The Ministry of Health and Family Welfare has released the National Guidelines on Fire and Life Safety in Healthcare Facilities (2026). These guidelines have been developed through extensive consultations with experts from a wide range of leading institutions and hospitals, ensuring a robust and comprehensive framework to enhance fire safety across healthcare facilities.This document provides comprehensive guidelines and standards for fire life safety management in healthcare facilities in India. The guidelines comprehensively address multiple critical dimensions, including governance frameworks, risk assessment and mitigation, infrastructure planning, emergency response systems, training and capacity building of healthcare personnel, compliance mechanisms, and awareness generation. They also incorporate updated provisions for specialized high-risk areas such as Intensive Care Units (ICUs), Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs), and Operation Theatres (OTs), where stringent safety protocols are essential. Importance of Fire and Life Safety in Healthcare Ensuring high safety standards in healthcare facilities is vital for protecting patients, staff, and infrastructure.The Ministry has developed comprehensive guidelines to improve fire safety preparedness, including prevention, detection, mitigation, and emergency response measures.Governance and Responsibilities in Fire Safety Hospital administration holds overall responsibility for compliance, fire safety planning, and staff training.Fire Safety Committees and designated Fire Safety Officers oversee risk assessments, fire drills, and coordination with external agencies.Risk Assessment and Fire Safety Planning Regular fire hazard assessments are mandatory, with documentation and annual audits involving local fire services.Facilities must categorize risk zones (high, moderate, low) and develop detailed Fire Safety Plans covering prevention, detection, evacuation, and external coordination.Infrastructure and Safety Measures Fire prevention includes material safety, electrical safety, and proper storage of combustibles.Fire detection and suppression systems such as alarms, sprinklers, hydrants, and extinguishers are essential for early response.Emergency Response and Evacuation Procedures Clear protocols for immediate fire response, evacuation routes, assembly points, and incident reporting are critical.Regular drills and staff training ensure preparedness and effective evacuation during emergencies.Training, Compliance, and Community Awareness Mandatory fire safety training for staff, including specialized drills for critical areas.Regular audits, fire safety certificates, and awareness campaigns promote a safety culture within healthcare facilities.Annexures and Technical Guidelines Detailed technical standards for electrical safety, firefighting equipment, and evacuation procedures are provided.Guidelines align with national codes like NBC 2016 and BIS standards to ensure comprehensive safety infrastructure.Fire Prevention and Material Safety Measures Buildings must comply with NBC ‘Fire Zones’ 1 standards, with non-combustible major structural elements in institutional occupancies. Existing buildings are exempt unless altered or hazardous.Internal finishes, false ceilings, and suspension systems should be non-combustible to prevent fire spread.Medical Gas and Electrical Safety Protocols Medical gases like oxygen pose fire hazards; storage and pipelines must be controlled, colour-coded, and routed away from ignition sources. Gas pipelines should use oxygen-compatible materials.Electrical safety measures include avoiding overloading, using certified equipment, regular wiring checks, and proper earthing. Critical areas like ICUs and OTs require special electrical protections.Construction and Design Safety Considerations High-rise buildings need special fire safety planning, including compartmentation, fire doors, fire-resistant zones, and fireman’s lifts. Means of egress and refuge areas are essential.Proper signage, emergency lighting, penetration sealing, and storage practices are vital for containment and safe evacuation.Fire Detection and Alarm Systems Systems should include automatic smoke, heat, flame detectors, manual call points, and central control panels. Integration with other fire safety measures ensures coordinated response.Regular testing and maintenance are mandatory, with records kept for at least three years.Fire Suppression Systems Sprinkler systems designed per IS 15105 and hydrant/hose reel systems per IS 13039 are critical for early fire control. They must be integrated with detection systems.Portable fire extinguishers should follow IS 2190 standards, with appropriate types for different fire classes.Smoke Exhaust and HVAC Integration Smoke exhaust systems must effectively remove smoke, with fans and ductwork made from noncombustible materials. They should activate automatically with fire detection.HVAC systems should operate independently during normal conditions and integrate with smoke control during emergencies to prevent smoke migration and maintain safe egress.Emergency Response and Evacuation Procedures Immediate detection involves reporting and activating alarms following R.A.C.E. protocol. The Fire Command Centre coordinates response and system control.Evacuation prioritizes horizontal movement, especially for ICU and critical patients, with detailed plans, staff training, and designated assembly points. Regular mock drills and incident reporting are essential.Fire Safety Training and Compliance All staff undergo fire safety induction, with specialized training for ICU, OT, and security personnel on patient evacuation.Regular mock drills, fire safety audits, and obtaining valid fire safety certificates ensure ongoing compliance and preparedness.Fire Safety Signage and Patient Orientation Fire safety instructions must be prominently displayed in multiple languages, with clear signage, pictograms, and illuminated signs.Patients and visitors should receive orientation on exits, assembly points, and fire protocols during admission, reinforced periodically.Fire Safety Procedures and Reporting Immediate reporting of fire, heat, or smoke is mandatory unless prior report has been made. No regulation should delay reporting actions.Fire drills must be conducted quarterly during the first two years and biannually thereafter. Records of drills must be maintained for three years and be accessible for inspection.Signage and Identification Requirements Conspicuous signs at lift landings instruct occupants to use stairs during fire, with specified size, color, and placement standards.Floor numbering, stair, lift, and re-entry signs must be clearly posted with contrasting colors and proper placement to guide safe egress.Fire Safety Plan and Management The Fire Safety Plan must follow a prescribed format, be distributed to tenants and staff, and updated within 30 days of any changes.A Fire Command Centre is required, equipped with communication tools, plan copies, and detailed floor plans for effective incident management.Fire Safety Roles and Responsibilities Designated Fire Safety Director and Deputy oversee fire preparedness, organize drills, supervise fire teams, and ensure readiness.Fire Wardens, Marshals, and Fire Technicians are assigned per floor, with clear duties for evacuation, fire suppression, and communication during emergencies.Emergency Communication and Alarm Systems Reliable communication and fire alarm systems must be maintained, with regular testing and clear alarm signals to ensure prompt staff response.Alarm points should be strategically located, and staff trained in alarm activation and extinguisher use.Fire Prevention and Mitigation Measures Structural safety includes fire-resistant construction, self-closing doors, and proper ventilation.Electrical safety involves scheduled assessments, maintenance, and prohibition of unauthorized appliances.Oxygen and medical gas safety require secure storage, leak testing, and avoidance of ignition sources.NICU-Specific Fire Evacuation Considerations Objectives focus on safety, rapid detection, coordinated evacuation, and continuity of neonatal care.Evacuation protocols prioritize stable infants, critical cases, and detailed preparation, including identification, thermal protection, and equipment management.Fire Detection, Suppression, and Containment Install addressable smoke and heat detectors linked to alarm panels, with regular testing.Use appropriate extinguishers (CO2 for electrical, ABC for general fires), and ensure fire doors and HVAC systems contain smoke spread.Evacuation and Response Protocols Evacuation is triggered by visible fire, smoke, or alarms, with options for localized, horizontal, or vertical movement.Clear roles are assigned to teams, with detailed procedures for patient transfer, tracking, and safe zone management.Post-Incident Recovery and Review Structural, electrical, and equipment assessments are essential before re-entry.Staff debriefing, incident documentation, root cause analysis, and corrective actions are critical for continuous improvement.Replenishment of supplies, equipment, and updating protocols ensure readiness for future incidents.Critical Patient Evacuation Procedures Detailed step-by-step guides for evacuating neonatal, pediatric, and adult critical patients, emphasizing team roles, equipment handling, and safety during transfer.Tasks include assigning team members, securing respiratory support, disconnecting equipment, mobilizing trolleys, and ensuring patient stability at designated safe zones.Team Composition and Responsibilities Critical evacuations involve teams of four with designated roles: doctor, nurse, and attendants, each responsible for documentation, equipment checks, patient support, and movement.Clear responsibilities include medication documentation, equipment detachment, patient support, and coordination during transit and at the safe zone.Fire Safety and Preparedness in Healthcare Settings Emphasizes early detection, activation of CODE RED, and adherence to RACE principles for fire response.Regular training, drills, and display of fire safety plans, evacuation maps, and equipment readiness are vital for preparedness.Fire Evacuation Equipment and Kits Specific contents for neonatal, pediatric, and adult ICU evacuation kits include ventilators, oxygen supplies, airway management tools, medications, and safety gear.Equipment lists are tailored to ICU size and patient load, with provisions for portable ventilators, monitors, stretchers, and fire safety tools.Fire Response Activation and Protocols Immediate actions upon detecting fire signs include activating alarms, informing authorities, and initiating RACE.Roles are assigned for rescue, alarm, containment, and evacuation, with protocols for small fire extinguishment or full evacuation if necessary.Evacuation Strategies and Prioritization Evacuation types include localized, horizontal, vertical, and full ICU evacuation based on fire severity.Prioritization follows triage order: patients in immediate danger, stable ambulatory, dependent non-ventilated, and ventilated critical patients.Patient Transfer Methods and Safety Patients are moved via ambulatory support, wheelchairs, stretchers, spine boards, or drag sheets, with ventilated patients transferred using portable ventilators.Ensures secure identification, continuous monitoring, and minimal equipment during transfer.Post-Evacuation Stabilization Critical to reassess and stabilize patients in safe zones with full monitoring, airway management, and medication support.Focus on preventing secondary complications and ensuring proper documentation and communication.Fire Safety Infrastructure and Training Ensures unobstructed exits, fire doors, and marked safe zones.Regular staff training, mock drills, and competency assessments in fire response, extinguisher use, and patient evacuation techniques are mandatory.Hospital-Wide Fire Safety Equipment Essential items include fire extinguishers, manual call points, emergency lighting, signage, and evacuation aids like stretchers and drag sheets.Additional safety gear includes fireproof blankets, walkie-talkies, and patient identification systems.Special Considerations for Operation Theaters Focuses on fire risks from surgical equipment, anesthetic gases, and electrical devices.Emphasizes safety protocols for equipment handling, fire suppression systems, and evacuation procedures during surgical emergencies.