A RACE response is a four-step fire safety protocol used primarily in hospitals and healthcare facilities. RACE stands for Rescue, Alarm, Confine, and Evacuate/Extinguish. It gives staff a memorized sequence of actions to follow the moment a fire is discovered, prioritizing human safety first and property protection second. In many hospitals, the RACE protocol activates automatically when a “Code Red” is announced overhead.
What Each Letter Stands For
Rescue comes first. Anyone in the immediate area of fire or smoke needs to be moved to safety before anything else happens. This means helping patients, visitors, or coworkers who can’t move themselves, and closing doors behind you as you leave the danger zone.
Alarm is the next priority. This involves two simultaneous actions: shouting “fire” to alert people nearby and pulling the nearest fire alarm station so the entire building is notified. In hospitals, pulling the alarm typically triggers a chain reaction. Fire and smoke doors close automatically in the affected area, security dispatches to the scene, and a Code Red is announced over the public address system.
Confine means limiting the fire’s ability to spread. The single most effective action here is closing doors and windows. A closed door can hold back smoke and flames for a surprisingly long time, buying critical minutes for evacuation. This step is simple but easy to skip in a panic.
Evacuate or Extinguish is the final step, and it’s intentionally an either/or decision. Evacuation is the default. Fire extinguishers should only be used by trained personnel, only on small fires, and only after the first three steps of RACE have already been completed. If there’s any doubt about whether the fire can be controlled, evacuation wins.
How Evacuation Works in a Hospital
Evacuating a hospital is fundamentally different from evacuating an office building. Many patients are on ventilators, connected to IVs, or unable to walk. That’s why hospitals use a tiered approach. Horizontal relocation, moving patients to a safer area on the same floor, is preferred over vertical evacuation to a different floor whenever possible. Moving patients down stairwells is slower, riskier, and requires more staff.
Each building typically has its own specific evacuation procedures that account for layout, stairwell locations, and the types of patients on each unit. Staff are expected to know these routes before an emergency happens, not figure them out during one.
Oxygen and Medical Gas Hazards
One fire risk unique to healthcare settings is the presence of medical oxygen and other compressed gases. Oxygen doesn’t burn on its own, but it dramatically accelerates any fire it feeds. Shutting off the oxygen supply to an affected area is sometimes necessary, but it’s not a decision just anyone can make. Only a charge nurse or clinical supervisor can turn off medical gas valves, and typically only when directed by the fire department or facility management.
Before shutting off gas, clinical staff need to account for every patient in the affected area who depends on that supply and have alternative ventilation ready, such as manual bag-mask ventilation. Once a gas valve is shut off, only authorized facilities personnel can turn it back on. This prevents well-meaning but premature restarts that could reignite a hazard.
Using a Fire Extinguisher: The PASS Technique
If you’re trained and the fire is small enough to attempt extinguishing, OSHA recommends the PASS technique. Pull the pin on the extinguisher (this breaks the tamper seal). Aim the nozzle low, at the base of the fire rather than at the flames. Squeeze the handle to release the extinguishing agent. Sweep side to side across the base of the fire until it appears to be out.
The key detail people often miss: you aim at the base. Spraying into the flames themselves won’t cut off the fuel source. And if the extinguisher runs out before the fire does, abandon the attempt and evacuate immediately.
Why RACE Exists as a Protocol
OSHA requires all employers to maintain emergency action plans, including adequate exit routes, functioning alarm systems, clearly marked and lighted exits, and unobstructed pathways. For healthcare facilities specifically, compliance with the National Fire Protection Association’s Life Safety Code satisfies OSHA’s exit-route requirements. Written emergency plans must be kept on-site and accessible to all employees. Businesses with 10 or fewer employees can communicate the plan verbally instead.
The RACE acronym exists because emergencies compress decision-making into seconds. Having a memorized, sequential protocol means people don’t freeze trying to figure out what to do first. The order matters: rescue people before sounding the alarm, sound the alarm before trying to contain the fire, contain the fire before deciding whether to evacuate or fight it. Each step protects the next one. Skip the sequence and you risk, for example, trying to extinguish a fire while patients are still trapped in the room behind you.