California’sStandardizedHealthcare

Emergency Codes

Staff Training PresentationStaff Training Presentation

September 2009September 2009

BackgroundBackground• In 1999, hospital shooting with 3 In 1999, hospital shooting with 3

employees dead!employees dead!• Code Gray paged because a code didn’t Code Gray paged because a code didn’t

exist for a person with a weapon.exist for a person with a weapon.• Staff ran Staff ran toto the incident without knowing the incident without knowing

the danger!the danger!

• The Hospital Association of Southern The Hospital Association of Southern California (HASC) initiated a project to California (HASC) initiated a project to standardize emergency codes.standardize emergency codes.

• Today, these codes are used throughout Today, these codes are used throughout the US and even internationally!the US and even internationally!

PurposePurpose• In general, the codes are based on a color-In general, the codes are based on a color-

coded system, with some clarifying coded system, with some clarifying information to aid in response.information to aid in response.

• Hospital emergency codes are used to Hospital emergency codes are used to alert staff in a myriad of emergency alert staff in a myriad of emergency situations.situations.

• They are designed to convey essential They are designed to convey essential information as quickly, and with as little information as quickly, and with as little confusion as possible whilst also remaining confusion as possible whilst also remaining discrete in order to keep both patients and discrete in order to keep both patients and visitors calm.visitors calm.

Why Standardize?Why Standardize?• Today’s healthcare workforce is Today’s healthcare workforce is

highly mobilehighly mobile• Physician, nurses, and support staff Physician, nurses, and support staff

often work in more than one facility – often work in more than one facility – sometimes within the same day!sometimes within the same day!

• Patient Safety!!!Patient Safety!!!• Codes that trigger an emergency Codes that trigger an emergency

response should be standardized to response should be standardized to help ensure quick action.help ensure quick action.

2009 Survey2009 Survey• 262 respondents throughout California262 respondents throughout California• 70% compliance in the original codes 70% compliance in the original codes

(over 180 hospitals).(over 180 hospitals).• 84% compliance in SoCal84% compliance in SoCal• 65% compliance in NoCal & Central Cal65% compliance in NoCal & Central Cal• 11% compliance in San Diego & Imperial 11% compliance in San Diego & Imperial

CountiesCounties

• 2 new codes added in 2008:2 new codes added in 2008:• Patient Elopement – Code GreenPatient Elopement – Code Green• Emergency Alert – Code Triage: AlertEmergency Alert – Code Triage: Alert

Trending Towards Trending Towards Standardization in Standardization in

CaliforniaCalifornia

““Go Live”Go Live”• Our goal is to standardize our Our goal is to standardize our

overhead emergency codes, in overhead emergency codes, in conjunction with all California conjunction with all California hospitals, by January 1, 2010.hospitals, by January 1, 2010.

StandardizedStandardizedEmergency CodesEmergency Codes

Description Old Code New Code Fire CODE RED Adult Medical Emergency CODE BLUE Pediatric Medical Emergency CODE WHITE Infant Abduction CODE PINK Child Abduction CODE PURPLE Bomb Threat CODE YELLOW Combative Person CODE GRAY Person w/ Weapon or Hostage Situation CODE SILVER Hazardous Material Spill / Release CODE ORANGE Missing High Risk Patient * CODE GREEN Limited activation of selected key personnel for potential incident *

CODE TRIAGE – EMERGENCY ALERT

Activate Emergency Operations Plan for Internal Incident

CODE TRIAGE – INTERNAL

Activate Emergency Operations Plan for External Incident

CODE TRIAGE – EXTERNAL

* Denotes a changed code.

Code RedCode RedFireFire

• Purpose: To provide an appropriate Purpose: To provide an appropriate response in the event of an actual response in the event of an actual or suspected fire in order to or suspected fire in order to protect life, property and vital protect life, property and vital services.services.

Code BlueCode BlueMedical EmergencyMedical Emergency

• Purpose: To provide an appropriate Purpose: To provide an appropriate response to a suspected or response to a suspected or eminent cardiopulmonary arrest or eminent cardiopulmonary arrest or a medical emergency for an adult a medical emergency for an adult patient.patient.

Code WhiteCode WhiteMedical Emergency - Medical Emergency -

PediatricPediatric• Purpose: To provide an appropriate Purpose: To provide an appropriate

response to a suspected or response to a suspected or eminent cardiopulmonary arrest or eminent cardiopulmonary arrest or a medical emergency for a a medical emergency for a pediatric patient.pediatric patient.

Code PinkCode PinkInfant AbductionInfant Abduction

• Purpose: To provide an appropriate Purpose: To provide an appropriate response in the event of the response in the event of the abduction, or attempted abduction abduction, or attempted abduction of an infant from the facility.of an infant from the facility.

Code PurpleCode PurpleChild AbductionChild Abduction

• Purpose: To provide an appropriate Purpose: To provide an appropriate response in the event of the response in the event of the abduction, or attempted abduction abduction, or attempted abduction of a child from the facility.of a child from the facility.

Code YellowCode YellowBomb ThreatBomb Threat

• Purpose: To provide an appropriate Purpose: To provide an appropriate response in the event of a bomb response in the event of a bomb threat or the discovery of a threat or the discovery of a suspicious device.suspicious device.

Code GrayCode GrayCombative PersonCombative Person

• To provide an appropriate To provide an appropriate response to situations involving a response to situations involving a combative or potentially combative or potentially combative person(s).combative person(s).

Code SilverCode SilverPerson with Weapon / Person with Weapon /

HostageHostage• Purpose: To provide an appropriate Purpose: To provide an appropriate

response in the event of an response in the event of an incident involving a person with a incident involving a person with a weapon or who has taken hostages weapon or who has taken hostages within the facility (includes an within the facility (includes an “active shooter” incident).“active shooter” incident).

Code OrangeCode OrangeHazardous Material Hazardous Material

Spill/ReleaseSpill/Release• Purpose: To provide an appropriate Purpose: To provide an appropriate

response to an actual or suspected response to an actual or suspected hazardous material spill or release hazardous material spill or release in a manner that is safe for staff, in a manner that is safe for staff, patients and visitors. patients and visitors.

Code GreenCode GreenPatient ElopementPatient Elopement

• Purpose: To provide an appropriate Purpose: To provide an appropriate response in the event of a response in the event of a missing / eloping patient who is missing / eloping patient who is determined to be a danger to determined to be a danger to themselves or is identified as a themselves or is identified as a safety risk.safety risk.

Code Triage: AlertCode Triage: AlertEmergency AlertEmergency Alert

• Purpose: To inform appropriate Purpose: To inform appropriate staff that an incident (“all staff that an incident (“all hazards”) has occurred, or may hazards”) has occurred, or may occur, that could potentially occur, that could potentially disrupt the normal operation of the disrupt the normal operation of the facility.facility.

Code Triage: InternalCode Triage: InternalInternal EmergencyInternal Emergency

• Purpose: To activate the Purpose: To activate the organization’s Emergency organization’s Emergency Operations Plan (EOP) in response Operations Plan (EOP) in response to an event that has occurred to an event that has occurred within the facility.within the facility.

Code Triage: ExternalCode Triage: ExternalExternal EmergencyExternal Emergency

• Purpose: To activate the Purpose: To activate the organization’s Emergency organization’s Emergency Operations Plan (EOP) in response Operations Plan (EOP) in response to an event that has occurred to an event that has occurred outside the facility that has, or is outside the facility that has, or is likely to disrupt the facility’s likely to disrupt the facility’s normal operations.normal operations.

How to activate a How to activate a code…code…

• In our facility call:In our facility call:

Our Hospital's PolicyOur Hospital's Policy

• Hospital Policy #Hospital Policy #• The emergency codes may also be The emergency codes may also be

posted in wall charts around the posted in wall charts around the hospital, or found on the back of ID hospital, or found on the back of ID cards or other quick reference cards or other quick reference materials.materials.

SummarySummary

• Do I know the emergency codes Do I know the emergency codes and their definitions?and their definitions?

• Do I know what number to dial and Do I know what number to dial and when it is appropriate to call each when it is appropriate to call each emergency code?emergency code?

• Do I know my roles and Do I know my roles and responsibilities for each responsibilities for each emergency code?emergency code?

““Go Live” DateGo Live” Date

January 1, January 1, 20102010

Questions?Questions?

Please contact:Please contact: