Hospital emergency codes are coded messages often announced over a public address system of a hospital 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 to staff while preventing stress and panic among visitors to the hospital. Such codes are sometimes posted on placards throughout the hospital or are printed on employee identification badges for ready reference.
Hospital emergency codes have varied widely by location, even between hospitals in the same community. Confusion over these codes has led to the proposal for and sometimes adoption of standardized codes. In many American, Canadian, New Zealand and Australian hospitals, for example "code blue" indicates a patient has entered cardiac arrest, while "code red" indicates that a fire has broken out somewhere in the hospital facility.
In order for a code call to be useful in activating the response of specific hospital personnel to a given situation, it is usually accompanied by a specific location description (e.g., "Code red, second floor, corridor three, room two-twelve"). Other codes, however, only signal hospital staff generally to prepare for the consequences of some external event such as a natural disaster.
Australian hospitals and other buildings are covered by Australian Standard 4083 (1997) [1]
Victoria, Australia.
Emergencies (Public Hospital services)
Codes in Alberta are prescribed by Alberta Health Services. [2]
Codes used in British Columbia, prescribed by the British Columbia Ministry of Health. [3]
Codes used in Manitoba as defined in WRHA policy,"Codes: Standardized Emergency"; policy# 50.00.010
The following codes are in use in Nova Scotia. [4] [5]
In Ontario, a standard emergency colour code system is set by the Ontario Hospital Association (OHA) is used, with minor variations for some hospitals. Additional clinical codes, such as code transfusion, code trauma, code 99, etc. are not set by the OHA. [7] [8] [9]
The following codes are in use in Quebec. [10]
Codes used in Saskatchewan, prescribed by the Saskatchewan Health Authority. [11]
The following codes are in use in Yukon. [12]
In the UK, hospitals have standardised codes across individual NHS trusts (England and Wales) and health boards (Scotland), but there are not many standardised codes across the entire NHS. This allows for differences in demands on hospitals in different areas, and also for hospitals of different roles to communicate different alerts according to their needs (e.g., a major trauma centre like St. George's Hospital in South London has different priority alert needs to a rural community hospital like West Berkshire Community Hospital). Some more standardised codes are as follows:
Otherwise, non-colour codes are mostly used across the NHS:
In 2000, the Hospital Association of Southern California (HASC) [15] [16] [17] determined that a uniform code system was needed after three people were killed in a shooting incident at a hospital after the wrong emergency code was called. While codes for fire (red) and medical emergency (blue) were similar in 90% of California hospitals queried, 47 different codes were used for infant abduction and 61 for combative person. In light of this, the HASC published a handbook titled Healthcare Facility Emergency Codes: A Guide for Code Standardization listing various codes and has strongly urged hospitals to voluntarily implement the revised codes.
In 2003, Maryland mandated that all acute hospitals in the state have uniform codes. [18]
In 2008, the Oregon Association of Hospitals & Health Systems, Oregon Patient Safety Commission, and Washington State Hospital Association formed a taskforce to standardize emergency code calls. [19] After both states had conducted a survey of all hospital members, the taskforce found many hospitals used the same code for fire (code red); however, there were tremendous variations for codes representing respiratory and cardiac arrest, infant and child abduction, and combative persons. After deliberations and decisions, the taskforce suggested the following as the Hospital Emergency Code: [20]
In 2015, the South Carolina Hospital Association formed a work group to develop plain language standardization code recommendations. Abolishing all color codes was suggested. [21] In 2016, the Texas Hospital Association encouraged the use of standardized plain language emergency alerts at all Texas hospitals. [22] The only color code that was still recommended was "code blue," meaning a cardiac arrest.
Plain language alerts are announced using the following format: Alert type + description + location (general to specific) + instructions (if applicable). [22] [23] For example, if a patient in ICU Bed 4 went into cardiac arrest, the alert would be "Medical alert + code blue + second floor + intensive care unit + bed 4."
Note: Different codes are used in different hospitals.
"Code blue” is used to indicate that a patient requires resuscitation or is in need of immediate medical attention, most often as the result of a respiratory arrest or cardiac arrest. When called overhead, the page takes the form of "Code blue, [floor], [room]" to alert the resuscitation team where to respond. Every hospital, as a part of its disaster plans, sets a policy to determine which units provide personnel for code coverage. In theory any medical professional may respond to a code, but in practice, the team makeup is limited to those with advanced cardiac life support or other equivalent resuscitation training. Frequently these teams are staffed by physicians from anesthesia, internal medicine or emergency medicine, respiratory therapists, pharmacists, and nurses. A code team leader will be a physician in attendance on any code team; this individual is responsible for directing the resuscitation effort and is said to "run the code".
This phrase was coined at Bethany Medical Center in Kansas City, Kansas. [24] The term "code" by itself is commonly used by medical professionals as a slang term for this type of emergency, as in "calling a code" or describing a patient in arrest as "coding" or "coded".
In some hospitals or other medical facilities, the resuscitation team may purposely respond slowly to a patient in cardiac arrest, a practice known as "slow code", or may fake the response altogether for the sake of the patient's family, a practice known as "show code". [25] Such practices are ethically controversial, [26] and are banned in some jurisdictions.[ citation needed ]
"Plan blue" was used at St. Vincent's Hospital in New York City to indicate arrival of a trauma patient so critically injured that even the short delay of a stop in the ER for evaluation could be fatal; "plan blue" was called out to alert the surgeon on call to go immediately to the ER entrance and take the patient for immediate surgery.[ citation needed ]
"Doctor" codes are often used in hospital settings for announcements over a general loudspeaker or paging system that might cause panic or endanger a patient's privacy. Most often, "doctor" codes take the form of "Paging Dr. Sinclair", where the doctor's "name" is a code word for a dangerous situation or a patient in crisis, e.g.: "Paging Dr. Firestone, third floor," to indicate a possible fire on the floor specified.[ citation needed ]
Specific to emergency medicine, incoming patients in immediate danger of life or limb, whether presenting via ambulance or walk-in triage, are paged locally within the emergency department as "resus" [ri:səs] codes. These codes indicate the type of emergency (general medical, trauma, cardiopulmonary or neurological) and type of patient (adult or pediatric). An estimated time of arrival may be included, or "now" if the patient is already in the department. The patient is transported to the nearest open trauma bay or evaluation room, and is immediately attended by a designated team of physicians and nurses for purposes of immediate stabilization and treatment.[ citation needed ]
In medicine, triage is a process by which care providers such as medical professionals and those with first aid knowledge determine the order of priority for providing treatment to injured individuals and/or inform the rationing of limited supplies so that they go to those who can most benefit from it. Triage is usually relied upon when there are more injured individuals than available care providers, or when there are more injured individuals than supplies to treat them.
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
Cardiac arrest, also known as sudden cardiac arrest, is when the heart suddenly and unexpectedly stops beating. As a result, blood cannot properly circulate around the body and there is diminished blood flow to the brain and other organs. When the brain does not receive enough blood, this can cause a person to lose consciousness. Coma and persistent vegetative state may result from cardiac arrest. Cardiac arrest is also identified by a lack of central pulses and abnormal or absent breathing.
An emergency medical technician is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and some part-time departments require their firefighters to at least be EMT certified.
A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through emergency medical technicians, paramedics, emergency physicians and anesthesiologists.
An emergency is an urgent, unexpected, and usually dangerous situation that poses an immediate risk to health, life, property, or environment and requires immediate action. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath.
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center.
Health Sciences North is a teaching hospital in Greater Sudbury, Ontario, Canada. HSN offers a variety of programs and services, with regional programs in the areas of cardiac care, oncology, nephrology, trauma and rehabilitation. Patients visit HSN from a wide geographic area across northeastern Ontario.
Basic life support (BLS) is a level of medical care which is used for patients with life-threatening condition of cardiac arrest until they can be given full medical care by advanced life support providers. It can be provided by trained medical personnel, such as emergency medical technicians, qualified bystanders and anybody who is trained for providing BLS and/or ACLS.
Traumatic cardiac arrest (TCA) is a condition in which the heart has ceased to beat due to blunt or penetrating trauma, such as a stab wound to the thoracic area. It is a medical emergency which will always result in death without prompt advanced medical care. Even with prompt medical intervention, survival without neurological complications is rare. In recent years, protocols have been proposed to improve survival rate in patients with traumatic cardiac arrest, though the variable causes of this condition as well as many coexisting injuries can make these protocols difficult to standardize. Traumatic cardiac arrest is a complex form of cardiac arrest often derailing from advanced cardiac life support in the sense that the emergency team must first establish the cause of the traumatic arrest and reverse these effects, for example hypovolemia and haemorrhagic shock due to a penetrating injury.
A crash cart,code cart,crash trolley or "MAX cart" is a set of trays/drawers/shelves on wheels used in hospitals for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support protocols (ACLS/ALS) to potentially save someone's life. The cart carries instruments for cardiopulmonary resuscitation and other medical supplies while also functioning as a support litter for the patient.
In addition to distress signals like Mayday and pan-pan, most vessels, especially passenger ships, use some emergency signals to alert the crew on board. In some cases, the signals may alert the passengers to danger, but, in others, the objective is to conceal the emergency from unaffected passengers so as to avoid panic or undue alarm. Signals can be in the form of blasts on alarm bells, sounds on the ship's whistle or code names paged over the PA system.
Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing).
Advanced trauma life support (ATLS) is a training program for medical providers in the management of acute trauma cases, developed by the American College of Surgeons. Similar programs exist for immediate care providers such as paramedics. The program has been adopted worldwide in over 60 countries, sometimes under the name of Early Management of Severe Trauma, especially outside North America. Its goal is to teach a simplified and standardized approach to trauma patients. Originally designed for emergency situations where only one doctor and one nurse are present, ATLS is now widely accepted as the standard of care for initial assessment and treatment in trauma centers. The premise of the ATLS program is to treat the greatest threat to life first. It also advocates that the lack of a definitive diagnosis and a detailed history should not slow the application of indicated treatment for life-threatening injury, with the most time-critical interventions performed early.
A Disaster Medical Assistance Team (DMAT) is a specialized group under the National Disaster Medical System (NDMS), part of the U.S. Department of Health and Human Services. These teams are composed of professional medical personnel including physicians, physician assistants (PA), nurses, paramedics, pharmacists, and logistical and administrative support staff. DMATs are deployed to provide rapid-response medical care, support hospitals with excess patient loads, and engage in patient triage and emergency care during significant incidents such as natural disasters, terrorist attacks, disease outbreaks, and national special security events.
The Medical Priority Dispatch System (MPDS), sometimes referred to as the Advanced Medical Priority Dispatch System (AMPDS) is a unified system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and pre-arrival instructions. Priority Dispatch Corporation is licensed to design and publish MPDS and its various products, with research supported by the International Academy of Emergency Medical Dispatch (IAEMD). Priority Dispatch Corporation, in conjunction with the International Academies of Emergency Dispatch, have also produced similar systems for Police and Fire
The Trauma Hawk Aero-Medical Program provides air ambulance services for Palm Beach County, Florida. On-scene paramedics will decide whether or not a Traumahawk is necessary in a situation. On average, a Traumahawk is dispatched between 1 and 5 times a day for traumatic injuries, including those from vehicle accidents to sports injuries, as well as transport for stroke and cardiac patients. Operated by the Health Care District of Palm Beach County, the service uses two identical 1999 Sikorsky S76-C+ helicopters as air ambulances.
A mass casualty incident describes an incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties. For example, an incident where a two-person crew is responding to a motor vehicle collision with three severely injured people could be considered a mass casualty incident. The general public more commonly recognizes events such as building collapses, train and bus collisions, plane crashes, earthquakes and other large-scale emergencies as mass casualty incidents. Events such as the Oklahoma City bombing in 1995, the September 11 attacks in 2001, and the Boston Marathon bombing in 2013 are well-publicized examples of mass casualty incidents. The most common types of MCIs are generally caused by terrorism, mass-transportation accidents, fires or natural disasters. A multiple casualty incident is one in which there are multiple casualties. The key difference from a mass casualty incident is that in a multiple casualty incident the resources available are sufficient to manage the needs of the victims. The issue of resource availability is therefore critical to the understanding of these concepts. One crosses over from a multiple to a mass casualty incident when resources are exceeded and the systems are overwhelmed.
The MET call was designed at the Liverpool Hospital, Sydney, Australia in 1990 and has continued to develop and spread around the Western world as part of a Rapid Response System. The MET call is a hospital-based system, designed for a nurse to alert and call other staff for help when a patient's vital signs have fallen outside set criteria. These criteria were designed around studies suggesting that certain vital sign ranges and symptoms occur before poor patient conditions which may lead to death. In the original model, the criteria also include "and any patient you are seriously worried about", although this is not included in all hospitals despite some observational trials showing it is the most commonly used calling criteria in hospitals that use it.
The New York City Fire Department Bureau of Emergency Medical Services is a division of the New York City Fire Department (FDNY) in charge of emergency medical services for New York City. It was established on March 17, 1996, following the merger of the FDNY and New York City Health and Hospitals Corporation's emergency medical services division. FDNY EMS provides coverage of all five boroughs of New York City with ambulances and a variety of specialized response vehicles.