Nursing Student Orientation. Emergency Codes

Nursing Student Orientation Emergency Codes

EMERGENCY CODES CODE RED - FIRE CODE PURPLE HOSTAGE OR PERSON WITH A WEAPON CODE BLUE CARDIAC ARREST CODE GREEN - EVACUATION CODE YELLOW MISSING PATIENT CODE BLACK BOMB THREAT CODE WHITE VIOLENT PERSON CODE BROWN CHEMICAL SPILL CODE PINK NEONATAL ARREST CODE ORANGE - DISASTER

Emergency Codes at HDGH Students are expected to have an understanding of the Emergency Codes system, including the Code definitions and how to respond to a Code called organization-wide and /or in their area. It is each person s responsibility to familiarize themselves with the Emergency Codes procedures at whichever site(s) and Unit they are working. The most current information about Emergency Codes is located on the HDGH Intranet.

What to do in an Emergency at HDGH: Dial 3333 to alert Switchboard of an Emergency Provide the following information: Name of CODE Name of Building (please use one the three names listed below) Tayfour Tower - Main Entrance (includes Casgrain, East Wing, Tayfour Tower, Community Psychiatric Hospital/CPH) Toldo Neurobehavioral Institute Emara Building Exact Location (Room # or Department) At all other sites, Regional Children s Centre & Off-Site programs Dial 911

Code Red - FIRE Remain calm and follow the acronym R.A.C.E. Rescue/Remove anyone from immediate danger to a safe area Alarm Pull the nearest fire alarm Dial 3-3-3-3 to alert Switchboard with Code/Building/Location Off site: Call 9-1-1 Contain the fire by closing all doors/windows, clear hallways of obstructions Extinguish the fire with the appropriate extinguisher or evacuate the area

Extinguish When using a fire extinguisher remember to P.A.S.S P A S S Pull the pin Aim nozzle at base of fire Squeeze handle Sweep nozzle side to side

Code Purple Hostage / Person with a Weapon A Code Purple is called in the event any person is forcibly confined or held against their will, with the threat of a weapon or threat of violence. Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Dial 9-1-1 immediately and give operator all necessary information. DO NOT attempt any action. Ensure safety of patients and visitors in the immediate area. Dial 3-3-3-3 and advise Switchboard that 9-1-1 was called for a Code Purple. Wait for Security and police to arrive. DO NOT initiate conversation with the hostage taker(s) but do answer if spoken to. Write down or remember any demands or actions

Code Blue Cardiac Arrest Medical Emergency in Adult or Child (>8yrs) or Paediatric: Medical Emergency in Child (1mth-8yrs) Dial 3333 to alert Switchboard of a Code Blue Provide the following information: 1. Name of CODE (e.g. CODE BLUE) 2. Name of Building (e.g. DR. Y. Emara) 3. Exact Location (e.g. Room # or Department) Switchboard will call 9-1-1 and notify Security of EMS arrival Staff should aid in directing EMS upon arrival Code Blue Regional Children s Centre and Off-site Programs Dial 9-1-1 for a medical emergency Staff should aid in directing EMS upon arrival Code Blue Outside of the Campus Buildings For an unresponsive person on hospital property (but outside of physical buildings): Dial 9-1-1 Staff should aid in directing EMS upon arrival

Code Green - Evacuation Code Green refers to an internal or external event and other situations requiring a partial or complete evacuation of the health care facility. Level I - Horizontal Evacuation All persons in a zone or wing are moved beyond a corridor fire separation door to an adjacent safe area on the same floor. Level II - Vertical Evacuation All persons are moved to another floor, preferably two floors down. Level III - Total/Premises Evacuation All persons are removed from the affected building. This may be outside or to another building. NOTE: Green Tape is put up as an X across the door jamb of a room to indicate room all clear.

Code Yellow Missing Patient WHEN YOU DISCOVER THAT A PATIENT IS MISSING Step 1 Staff in immediate area to conduct thorough search of department. Step 2 - If not found RP/most responsible person to contact security at x 72030 and provide the following information: Patient name Department and unit Patient description (including clothing) Time and location last seen Security will search common areas and review video footage. If patient/client is located on site security to call unit If patient/client is located leaving campus / If not found security to notify RP/ most responsible person on unit. If during regular business hours: Charge Nurse contacts Operations Manager. If after hours: Unit to contact After Hours Manager

Code Yellow Missing Patient cont d Operations Manager/ After-hours Manager in consultation with the RP/most responsible person determine if a Code Yellow should be called. If a 30 minutes have passed since the patient was discovered missing, a Code Yellow will be called. If the operations manager/after-hours manager determines that a Code Yellow is to be called the manager then instructs the unit to: Contact switchboard at 3333 to page a Code Yellow and a broadcast voicemail drop Notify Executive On Call

Code Yellow Missing Patient cont d Upon hearing the Code Yellow Page: All Staff: check voicemail for situation/patient details Staff on duty should search their area immediately. If patient is found call security at ext. 72030 Security: Conduct more in-depth search of the grounds and all unoccupied areas Once security search is complete if patient not found security to contact the RP on the unit When the situation is resolved: The RP/most responsible person will notify Security Security to contact switchboard and inform that the Code Yellow has been resolved Switchboard to do an overhead page and a voicemail broadcast that the Code Yellow has been resolved Operations manager/manager on call who will then inform the Executive On Call that the situation has been resolved

Code Black Bomb Threat Threats by Mail: Immediately call Security at 72030 Avoid handling the document. Threats by Phone: Remain calm, listen carefully, make notes, do not interrupt, and DO NOT hang up. Appoint a person to call 3-3-3-3 to notify Switchboard of the code or call 9-1-1 (off-site only) with details of threat. Complete a Telephone Bomb Threat Report (in Emergency Codes Kit). Switchboard notifies Security, Facilities, CEO, and Police.

Code Black Bomb Threat cont d Once a CODE BLACK is called: all staff are to turn off all pagers and cell phones. Do NOT use pagers, two-way radios, or cell phones unless there is an emergency or permission has been given by the Incident Commander. Search Procedures Searching the building as a result of a bomb threat is the hospital s responsibility. Staff should search their own area for anything out of the ordinary using the Departmental Search Grid and a highlighter (found in the Emergency Codes Kit). Areas of public access, such as reception areas, washrooms, entrances/exits, should be searched first. Grid is forwarded to Administration once completed. Security and Facilities will conduct a search of the premises using facility floor plans. If a suspicious object is located, it should not be touched or moved. Patients, staff or others must be removed from the area and the area secured. Proper Searching Method: Floor level Eye level Ceiling level

Code White Violent Person A Code White should be called when an employee/affiliate witnesses, or is involved with any individual who is not responding to de-escalation intervention and is: 1. Threatening, harassing or being verbally abusive to another individual 2. Attempting to harm themselves or others despite appropriate intervention 3. Attempting to destroy property despite appropriate intervention Calling a Code White Mental Health (inpatient and outpatient) Activate your Personal Alarm (PAL or panic button) All Other Areas - Call 3333 Inform switchboard of the following: a Code White is occurring Patient Name Location (building, floor and room number) Note: if the location changes, please provide ongoing updates to switchboard Important: If the situation requires police intervention call 9-911 Switchboard to do an overhead broadcast announcing a Code White along with the location

Code White Violent Person cont d Upon hearing an overhead page of CODE WHITE: Any code white trained staff who are present in the immediate area/unit are to respond promptly, all others should continue with their ongoing duties The staff with the best rapport with the individual are to take the Lead role in responding and deescalating When security arrives on scene the Lead will provide information/direction on how to proceed If the individual is responding, continue to use supportive verbal intervention techniques. If the individual is not responding and violent behaviour is escalating, the Lead should direct security to physically intervene with the clinical team on hand for support NOTE: It is an expectation that staff from the unit where the Code White originates will remain with the response team(s) throughout the duration of the Code.

Code White Violent Person cont d When the situation is resolved: The Lead will: Notify security that the situation is resolved Conduct a debrief enter Code White into RiskPro Other reports, as required (for example, operations/after-hours manager informed of any injury) Security will notify switchboard to announce the Code White all clear

Code Brown Chemical Spill Level I - Departmental Response Small spill easily cleaned up with soap and water, or departmental spill kit. Contents are identifiable and pose no threat of irritation to skin, eyes, or lungs. Do NOT call a Code Brown. The department that experienced the spill is responsible for cleaning it up. Housekeeping can be requested to assist with the cleanup, if available, and if they are trained to work with the spill. Level II - Code Brown Team Response Dial Switchboard at 3-3-3-3. Large spill that requires special clean-up procedures OR is unidentifiable and may be hazardous. Code Brown Team will respond. Level III - External Response Dial Switchboard at 3-3-3-3. Health / Fire / Environmental hazard requires special clean-up procedures. Fire Department responds. NOTE: The Most Responsible Person (MRP) of the area with the spill will complete the incident report in Risk Monitor Pro AND the Code Brown Review Checklist for all Level II and Level III spills.

Code Pink Neonatal Arrest Medical Emergency in an Infant (<1mth) There is no Code Pink Team at HDGH, Tayfour Campus Dial 9-1-1 for a medical emergency Dial 3-3-3-3 to notify Switchboard of the Code, Building, and Specific Location. Staff should aid in directing EMS upon arrival. Regional Children s Centre and Off-site Programs: Dial 9-1-1 for a medical emergency. Staff should aid in directing EMS upon arrival.

Code Orange - Disaster A Code Orange is called when a disaster has occurred in the community. The main role of staff at HDGH Tayfour Campus in the event of an external community disaster is to prepare for the possible admission of patients from WRH to enable the acute care sites (Metropolitan and Ouellette Campuses) to respond to the immediate critical needs of patients. Some examples of external disasters: Tornado Fire Toxic Spill Earthquake Explosion Motor Vehicle Accident

Code Orange Disaster cont d Code Orange Advisory Code Orange Alert Code Orange Levels I, II, III Code Orange All Clear Code Orange Decomtam Considered a precautionary stage. Called when events have taken place that increase the likelihood that a disaster will occur in the community. The hospital has been notified that a disaster has occurred in the community. No casualties are arriving yet. Hospital is receiving casualties (I = less than 4, II = more than 4, III = many more than 4) Departments immediately affected will be involved All staff should stand by for further direction. Specific areas will be set-up for media, family, discharge, treatment Hospital is no longer receiving casualties Staff will continue to care for current casualties and complete duties as assigned Staff may return to their department when indicated by MRP in designated areas The Code Orange Operations Report should be completed May be used to indicate that the situation includes a chemical, biological, and/or radioactive disaster requiring implementation of lockdown and/or decontamination procedures. The response levels and actions remain the same as outlined in the Code Orange Policy. Decomtam will require special actions from Emergency, Security and Facilities

Questions you will want to ask about Emergency Procedures in your specific Unit Where are the emergency exits? Where are the Fire Alarm pull stations? What is my role and my unit s role, in an emergency? What happens after hours? Where is the Emergency Codes information located? (manual and online) Nursing Student Orientation 2014