Horizontal Evacuation in Hospitals

Horizontal evacuation means moving patients, staff and visitors away from a fire or smoke-affected area to a safer area on the same floor. In hospitals, this usually involves crossing a fire-resistant compartment barrier rather than immediately moving vulnerable patients downstairs or outside.

How it works

A hospital floor is divided into fire and smoke compartments so that occupants can be relocated into an adjoining protected area. In progressive horizontal evacuation, people may be moved successively through additional compartments if the threat spreads.

• Movement is directed away from the affected compartment through protected routes and fire doors.
• Priority is based on immediate danger, patient mobility, clinical dependence and the resources needed for transfer.
• Patients requiring beds, wheelchairs, life-support equipment or staff assistance are moved according to the hospital's evacuation plan.

Why hospitals use it

Many hospital occupants cannot evacuate independently, and rapid movement through stairways may interrupt treatment or endanger critically ill patients. Horizontal evacuation therefore supports a phased evacuation while fire control, rescue and clinical care continue.

• It reduces the distance for which non-ambulatory patients must initially be transported.
• It limits unnecessary movement of patients who remain protected within a safe compartment.
• It helps avoid congestion in stairs and final exits during the initial response.

Conditions and limitations

The strategy is effective only when compartmentation, detection, alarms, protected escape routes and trained staff function together. It is not the final response if smoke, heat or fire compromises the receiving compartment.

• Vertical evacuation to another floor, or evacuation outside the building, becomes necessary when same-floor refuge cannot remain safe.
• Fire doors must not be obstructed or wedged open because this defeats smoke and fire separation.
• Regular drills must account for patients with restricted mobility and essential medical equipment.