Hospital Codes North York General Hospital Student Orientation revised Sept 2013
Attention Attention Code Now what?? Refer to the Code Manual or Intranet
Code RED Code WHITE Code PURPLE Code BLACK Code YELLOW Code GREEN Code GREY Code ORANGE Code AMBER Code BROWN FIRE VIOLENT PATIENT HOSTAGE TAKING/ PERSON WITH A WEAPON BOMB/SUSPICIOUS PKGE MISSING PATIENT EVACUATION AIR EXCLUSION External Disaster Missing Infant/Child Hazardous Spill/Leak
What about Code Blue? and Code Pink?
Code Blue and Code Pink.. A respiratory or Cardiac Arrest Can be actual or impending Code Blue 18 yrs of age or older Code Pink 0-12yrs Code Pink Adolescent 13-17yrs
Staff and Students #1 Responsibility If Code Blue is announced on your unit, all staff and students should return to the unit immediately
#2 Responsibility Protect yourself and others Code Blue is considered a HIGH RISK procedure.
Equipment If you don t use it you will lose it!
Initiating A Code Blue
Initiating a Code Blue Push the code button in the room Dial 5555 OR Seniors Health Center dial 9 and then 911
Okay so I dialed 5555 now what? Information they need to know: Type of Code Where are you? Unit, Room, Bed Number
Codes & Who Responds Second floor up: CrCU staff (excluding pediatrics) First floor, ground floor (including the cafeteria), lower level: ED Staff
Codes & Who Responds Hospital Grounds/Parking Lot: ED staff respond as well as 911 is called simultaneously 4000 Leslie Street & Seniors Health Center: 911 is called
Code Blue Team Members Responsibilities
MD on Scene Internal Medicine Physician or the Emergency Room Physician Responsible for running the Resuscitation
Anesthetist/RRT Establishes or assists in securing and maintaining a patent airway Anesthetist is on call if needed
CrCU or ER nurse Delegates & Coordinates: - C-A-B - IV access/ Medication - Documentation/Monitoring - Ensures room is not overcrowded - Accompanies patient during transfer - Defibrillation according to ACLS standards (certified RN only)
Nurse & Lab Technician Nurse (most skilled in the room) ensures patent IV route is established if not already in place (16-20G preferable) Lab Technician provides ECG/Venipuncture as needed
Charge Nurse/Unit Co-ordinator Notify most responsible physician & call family Consult Chaplaincy/Social Worker as needed Ensure Crash Cart equipment and drugs are replenished immediately after code Facilitate completion of Cardiac Arrest Record
What about me the student? What do I have to do??
Primary Nurse/First Qualified Person on Site Stay where you are don t leave the patient Call for HELP!! Check the patient s CAB s Circulation Check for a pulse Airway/Breathing- look, listen, feel Participate in compressions if you are CPR certified
Oh No I can t feel a pulse? Now what?? Start chest compressions
Nurse #2/Second Qualified Person on Site Initiate Code Blue if not already done Don mask, gloves, gown and goggles before entering room Place backboard under patient Relieve First Nurse to don 4 point PPE & grab ambu-bag/orange roll 1 person CPR 1 person Bagging with Ambu Bag hook up to oxygen
3 rd and 4 th RN/Qualified Person Bring the Crash Cart if not already there Ensure patient s chart and MAR are readily available
Ensure other patients are being cared for **especially in the same room (Students to remove patients from room if possible)
Do not forget the Family Every patient has someone who loves them. They need your support. Family and loved ones should be present during the resuscitation whenever possible
Code is done now what? Call someone who cares Preceptor/ Nurse Educator Your Clinical Advisor Fellow Student Participating in the Debrief will be helpful to you. Talking is the best medicine!
Name these Codes! 1. A gunman has entered the ED and is threatening staff. 2. A pregnant woman is about to give birth in the elevator- she is only 6 months along! 3. A patient chokes in the cafeteria. 4. A visitor slips on ice outside the main entrance and is bleeding profusely from their head. 5. An unknown caller tells you that something bad is going to happen. And they have left us a gift.
Name these Codes! 6.There has been a large pile up on the 404 due to an ice storm. Large numbers of victims are expected. 7. A nurse has spilled chemotherapy on the floor. 8. You have not been able to find your patient despite searching for him. 9. A chemical plant upwind of the hospital is on fire. Toxic fumes are headed our way. 10.There has been a fire on an inpatient unit. 11. The fire has now spread and staff are unable to contain it.