Ethan Rhodes
Hospital emergency codes are coded messages announced over a public address system to alert staff to emergencies. The use of codes conveys essential information quickly and with minimal misunderstanding to staff, while preventing stress and panic among visitors. While there is no universal standard, with codes varying by location and even between hospitals in the same community, they generally follow a pattern. For example, code red means there is a fire, and staff will execute their fire response. Code blue means a patient has gone into cardiac arrest. Other codes include code orange, which warns of hazardous material incidents, and code silver, which indicates an armed person or hostage situation.
| Characteristics | Values |
|---|---|
| Code Red | Fire |
| Code Blue | Cardiac/respiratory arrest or non-patient medical emergency |
| Code Yellow | Bomb threat, disaster/mass casualty event |
| Code Grey | Combative person, security assistance required, severe weather |
| Code Silver | Armed person, hostage situation |
| Code Pink | Mother unexpectedly going into labour, newborn medical emergency, infant abduction or missing |
| Code Orange | Hazardous material incident |
| Code Black | Bomb threat, severe weather, hospital at capacity |
| Code Purple | Child abduction or missing |
| Code Green | Bomb threat, combative person, patient elopement |
| Code Adam/Amber | Missing infant, child, or person |
| Non-colour codes | 2222 (crash call or peri-arrest call) |
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What You'll Learn
Code Red: Fire
Hospital emergency codes are used to alert staff to various classes of on-site emergencies. They are intended to convey essential information quickly and clearly, while preventing panic among visitors to the hospital. Hospital emergency codes vary widely by location, even between hospitals in the same community.
Upon a Code Red announcement, staff and visitors will clear the hallways and move between fire-barrier doors and areas. Any doors within easy reach are closed to help contain the fire and prevent it from spreading. The HVAC systems are turned off, and medical staff begin the process of extinguishing the fire.
In the US, staff in hospital departments outside of the fire area do not immediately evacuate. Instead, they remain in their departments, staying close to their patients, and waiting for a Code Green, which indicates it is time to evacuate. In medical clinics, the process is slightly different; once the fire alarm goes off, visitors are escorted to fire exits.
Common causes of hospital fires include mattress fires combined with patients smoking and patients using flammable anesthetics.
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Code Blue: Cardiac arrest
While there is no universal set of hospital codes, "Code Blue" is often used in hospitals in the US, Canada, New Zealand, and Australia to indicate that a patient has entered cardiac arrest and requires immediate medical attention.
Cardiac arrest is a life-threatening condition in which the heart suddenly stops beating, cutting off blood flow to the brain and the rest of the body. When a "Code Blue" is announced, it means that someone is in danger of dying and requires immediate medical attention. It does not mean that someone has died.
The goal of using codes is to alert the relevant hospital personnel and convey essential information quickly and effectively, while preventing panic among visitors and non-medical staff. In the context of a "Code Blue," a dedicated team of healthcare providers will respond to the emergency, utilizing various methods to revive the patient, including cardiopulmonary resuscitation (CPR), intubation, defibrillation, and medications.
CPR involves chest compressions, which keep blood moving to the organs until the patient's regular heartbeat starts again. Intubation is used to establish an open airway by inserting a tube through the mouth or nose and into the trachea. Defibrillation is the use of an automated external defibrillator (AED) to deliver a life-saving shock to the patient, with the goal of restoring a normal heart rhythm. Additionally, medications such as epinephrine and amiodarone may be administered to affect muscle contractions, widen the airway, and restore a safe heart rhythm.
The "Code Blue" team should consist of individuals with assigned roles and responsibilities. These roles may include performing chest compressions, checking the pulse, operating the defibrillator, establishing an airway, administering medications, and coordinating the overall response. It is crucial for each staff member to be aware of their specific role during a "Code Blue" to ensure a swift and effective response.
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Code Black: Security threat
Hospital emergency codes are coded messages that are often announced over a hospital's public address system. They are used to alert staff to various classes of on-site emergencies. The use of codes is intended to convey essential information quickly and with minimal misunderstanding among staff while preventing stress and panic among visitors.
Code Black is used to indicate a bomb threat or an active shooter situation. Upon activation of Code Black, hospital staff will take immediate action to protect themselves, patients, visitors, and the facility from harm or injury. Hospital staff will follow established protocols for evacuating patients, securing the facility, and contacting law enforcement or security personnel. The goal of a Code Black declaration is to ensure the safety and security of everyone in the hospital and to prevent any harm or injury to individuals or the facility.
In Australia, Code Black is used more broadly to indicate that security is needed because someone is armed and is a threat to themselves or others.
In the UK, a Code Black is declared when a hospital is at capacity and has no available beds for new admissions from the emergency department. This code is declared by the hospital's general bed manager, who then relays this to the local ambulance service and posts updates for local healthcare services.
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Code Grey: Non-threatening security issue
Hospital emergency codes are meant to convey essential information quickly and clearly to staff while preventing stress and panic among visitors. These codes vary widely by location, even between hospitals in the same community.
Code Grey is a response to violent or threatening behaviour in a healthcare facility. It indicates a physical threat requiring security and is called when an individual becomes violent, threatening, or aggressive, creating a health or safety risk. When a code grey is activated, security personnel are typically called to the area to help resolve the situation or remove the individual(s) from the premises if necessary.
In some cases, physical restraint or sedation may be necessary to manage the individual and protect others. This is particularly true if the patient requires urgent medical or psychiatric treatment but has not responded well to other control techniques. However, physical restraint should only be considered as a last resort, and hospital security or police may need to be involved.
The team assembled in response to a Code Grey should have predetermined and well-documented roles and procedures to follow. They should also ensure that all necessary supplies, such as gloves and goggles, are available when needed.
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Code Orange: Hazardous material incident
Hospital emergency codes are meant to convey essential information quickly and efficiently to hospital staff while preventing panic among visitors. These codes vary widely by location, even between hospitals in the same community.
Code Orange is one such emergency code used in hospitals to indicate a hazardous material incident or spill. In 2020, a survey found that Code Orange was used consistently across thirteen states with uniform codes to indicate a hazardous material spill or release.
When a Code Orange is declared, hospital staff are alerted to a potential or ongoing incident involving hazardous materials. This could include incidents such as chemical spills, gas leaks, or exposure to radioactive materials. The code is meant to prompt a swift and coordinated response from the hospital staff to contain the incident, treat any affected individuals, and minimise the impact on the hospital and its occupants.
The specific procedures and protocols for a Code Orange may vary between hospitals, but they generally involve activating specialised hazardous materials response teams, evacuating and isolating affected areas, and implementing decontamination procedures. Staff members with specific roles and responsibilities, such as those trained in handling hazardous materials or those responsible for environmental control, may take charge or assist in managing the incident.
The declaration of a Code Orange may also involve coordination with external agencies, such as emergency services, fire departments, or environmental agencies, especially if the incident extends beyond the hospital premises or requires resources beyond the hospital's capabilities.
The primary goal of a Code Orange is to ensure the safety of patients, staff, and visitors while effectively managing the hazardous material incident to prevent further harm or damage.
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