Hailey Tran
Hospital emergency codes are coded messages announced over a public address system to alert staff to various classes of on-site emergencies. The use of codes allows hospitals to convey essential information quickly and with minimal misunderstanding to staff while preventing stress and panic among visitors. Hospital emergency codes vary widely by location, even between hospitals in the same community. This potential for confusion has led many states to adopt standardized codes for all hospitals. In this context, a code white typically means a person within the facility is behaving violently towards other patients or staff, and security guards are often present to assist.
| Characteristics | Values |
|---|---|
| Code Purpose | To alert staff to an emergency or another significant event |
| Code Conveyance | Often announced over a public address system |
| Code Color | White |
| Code Meaning | Pediatric medical emergency, combative person without a weapon, violent patient, or emergency operating procedures |
| Code Action | Follow the protocol and procedures outlined by your healthcare facility |
| Code Location | Varies, but consistent across 13 states as of 2020 |
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What You'll Learn
Call a Code White when de-escalation techniques are not working
Hospital emergency codes are coded messages announced over a public address system to alert staff to various classes of on-site emergencies. The use of codes allows hospital staff to respond quickly and appropriately to different incidents, conveying essential information with minimal misunderstanding.
Code White typically means a person within the facility is behaving violently towards other patients or staff. It is important to note that de-escalation techniques may not always be effective, and it is vital to call a Code White when these techniques are not working. If the patient's agitation surpasses the effectiveness of de-escalation techniques, it is recommended to call a Code White and follow the facility's protocol. Nearby colleagues will be able to assist by following the facility's protocol for handling agitated and combative patients. Most hospital facilities have security guards, and it is advised to contact security for assistance if possible. Restraints are also covered in a facility's Code White protocol.
It is important to remain calm, rational, and professional when dealing with agitated patients. Staff should empathize with the patient's feelings and set respectful boundaries. If it seems safe, it may be helpful to move the patient away from public spaces and into a private area to talk. De-escalation techniques can be useful when dealing with violent or aggressive behavior, but it is important to consider the individual patient, the circumstances, and the context of the situation. If at any time the patient threatens harm or the staff feels unsafe, contact the police or emergency services immediately.
The meaning of Code White varies across different states and hospitals. In California, it refers to a pediatric medical emergency, while in Louisiana, it indicates a combative person without a weapon. In New Hampshire, Code White refers to emergency operating procedures. In some states, Code Grey is used to indicate a combative person, while Code Red is used for fires or probable fires.
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Follow the protocol and procedures outlined by your healthcare facility
Hospital emergency codes are meant to convey essential information quickly and efficiently to staff while preventing panic among visitors. However, these codes have varied widely by location, even between hospitals in the same community, leading to confusion and delays in emergency response. To address this issue, many states and hospital associations have recommended or mandated the adoption of standardized codes.
When a code white is called in a hospital, it typically indicates that a person within the facility is behaving violently towards other patients or staff and poses a danger to themselves or others. The specific definition of a code white may vary slightly depending on the state or hospital, but it generally refers to a combative person without a weapon.
In the event of a code white, it is crucial to follow the protocol and procedures outlined by your healthcare facility. Most hospitals have established protocols for managing violent or potentially violent patients, which may include de-escalation techniques, the use of restraints, and the involvement of security personnel. Familiarize yourself with your facility's code white protocol, including any specific procedures for contacting security and utilizing restraints. These protocols are designed to ensure the safety of both staff and patients during violent incidents.
Depending on your role and position within the hospital, your actions during a code white may vary. Each employee may have a preassigned role, and it is important to understand your responsibilities and follow the instructions provided by the designated response team. For example, nearby colleagues of a combative patient should call a code white and follow the facility's protocol, which may include contacting security for assistance. Security guards are often an integral part of the response team during a code white and can provide protection for both staff and patients.
Adhering to standardized protocols during a code white ensures a coordinated and efficient response. It is important to remember that acts of violence within healthcare facilities cannot always be prevented, but being prepared and following established procedures can help minimize the impact and maintain a safe environment for everyone involved.
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Understand the variations in code white between states
Hospital emergency codes are coded messages announced over a public address system to alert staff to different classes of on-site emergencies. They are designed to convey essential information quickly and with minimal misunderstanding to staff while preventing stress and panic among visitors.
While many hospital codes are standardised across healthcare systems, there can be significant variations between states, countries, and even individual hospitals. For example, in Canada, "Code Black" often refers to a bomb threat, but in some hospitals, it may indicate severe weather. In the UK, hospitals have standardised codes across individual NHS trusts, but there is no standardisation across the entire NHS. In the US, states may have differing recommendations for emergency codes, with some leaving it up to individual facilities to establish their own systems.
In 2020, a survey of hospitals in Oregon and Washington State found that while many hospitals used the same code for fire (code red), there were variations in codes representing respiratory and cardiac arrest, infant and child abduction, and combative persons. Consistent across the thirteen states with uniform codes as of 2020 were code red (fire), code blue (cardiac arrest and/or medical emergency), and code orange (hazardous material spill/release).
Some other colour codes used in multiple states include:
- Code white: paediatric medical emergency, combative person without a weapon, or emergency operating procedures (depending on the state)
- Code grey: security needed, someone is unarmed, and is a threat to themselves or others
- Code pink: a mother is going into labour unexpectedly, or there is a newborn medical emergency
In 2025, the Washington State Hospital Association (WSHA) recommended plain-language codes, although it advised keeping the legacy colour codes of "Code Blue" and "Amber Alert." As of 2025, only Maryland has mandated that all acute hospitals in the state have uniform codes.
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Contact security for assistance
A code white is typically declared when a patient within a hospital is behaving violently towards other patients or staff. This means the patient is agitated and combative and may be a danger to themselves or others.
If you are a healthcare worker witnessing or experiencing this situation, it is vital that you call a code white. Your nearby colleagues will be able to assist you by following your facility's protocol. Most hospital facilities have security guards, and you should contact them for assistance. This can provide you and others with protection. Security guards will be trained to handle violent patients and will know the appropriate de-escalation techniques and restraints to use.
The procedure for contacting security will differ depending on the hospital. Some hospitals have internal phones from which you can dial a specific number, such as 5555, to report an emergency. You will then need to state your location and describe the emergency. Other hospitals may have different methods of contacting security, such as overhead paging codes. It is important to be aware of the specific procedures of your hospital so that you can respond appropriately in an emergency.
In some cases, a code gray may be announced instead of a code white if a person is combative but unarmed. This will still draw staff members to the scene and alert them to the presence of a potentially violent individual.
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Restrain the patient if necessary
In a hospital setting, a Code White is called when a patient is violent or potentially violent, and they pose a danger to themselves or others. This situation calls for immediate action and often requires specific protocols to be followed.
When dealing with a combative patient, the first step is always to attempt de-escalation techniques. These techniques vary but are designed to calm the patient and prevent the situation from escalating further. If de-escalation techniques are ineffective, and the patient continues to be agitated and combative, it may be necessary to restrain them.
Restraining a patient is a serious step and should only be done when all other options have been exhausted. The decision to restrain should be made in collaboration with other staff members, including security personnel, as their presence can provide protection for both staff and patients. The type of restraints used will depend on the specific situation and the patient's level of agitation. Restraints may include physical restraints, such as straps or soft ties, or chemical restraints, such as medication to calm the patient.
It is important to note that the use of restraints should be done in accordance with the hospital's protocol and applicable laws and regulations. The patient's safety and well-being must always be a priority, and restraints should only be used as a last resort to prevent harm to the patient or others. In addition, it is crucial to continuously monitor a restrained patient to ensure their physical and mental health is stable.
Overall, when dealing with a Code White situation, it is essential to follow the healthcare facility's protocols and procedures. Each hospital may have its own specific guidelines, and it is important for staff to be familiar with them to effectively manage violent or potentially violent patients.
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Frequently asked questions
Code White typically means a person within the hospital is behaving violently towards other patients or staff. It indicates a paediatric medical emergency, a combative person without a weapon, or emergency operating procedures depending on the state.
During a 'Code White', follow the protocol and procedures outlined by your healthcare facility. If de-escalation techniques are not applicable, call a 'Code White' so nearby colleagues can assist you in handling agitated patients.
Hospital emergency codes are coded messages announced to alert staff to various classes of on-site emergencies. They are intended to convey essential information quickly and with minimal misunderstanding.
Hospital emergency codes allow trained hospital personnel to respond quickly and appropriately to various incidents. They are important as they enhance the safety of staff, patients, and visitors.
