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]
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 response code set by the Ontario Hospital Association is used, with minor variations for some hospitals. [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 ]
First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is generally performed by someone with basic medical training. Mental health first aid is an extension of the concept of first aid to cover mental health, while psychological first aid is used as early treatment of people who are at risk for developing PTSD. Conflict first aid, focused on preservation and recovery of an individual's social or relationship well-being, is being piloted in Canada.
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.
A paramedic is a healthcare professional trained in the medical model, whose main role has historically been to respond to emergency calls for medical help outside of a hospital. Paramedics work as part of the emergency medical services (EMS), most often in ambulances. They also have roles in emergency medicine, primary care, transfer medicine and remote/offshore medicine. The scope of practice of a paramedic varies between countries, but generally includes autonomous decision making around the emergency care of patients.
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.
Basic life support (BLS) is a level of medical care which is used for patients with life-threatening illnesses or injuries 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, and by qualified bystanders.
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.
Louisville Metro Emergency Medical Services is the primary provider of pre-hospital life support and emergency care within Louisville-Jefferson County, Kentucky. LMEMS is a governmental department that averages 90,000 calls for service, both emergency and non-emergency, each year.
A flight nurse is a registered nurse specializing in the field of providing comprehensive pre-hospital, emergency critical care, and hospital care to a vast scope of patients. The care of these patients is generally provided during aeromedical evacuation or rescue operations aboard helicopters, propeller aircraft, or jet aircraft. On board a rescue aircraft, is a flight nurse, accompanied by flight medics and respiratory practitioners, as well as the option of a flight physician for comprehensive emergency and critical transport teams. The inclusion of a flight physician is more common in pediatric and neonatal transport teams. A critical care flight nurse must be able to deal with all age groups with broad critical emergencies. With no physicians on site, the nurses scope of practice is expanded. The critical care experience is transferred over to a flight nurse with impacting factors such as altitude and changes in pressure, gravitational forces, and weather. Some patients may experience exacerbations because of factors related to the cabin environment, including hypoxia, limited mobility, gas expansion, and the risk of injury related to turbulence. Resources for definitive care are limited. Aeromedical evacuation crews coordinate with other organizations to plan for the safe and timely care and evacuation of patients. Crews must be prepared for patients with trauma and mental health illnesses.
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
Emergency medical services in Australia are provided by state ambulance services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia and the Northern Territory.
The following outline is provided as an overview of and topical guide to emergency medicine:
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 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.
Air medical services are the use of aircraft, including both fixed-wing aircraft and helicopters to provide various kinds of medical care, especially prehospital, emergency and critical care to patients during aeromedical evacuation and rescue operations.
GoodSAM is a global emergency and volunteer service platform and associated community co-founded by Mark Wilson OBE, Ali Ghorbangholi OBE and Ali Haddad in 2013. It is used by ambulance, police, fire, government, charity and health services to improve immediate emergency management, largely through video enabling Instant-On-Scene video assessment and from the platform's ability to alert trusted responders to provide immediate help. It is also the platform used to deploy nearly 800,000 NHS Volunteers across the UK to support those isolating or suffering with Covid
Emergency medical services in Russia is a type of medical assistance provided to citizens in cases of accident, illnesses, injuries, poisonings, and other conditions requiring urgent medical intervention. These services are typically provided by a city or regional government, public emergency hospital, or the Disaster Medical Service. The emergency number for dialing an ambulance in Russia is 03 or the generic European 112.