Rapid and reliable emergency response is essential in hospital environments, particularly in high-risk units such as radiation oncology. This paper presents the design of an intelligent alert system that integrates Artificial Intelligence (AI), Blockchain, and the Internet of Things (IoT) to enable real-time decision-making and secure event traceability. IoT sensors (e.g., smoke, temperature, and presence detectors) monitor environmental conditions, while a permissioned blockchain immutably records the captured data. An AI agent continuously analyzes this data to detect hazards—such as fire outbreaks—and autonomously triggers evacuation protocols, logging the decisions made on the blockchain. The system computes safe evacuation routes based on the incident’s location and real-time occupancy data, guiding patients and staff through visual and acoustic signals. The architecture is modular, secure, and compatible with hospital infrastructures, ensuring auditable records for compliance and post-incident analysis. A simulation within a radiation oncology department demonstrates its feasibility and potential for real-world deployment. This work lays the foundation for future implementations and highlights the promise of combining AI, blockchain, and IoT for smarter and more trustworthy emergency management in healthcare.