EMERGENCY CODES USED IN

HOSPITALS

Emergency Codes Used in Hospital Settings:

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. Hospital emergency codes have often
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.

Emergency codes and its activation dial number will varies from one institution
to another. Always follow your organizational policy and procedures for code
activation.

Purpose of emergency codes:

To provide medical care and support to patients and incident victims while
maintaining care and safety of patients, employees and visitors within a health
care facility during an emergency event or incident.

Codes used in Ministry of Health

 Code Red: Fire

 Code Blue: Medical lockdown

 Code Orange: Disaster or Mass Casualties

 Code Green: Evacuation

 Code Yellow: Missing Patient

 Code Amber: Missing or Abducted Infant or Child

 Code Black: Bomb Threat

  Code White: Aggression

 Code Brown: Hazardous Spill

 Code Grey: System Failure

 Code Pink: Pediatric Emergency and/or Obstetrical Emergency

COMMON CODES USED IN HOSPITAL :

Code Description Primary response Secondary response

Code RED External disaster like Dial Code number Personal protection
(As per your
1. Accident with mass Institution ) ask coordination with
for
casualty command nucleus
activation of code
2. Natural Calamity Red continue care of
 Report to CEO/DMS
3. Epidemics

And disaster
4. Bomb blasts/terrorist existing patients
response
activities
team

A potentially life Keep the person calm.

threatening situation Call Code (As per Check pulse and

your Institution ).
requiring a response of breathing.
Code BLUE Notify response
a team of designated team. Initiate CPR if

clinicians. Usually a Get a crash Cart necessary by qualified

cardiac arrest staff

Attempt to extinguish
R-Rescue patients
the fire
A-Activate code
number(As per your
P-Pull the pin
Institution )
Fire, smoke or order of
Code
A-Aim the nozzle at
BROWN(Fire) C- Contain the fire
something burning
base of fire
E-Extinguish or
evacuate
S-Squeeze the handle
the area
S- Sweep from side to side

Code YELLOW Medical Emergency Call code (As per Inform the treating
your Institution )
Poly Trauma : a Response physician.

situation that may Team Initiate appropriate

predispose to patient’s treatment urgently

 clinical deterioration and

medical emergency

other than cardiac arrest

Call Code : (As per

Internal disaster like Personal protection.
your Institution )
1. Building collapse Coordinate with
Ask for activation of
the
Code GRAY 2. Ceiling collapse disaster response team.

code and initiate

3. Internal pipeline Take care of staff and
Disaster
burst etc. patient safety
response team

Monitor & seal all

exits for anyone

Call code (As per attempting to leave

your Institution )
the hospital premises
An infant/child is Inform the child’s
name and (Infant/Child Abduction –
missing or is known to Consider using Code Pink
Code PINK looks and mention with an accompanying
have been location number to differentiate age
of the abducted infant / child
abducted/kidnapped carry out (e.g., Code Pink 3 ± a three
accountability year old). This helps staff
adjust to looking for a toddle
check versus an infant that may be
concealed in a bag or
suitcase).

Code PURPLE Patient is missing from Call code (As per Monitor the location.
your Institution ).
 Inform about the
patient’s

looks and location

Close all exits of
of
the ward unit
hospital premises
missing carry out all

accountability
checks

Call code (As per

Security Threat. your Institution ) Secure the area, staff

Verbal and Physical Protect/defend and patient’s from

Code GOLD yourself.
escalation situation violence. Attempt to
Call security inform
work place violence mitigate in peace
authority

Call (As per your

Institution ) Assist those who
Hazardous spill which is
Secure the area, have been
likely to cause unknown use PPE
contaminated. Take
HAZMAT effects, injury, illness or and go eye wash
area. them to staff clinic if
harm to the
Don’t allow people not so severe or
environment to step
emergency if severe
in the area
Hazmat Stickers:

Code Red:

Code Red should be immediately initiated whenever any one of the following
indications are observed:
1. Seeing smoke, sparks or a fire.
2. Smelling smoke or other burning material.
3. Feeling unusual heat on a wall, door or other surface.
4. In response to any fire/life safety system alarm.

Procedure:

Upon discovery of fire (suspected or actual)

1. At origin:
R.A.C.E.
Rescue patients, visitors and personnel from the immediate fire area.
Consider removing patients and staff from the adjoining rooms/floors.
Disconnect exposed oxygen lines from wall outlets.
Activate the fire alarm and notify others in the affected area to obtain
assistance. Follow your organization’s emergency reporting instructions.
Contain the fire and smoke by closing all doors
Extinguish the fire if it is safe to do so.

P.A.S.S. – Fire extinguishing techniques:

Pull the pin
Aim the nozzle of the extinguisher at the base of the fire
Squeeze the trigger
Sweep the extinguisher’s contents from side to side
Away from origin:
a. Listen to overhead paging system.
b. Prepare to assist, as needed. Do not automatically evacuate unless there is
an immediate threat to life. Wait for instructions.
c. Nursing personnel are to return to their assigned units.

CODE PINK: INFANT ABDUCTION:

Each institution should define the classification between Code Pink and Code
Purple. Some institution choose to define by age (e.g. Code Pink for infants up to
six months of age, and Code Purple for infants/children from six months to 13
years of age), by location of abduction (e.g., newborn nursery versus pediatrics
unit), or by some other characteristic (e.g., Code Pink for babies that cannot
walk and Code Purple for any child that is able to walk). The policy and
procedures for emergency codes should be understood by all staffs in the
hospital.

Typical Abductor: The following are characteristics of a typical abductor as

identified by the National Center for Missing and Exploited Children (NCMEC).
However, there is no guarantee an infant abductor will fit this description and
anyone acting suspicious in areas of risk for abductions should be reported
immediately.
• Female of “childbearing” age (range from 12-50), often overweight.
• Most likely compulsive; most often relies on manipulation, lying, and deception.
• Frequently indicates that she has lost a baby or is incapable of having one.
• Often married or cohabitating; companion’s desire for a child or the abductor’s
desire to provide her companion with “his” child may be the motivation for the
abduction.
• Usually lives in the community where the abduction takes place.
• Frequently initially visits the nursery and maternity units at more than one
healthcare facility prior to the abduction; asks detailed questions about
procedures and the maternity floor layout; frequently uses a fire exit stairwell for
escape; and may also try to abduct from the home setting.
• Usually plans the abduction, but does not necessarily target a specific infant;
frequently seizes on any opportunity present.
• Frequently impersonates a nurse or other allied healthcare personnel.
• Often becomes familiar with healthcare staff, staff work routines, and the
victim’s parents.
• Demonstrates a capability to provide “good” care to the baby once the
abduction occurs.
• May remove the newborn as follows: carrying the infant, carrying a bag large
enough to hold an infant, covering the infant with coat/baby blanket, or may be in
healthcare uniform/scrubs carrying the infant.
CODE GRAY: COMBATIVE PERSON:

Aggressive, combative or abusive behavior can be displayed by anyone; a

patient, a patient’s family member, staff, staff family members, or acquaintances
of employees and patients. Aggressive, combative or abusive behavior can
escalate into a more violent episode.

Recognizing early warning signs:

No single sign alone should cause concern, but a combination of any of the
following signs should be cause for concern and action.
• Direct or verbal threats of harm.
• Intimidation of others by words and or actions.
• Refusing to follow policies.
• Carrying a concealed weapon or flashing a weapon to test reactions.
• Hypersensitivity or extreme suspiciousness.
• Extreme moral righteousness.
• Inability to take criticism regarding job performance.
• Holding a grudge, especially against a supervisor.
• Often verbalizing hopes that something will happen to the other person
against whom the individual has the grudge.
• Expression of extreme desperation over recent problems.
• Intentional disregard for the safety of others.
• Destruction of property.

RESPONSE TO CODE GRAY:

a. Verbal Abuse – Personnel should provide assistance to the victim(s).

• Assist in attempts to verbally de-escalate the assailant.
• Call in a second person to take over.
• Add distance/barriers between victim and assailant.
b. Physical Battery – Prepare to provide assistance to the victim(s) by:
• Protecting self and others by assisting victim to stop/deflect blows by
the assailant.
• Creating a diversion by putting distance/barrier between victim and
assailant.
• Getting medical assistance if needed.
c. Assault with a weapon – Refer to Code Silver: Person with a weapon /hostage
situation policy.

CODE SILVER: A PERSON WITH A WEAPON AND OR HOSTAGE SITUATION:

To provide an appropriate response in the event of an incident involving a person

with a weapon or who has taken hostages within the facility (including an active
shooter incident).