Emergency Codes ilearn Module Text Version

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1 Emergency Codes ilearn Module Text Version Introduction LHSC is committed to providing a safe environment. But unforeseen emergencies can and do happen, both within and outside of our facilities. These emergencies may threaten our life, property, operations and/or the environment. This course will review the Emergency Response Codes and the actions to take if an emergency should occur. During an Emergency When emergencies occur, it is important that you know what to do and where you are located in the hospital. LHSC has one switchboard that handles all emergency calls to extension In an emergency, call the LHSC switchboard and state your emergency and exact location: Hospital site Zone/Building Floor Room Number Department In 2009, the Ontario Hospital Association standardized all Emergency Codes across Ontario. Having similar colour codes makes it easier for staff and affiliates to remember as they move from hospital to hospital and city to city across the province of Ontario. Emergency Codes The Emergency Response Code Card contains a description of all 11 emergency codes. Carry your Emergency Response Code Card with your ID and have it with you at all times when working at LHSC.

2 CODE BLUE: Cardiac Arrest, Medical Emergency Adult Code Blue is designed to respond to a medical emergency when an adult is experiencing a real or suspected loss of life. If the adult assessed is not responding, qualified individuals follow the ABCs of basic cardiac life support (Airway, Breathing, Circulation). In a Cardiac Arrest Call: 1. First person to respond should commence C.P.R. (if qualified). 2. Get help: call Give the following information: State Code Blue Adult Give exact location: hospital site, zone/building, floor, room number, department/unit 4. Assign someone to meet the cardiac arrest team. 5. All available team members will respond immediately to the area. Members of the team will assist with resuscitation according to their specific roles. CODE PINK: Cardiac Arrest, Medical Emergency Infant/Child Code Pink identifies a paediatric arrest from that of an adult. Code Pink is a medical emergency when an infant of child is experiencing a real or suspected loss of life. If the infant or child assessed is not responding, qualified individuals follow the ABCs of basic cardiac life support (Airway, Breathing, Circulation). In a Cardiac Arrest Call: 1. First person to respond should commence C.P.R. (if qualified). 2. Get help: call

3 3. Give the following information: State Code Pink Infant/Child Give exact location: hospital site, zone/building, floor, room number, department/unit 4. Assign someone to meet the cardiac arrest team. 5. All available team members will respond immediately to the area. Members of the team will assist with resuscitation according to their specific roles. CODE RED: Fire Fire in a health care facility is a frightening situation for patients, staff, and visitors alike. Quick disciplined action is necessary if lives are to be saved and property losses minimized. Code Red is designed to alert hospital personnel to the detection of smoke or fire. In the event of threat of fire, follow the R.E.A.C.T. procedures: R: Remove anyone in danger. E: Ensure doors and windows are closed. Smoke is the real killer, not the flames. A: Activate alarm (pull station). The building alarm system must be activated. C: Call switchboard at State Code Red Fire. T: Try to fight the fire if trained and it is safe to attempt! Otherwise evacuate.

4 CODE GREEN: Evacuation Code Green initiates an orderly response when evacuation within a certain perimeter (for example, a location within a building) is recommended. A Code Green may be ordered by the fire department, hospital senior leadership, or security. Bells will ring at double-time: 120 tones per minute. In a Code Green, the stages of evacuation are: Area of immediate danger (for example, a room). Horizontal: beyond corridor fire doors. Vertical: evacuate all occupants of the floor to the floor below. Listen to overhead page for instructions. Don t just leave! For off-site locations, evacuate immediately at bell tones and go to the Evacuation Assembly Point: Perth Drive Complex UH Byron Family Medical Clinic Victoria Family Medical Clinic South Street Hospital and Stiller Centre, consult with your leadership. CODE BROWN: In-Facility Hazardous Spill A Code Brown will be called if there is a spill/contamination, leak, unusual smell, gas, or vapour of a hazardous or unknown substance. A Code Brown is called to ensure the safe containment and management of the chemical spills or release.

5 In the event of a hazardous spill: S: Safely evacuate the immediate area. P: Prevent the spread of fumes. Ensure doors and windows are closed. I: Initiate the call to switchboard at State Code Brown In-Facility Hazardous Spill and give exact location. L: Leave electrical equipment alone. L: Locate information on the chemical(s) from the Material Safety Data Sheets (MSDS). CODE YELLOW: Missing Person, Code Amber Missing Child/Abduction The purpose of a Code Yellow is to alert staff and affiliates that the whereabouts of an individual is currently unknown to staff in a specific patient/client care area. A Code Amber is used if the individual missing is a child. Upon realizing that a patient is missing, the nurse/caregiver in charge of the unit/treatment area will: 1. Prepare pertinent information about the patient full description, clothing worn, last time seen and location of last sighting. 2. Conduct a systematic search of the floor/unit. 3. Utilize the paging system to request the patient return to the unit (Dial 0 and ask for switchboard). 4. Call and state Code Yellow Missing Person. 5. Notify the attending physician, leaders, and the family. 6. On return of the patient, notify all parties involved.

6 Response for a Code Amber: Code Amber is an extension of Code Yellow. The purpose is to initiate a comprehensive expedient search by designated staff to locate a missing or abducted child. Urgent response time is critical: 1. Call and state Code Amber Missing Child/Child Abduction. 2. Give a detailed description of the missing child or abductor. 3. Security and police will respond. 4. Conduct a systematic search of the floor/unit. 5. Move parents to a private room. If possible, restrict movement from the floor. CODE BLACK: Bomb Threat The purpose of a Code Black is to define the response to a written or verbal bomb threat, or the discovery of a suspicious package or object. Staff or affiliates are to report all bomb threats or suspicious packages immediately. In the event you receive a bomb threat by telephone: 1. Be calm and courteous. 2. Do not interrupt the caller. 3. Obtain as much information as possible. 4. Do not hang up the phone. 5. Call from another phone and state Code Black Bomb Threat. Give exact location: hospital site, zone/building, floor, room number, department/unit. Do not handle any suspicious packages. Do not use overhead page system.

7 CODE WHITE: Violent/Behavioural Situation A Code White is called when individuals become violent and/or display behaviour which threatens staff, patient/client and building occupant safety. In a Code White: 1. Remain alert. 2. Recognize escalating behaviour. 3. Call security in advance. 4. Give the person space. 5. Speak in a calm, non-threatening manner. 6. Call and state Code White. Give exact location: hospital site, zone/building, floor, room number, department/unit. 7. Advise if a weapon is involved. 8. Security will call police when required. Robbery procedures are department-specific. CODE PURPLE: Hostage Taking Code Purple is used in the event of an actual or potential on-site hostage situation. 1. Call State Code Purple Hostage Taking and give exact location. Advise if a weapon is involved. 3. Police will be notified immediately to handle the incident.

8 General Guidelines: Evacuate all persons from the area if it is safe to do so. Do not meet the demands of the hostage taker. Make every attempt to stall for time. Remain behind cover, even while talking with the hostage taker. CODE ORANGE: External Disaster, CBRN Disaster Code Orange is designed to activate a response following a natural, technological, or human caused incident, external to the hospital, resulting in casualties arriving faster and in greater number than the hospital can manage using normal processes, procedures and resources. Based on current resources and ability to respond effectively, a Code Orange may be declared. Response External Disaster: Central Ambulance Communications or an external emergency services agency will notify the Emergency Department of an external disaster resulting in mass casualties. A Code Orange may be declared. It is an expectation that all staff participate in the emergency response. You may be: Required to remain at the hospital for an extended period of time. Called in as part of a fanout. Reassigned to other necessary work, ensuring you have the skills and capacity to do the work. Ensure you have your hospital ID or you will not be let into the building.

9 Response CBRN (chemical, biological, radiological, nuclear/hazardous materials exposure): Central Ambulance Communications or the London Fire Department will notify the Emergency Department of an external disaster which may involve chemical, biological, radiological, or nuclear/hazardous materials exposure. A Code Orange CBRN will be declared. To ensure the safety of other patients, visitors and staff, these patients must be decontaminated prior to admittance. Security will lockdown the hospital, controlling entrances and the CBRN response team will be called to respond. CODE GREY: Infrastructure loss or failure, Code Grey Button-Down External Air Exclusion Code Grey may be called to alert the organization to a disruption or loss of essential services (for example, electrical, water supply/quality, waste removal, medical gas, heating/ventilation, information management systems). In the event of a loss of essential services: 1. Call and report the incident to the switchboard. 2. Listen for instructions on the public address system. 3. Instructions may also be received by or posted on the LHSC intranet home page. 4. Standby for further instructions. Response for a Code Grey Button-Down: The purpose of a Code Grey Button-Down is to control contaminated air from entering the building. This may be the result of an external chemical spill or fire.

10 Ensure doors and windows are closed. Provide wet towels to patients. All persons are to remain in the hospital. Power-down all vents, air conditioners. Access in to and out of the hospital will be restricted. Severe Weather Emergency Procedures In the event of a severe weather watch and/or warning there are recommended actions to ensure the safety of patients, staff, and visitors. These actions vary based on the category of severe weather: 1. Severe Weather Advisory Actual or expected weather conditions may cause concern or general inconvenience, but do not pose a serious enough threat to warrant a weather warning. 2. Severe Weather Watch Atmospheric conditions are favourable for tornadoes or a severe storm to occur, even though one has not yet developed. Staff will be advised that a weather watch is in effect. Switchboard will announce: Attention all staff, weather watch in effect. Assess all patients for the possibility of moving them into the hallways or evacuating to a lower level. Hallways must be cleared of all non-essential items. Ensure essential items are on one side of the hallway. 3. Severe Weather Warning If severe weather is highly probable, imminent, or occurring, action is necessary to protect patients/visitors. Staff may be instructed to move patients into the hallways or evacuate to a lower level. Staff will be advised that a weather warning is in effect. Switchboard will announce:

11 Attention all staff, severe weather warning in effect. The announcement will be repeated on a regular basis until an All Clear is announced. Active Threat An active threat occurs when a person threatens life safety and demonstrates severe assaultive behaviour. You may either witness the behaviour or hear sounds of violence with extreme emotional reactions. Assaultive behaviour can involve the use of weapons of deadly force, for example firearms or edged weapons. Response to an Active Threat Staff and affiliates should respond to an active threat in the following order of priority: 1. Evacuate If corridors are clear and you re not in plain sight of the assailant, evacuate the area. This will increase the distance between you and the assailant. Once you have evacuated, call or 911 from a safe area. Follow directions provided by the police. 2. Shelter in Place Shelter in place if you re unable to evacuate. Enter a room, turn out the lights, and lock the door. Place heavy furniture in front of the door. Remain quiet and silence wireless communications. Stay low and hidden from sight behind large objects. Wait for the all clear. 3. Self-Defence Use this response as a last resort. Use vigorous force and objects that will incapacitate the assailant. Render as much harm as possible to allow escape. Move quickly to safety.

12 Active Threat Patients, Families, and Visitors Provide the following options to patients, families, and visitors: Evacuate with staff and affiliates. Shelter in place by: closing doors, locking themselves in patient washrooms, or blocking doors with furniture inside patient rooms. Active Threat Police Arrival Police are in charge of the response and will be directing emergency instructions to building occupants. When police arrive: Approach them slowly. Raise your hands to show you do not have a weapon. Obey police orders. Emergency Lockdown A lockdown is called to secure access to the hospital exterior or specific areas inside the building. Lockdowns can be called in the following situations: Mass casualty (CODE ORANGE). Chemical, biological, radiological, nuclear, or explosives disaster (CODE ORANGE CBRNe). Severe violent behaviour (CODE WHITE, Active Threat). Hostage Taking (CODE PURPLE). Air exclusion (Code Grey Button-Down). Interior Emergency Lockdowns When an interior lockdown is initiated for specific areas, you should: Manually secure your work area. Close patient doors; advise patients to secure themselves in washrooms where possible. Proceed to safe rooms.

13 Expect police or security to be visible inside the building or at exterior doors. Safe Rooms A pre-designated room to shelter in place. Preferably equipped with a deadbolt lock, a telephone, and a door without a window. A bathroom can also serve as a safe room. Personal Preparedness Widespread emergencies can impact your home life. As an employee of a hospital there is an expectation to report to work as scheduled when an emergency arises. Preparedness and planning at home can lessen the impact. Step 1: Know the risks in your region. Step 2: Make a plan. Step 3: Prepare a kit. For more information and further details on being prepared in an emergency, check out the LHSC Disaster/Emergency Planning website.

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