade cladding. The materials used as external cladding were fiber cement boards and large-slab ceramic tiles. The model of large-scale test was 3.95 m × 3.95 m, the burning gas released from the burner was used as the source of fire. The test lasted one hour. The facade model was equipped with thermocouples. The cladding materials showed different behavior during the test. Large-slab ceramic tiles seemed to be a safer form of external cladding for ventilated facades. Unfortunately, they were destroyed much faster, for about 6 min. Large-slab ceramic tiles were destroyed within the first dozen or so minutes, then their destruction did not proceed or was minimal. In the case of fiber cement boards, the destruction started from the eleventh minute and increased until the end of the test. The authors referred the results of large-scale test to testing on samples carried out by other authors. The results presented the convergence of large-scale test with samples. External claddings was equipped with additional mechanical protection. The use of additional mechanical protection to maintain external cladding elements increases their safety but does not completely eliminate the problem of the falling-off of parts of the facade. As research on fiber cement boards and large-slab ceramic tiles presented, these claddings were a major hazard due to fall-off from facade.

Design of Hierarchical NiCo-LDH@PZS Hollow Dodecahedron Architecture and Application in High-Performance Epoxy Resin with Excellent Fire Safety

Developing advanced performance epoxy (EP) resin with low flammability and light smoke has been an increasing focus of its research. Especially, it is crucial to reduce the emission of smoke and toxic gases generated during the burning of EP, so that it meets the green and safe industrial requirement. Therefore, a 3D NiCo-LDH@PZS hollow dodecahedral structure was designed and synthesized by using the ZIF-67 as both the precursor and an in situ sacrificial template and the amino group-containing polyphosphazene (PZS) as interfacial compatibilizer and flame retardant cooperative. The release behaviors of heat, smoke, and poisonous gases were carefully investigated. More precisely, the EP/NiCo-LDH@PZS4.0 is endowed with a decrease of 30.9% and 11.2% of the peak heat release rate and the total heat release, respectively. The emissions of smoke and poisonous gases including nitric oxides, aromatic compounds, carbonyl compounds, oxycarbide, and hydrocarbons are much less as well. Especially, the maximum release concentrations of HCN of EP/NiCo-LDH4.0 are reduced by 87.8%. With regard to styrene, methane, and ethane, the maximum release concentrations of EP/NiCo-LDH@PZS4.0 are reduced by 85.9%, 90.6%, and 93.1%, respectively. The total yield of CO and CO₂ and the consumption of O₂ of EP/NiCo-LDH@PZS4.0 are also reduced by 64.5%, 32.4%, and 33.6%. The fractional effective dose, an index of toxicity smoke, of EP/NiCo-LDH@PZS4.0 is reduced by 20.4%. The DMA tests were performed to study the mechanical properties of EP composites, and the storage modulus and Tg of EP composites are increased with the incorporation of NiCo-LDH@PZS. The possible mechanism of flame retardant was proposed based on the analysis of the condensed and gas phases of EP composites.

Hierarchical Structure: An effective Strategy to Enhance the Mechanical Performance and Fire Safety of Unsaturated Polyester Resin

It is still a big challenge to prepare polymer/layered double hydroxide (LDH) composites with high performance, due to the strong agglomeration tendency of LDHs in the polymeric matrix. In this study, to avoid the agglomerated situation, the orientated LDH nanosheets were vertically grown on a ramie fabric surface, which was then embedded in unsaturated polyester resin (UPR) through the combination method of hand lay-up and vacuum bag. Due to the increased contact area and the restricted interfacial slip in the in-plane direction, the hierarchically LDH-functionalized ramie fabrics (denoted as Textile@LDH) significantly enhanced the mechanical performance of UPR composites. Then, the phosphorus- and silicon-containing coating (PSi) was used for the further improvement of the interfacial adhesion. The tensile strength of UPR/Textile@LDH@PSi composites increased by 121.67%, compared to that of neat UPR. The reinforcement mechanism was studied through analyzing the surface nano/microstructure and wetting properties of the raw and modified textiles, as well as the interfacial interaction between the ramie fabrics and UPR. Meanwhile, the thermal stability, thermal conductivity, and flame-retardant performance of ramie-reinforced UPR composites were improved. Particularly, as-prepared hierarchical Textile@LDH@PSi inhibited the heat release during the combustion process of fabric-reinforced UPR composites, and the peak heat release rate and total heat release values decreased by 36.56 and 47.57%, respectively, compared with the neat UPR/Textile composites. The suppression mechanism was further explored by analyzing the microstructure and chemical compositions of char residues. This research paved a feasible solution to improve the poor dispersion of LDHs in polymers and prepared the high-performance UPR composites with multifunctional applications.

Construction of Hierarchical Natural Fabric Surface Structure Based on Two-Dimensional Boron Nitride Nanosheets and Its Application for Preparing Biobased Toughened Unsaturated Polyester Resin Composites

It has been a big challenge to prepare the unsaturated polyester resin (UPR) composites with good fire safety, interfacial quality, and impact strength in an environmentally friendly way. In this study, to improve interfacial performance of fabric-reinforced UPR composites, nontoxic two-dimensional hexagonal boron nitride (h-BN) nanosheets were assembled on the surface of ramie fabrics, where sodium alginate acts as a green dispersant to disperse h-BN sheets during the process. Then, the biobased phosphorus-containing toughening agent (PCTA) was synthesized to simultaneously improve the impact strength and fire safety of the composite. With application of h-BN nanosheets-assembled fabric (AF) and 20 wt % of PCTA, the AF/UPR@PCTA₂₀ composite presented the maximum 41.2% decrease in the value of peak heat release rate and a maximum 17.8% decrease in the value of total heat release, which also reached V-0 rating in the vertical burning test. Meanwhile, the AF/UPR@PCTA₂₀ composite showed an obvious increase in limiting oxygen index, from 24.0 to 29.5% compared with RF/UPR. The flame retardant mechanism was investigated from gas phase and condensed phase. Furthermore, compared to neat RF/UPR composite, the AF/UPR@PCTA₂₀ composite showed a significant 68.8% improvement in impact strength, implying an extreme toughening effect of PCTA on UPR composites. The research provides a viable green method for the development of environmentally friendly UPR composites in the future.

Factors Associated with Home Fire Escape Plans in New South Wales: Multinomial Analysis of High-Risk Individuals and New South Wales Population

The preparation and practice of home-escape plans are important strategies for individuals and families seeking to reduce and/or prevent fire-related injury or death. The aim of this study was to assess the prevalence of and factors associated with, home-escape plans in the state of New South Wales (NSW), Australia. The study used data from two surveys—a 2016 fire safety attitudes and behaviour survey administered to high-risk individuals (n = 296) and a 2013 NSW health survey covering 13,027 adults aged 16 years and above. It applied multinomial logistic regression analyses to these data to identify factors associated with having a written home-fire escape plan, having an unwritten home-fire escape plan and not having any home-fire escape plan. The prevalence of written home-escape plans was only 4.3% (95% CI: 2.5, 7.5) for the high-risk individuals and 7.9% (95% confidence interval [CI]: 7.3, 8.6) for the entire NSW population. The prevalence of unwritten escape plans was 44.6% (95% CI: 38.8, 50.5) for the high-risk individuals and 26.2% (95% CI: 25.1, 27.2) for the NSW population. The prevalence of no-escape plan at all was 51.1% (95% CI: 45.2, 56.9) for the high-risk individuals and 65.9% (95% CI: 64.8, 67.1) for the NSW population. After adjusting for other covariates, the following factors were found to be significantly associated with unwritten-escape plan and no-escape plan prevalence: speaking only the English language at home, practicing home-fire escape plans infrequently, being married, being female and testing smoke alarms less often. Future fire interventions should target people who speak only English at home and people who test their smoke alarms infrequently. These interventions should be accompanied by research aimed at reversing the trend toward use of more flammable materials in homes.

Rapid Synthesis of Oxygen-Rich Covalent C2N (CNO) Nanosheets by Sacrifice of HKUST-1: Advanced Metal-Free Nanofillers for Polymers

A covalent oxygen-rich C₂N (CNO) network derived from metal-organic framework (HKUST-1) was innovatively synthesized by a rapid and green microwave irradiation method. This method can produce CNO multilayers efficiently, which paves a way for practical application of the nanosheets. Structural characterization and synthesis processes of CNO nanosheets were investigated to further understand the key role of HKUST-1. The as-prepared CNO has a layered feature, which theoretically favors to improve flame retardancy and mechanical performance of polymers. Desirable results were obtained as expected: the fire safety, antitensile, and impact resistance of polylactic acid (PLA) were prominently enhanced after adding CNO nanosheets, which can be attributed to the excellent dispersion and compatibility. PLA/CNO nanocomposite was self-distinguished at 2 wt % content of CNO, whereas the tensile strength was increased more than 36% compared with that of pure PLA, as well as the impact strength. This work broadens the application fields of CNO and endows it a possibility of actual application.

Dispersion and Burning Behavior of Hydrogen Released in a Full-Scale Residential Garage in the Presence and Absence of Conventional Automobiles - Supplemental Video Materials

The supplemental materials reported here provide standard high-definition (HD), high-speed, and infrared videos of the 13 full-scale hydrogen dispersion and burning experiments in a full-scale residential garage.

DOPO-Modified Two-Dimensional Co-Based Metal-Organic Framework: Preparation and Application for Enhancing Fire Safety of Poly(lactic acid)

Co-based metal-organic framework (Co-MOF) nanosheets were successfully synthesized by the organic ligands with Schiff base structure. The laminated structure gives Co-MOF nanosheets a great advantage in the application in the flame retardant field. Meanwhile, -C═N- from Schiff base potentially provides active sites for further modification. In this work, 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO) was used to modify Co-MOF (DOPO@Co-MOF) to further enhance its flame retardant efficiency. It is attractive that DOPO has a synergistic effect with Co-MOF on improving fire safety of poly(lactic acid) (PLA). The obvious decrease in the values of peak heat release (27%), peak smoke production (56%), and total CO yield (20%) confirmed the enhanced fire safety of PLA composites. The possible flame retardant mechanism was proposed based on characterization results. Moreover, the addition of DOPO@Co-MOF had a positive influence on the mechanical performance, including tensile properties and impact resistance. This work designed and synthesized two-dimensional MOFs with active groups. As-prepared Co-MOF with expected structure shows a novel direction of preparing MOFs for flame retardant application.

Back to Basics: Preventing Surgical Fires

When fires occur in the OR, they are devastating and potentially fatal to both patients and health care workers. Fires can be prevented by understanding the fire triangle and methods of reducing fire risk, conducting fire risk assessments, and knowing how to respond if a fire occurs. This Back to Basics article addresses the basics of fire prevention and the steps that can be taken to prevent fires from occurring.

Studies on Synthesis of Electrochemically Exfoliated Functionalized Graphene and Polylactic Acid/Ferric Phytate Functionalized Graphene Nanocomposites as New Fire Hazard Suppression Materials

Practical application of functionalized graphene in polymeric nanocomposites is hampered by the lack of cost-effective and eco-friendly methods for its production. Here, we reported a facile and green electrochemical approach for preparing ferric phytate functionalized graphene (f-GNS) by simultaneously utilizing biobased phytic acid as electrolyte and modifier for the first time. Due to the presence of phytic acid, electrochemical exfoliation leads to low oxidized graphene sheets (a C/O ratio of 14.8) that are tens of micrometers large. Successful functionalization of graphene was confirmed by the appearance of phosphorus and iron peaks in the X-ray photoelectron spectrum. Further, high-performance polylactic acid/f-GNS nanocomposites are readily fabricated by a convenient masterbatch strategy. Notably, inclusion of well-dispersed f-GNS resulted in dramatic suppression on fire hazards of polylactic acid in terms of reduced peak heat-release rate (decreased by 40%), low CO yield, and formation of a high graphitized protective char layer. Moreover, obviously improvements in crystallization rate and thermal conductivities of polylactic acid nanocomposites were observed, highlighting its promising potential in practical application. This novel strategy toward the simultaneous exfoliation and functionalization for graphene demonstrates a simple yet very effective approach for fabricating graphene-based flame retardants.

Using modeling and rehearsal to teach fire safety to children with autism

We evaluated the efficacy of an instructional procedure to teach young children with autism to evacuate settings and notify an adult during a fire alarm. A multiple baseline design across children showed that an intervention that included modeling, rehearsal, and praise was effective in teaching fire safety skills. Safety skills generalized to novel settings and maintained during a 5-week follow-up in both training and generalization settings.

Novel PEPA-functionalized graphene oxide for fire safety enhancement of polypropylene

Polypropylene (PP) is a general-purpose plastic, but some applications are constrained by its high flammability. Thus, flame retardant PP is urgently demanded. In this article, intumescent flame retardant PP (IFRPP) composites with enhanced fire safety were prepared using 1-oxo-4-hydroxymethyl-2,6,7-trioxa-1-phosphabicyclo [2.2.2] octane (PEPA) functionalized graphene oxide (PGO) as synergist. The PGO was prepared through a mild chemical reaction by the covalent attachment of a caged-structure organic compound, PEPA, onto GO nanosheets using toluene diisocynate (TDI) as the intermediary agent. The novel PEPA-functionalized graphene oxide not only improves the heat resistance of GO but also converts GO and PEPA from hydrophobic to hydrophilic materials, which leads to even distribution in PP. In our case, 7 wt% addition of PGO as one of the fillers for IFRPP composites significantly reduces its inflammability and fire hazards when compared with PEPA, by the improvement of first release rate peak (PHRR), total heat release, first smoke release rate peak (PSRR) and total smoke release, suggesting its great potential as the IFR synergist in industry. The reason is mainly attributed to the barrier effect of the unburned graphene sheets, which protects by the decomposition products of PEPA and TDI, promotes the formation of graphitized carbon and inhibits the heat and gas release.

Implementing AORN recommended practices for a safe environment of care

Providing a safe environment for every patient undergoing a surgical or other invasive procedure is imperative. AORN's "Recommended practices for a safe environment of care" provides guidance on a wide range of topics related to the safety of perioperative patients and health care personnel. The recommendations are intended to provide guidance for establishing best practices and implementing safety measures in all perioperative practice settings. Perioperative nurses should be aware of risks related to musculoskeletal injuries, fire, equipment, latex, and chemicals, among others, and understand strategies for reducing the risks. Evidence-based recommendations can give practitioners the tools to guide safe practice.

[Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire]

Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

An Evolution of Virtual Reality Training Designs for Children With Autism and Fetal Alcohol Spectrum Disorders

This article describes an evolution of training programs to use first-person interaction in virtual reality (VR) situations to teach safety skills to children with autism spectrum disorder (ASD) and fetal alcohol spectrum disorder (FASD). Multiple VR programs for children aged 2 to 9 were built and tested between 1992 and 2007. Based on these results, a learning design evolved that uses practice in virtual space with guidance and correction by an animated character, strategic limitations on allowed actions to force correct patterning, and customization of worlds and responses to simplify user controls. This article describes program evolution by comparing design details and results as variations in behavioral responses between disorders, differences in skill set complexity between different safety skills being taught, and improved technology required changes in the virtual training methodology. A series of research projects are summarized in which the VR programs proved effective for teaching children with ASD and FASD new skills in the virtual space and, where measured, most children generalized the actions to the real world.