Death toll to rise in nursing home inferno

About 20 badly burned residents, eight in a serious condition, were among those rushed to nine hospitals from the fire at the Quakers Hill Nursing Home in Sydney’s northwest.

Seventy-nine others with less serious injuries have been relocated to hospitals or care centres.

"It is a scene of total devastation," said NSW Fire Commissioner Greg Mullins.

Firefighters were confronted by their "worst nightmare" when they arrived at the inferno on Hambledon Road, Quakers Hill, shortly after 5 am (AEDT) today.

Flames were licking the roof after engulfing two rooms while thick, choking black smoke filled the building, blinding firefighters who had to crawl on the floor.

"[They] could not see their hands in front of their faces," said Commissioner Mullins.

"Crews had to literally crawl on their hands and knees into every room in the complex, reach up under the beds, searching cupboards, anywhere where someone