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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 British Columbia, 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


Code Description Primary response Secondary response Follow up
Code RED External disaster like

1. Accident with mass


2. Natural Calamity

3. Epidemics

4. Bomb blasts/terrorist


Dial  Code number (As per your Institution ) ask for

activation of code Red

Report to CEO/DMS

And disaster response


Personal protection

coordination with

command nucleus

continue care of

existing patients

Return to normal

duties when

code is


Document as


Code BLUE A potentially life

threatening situation

requiring a response of

a team of designated

clinicians. Usually a

cardiac arrest

Call Code (As per your Institution ).

Notify response team.

Get a crash Cart

Keep the person calm.

Check pulse and


Initiate CPR if

necessary by qualified


Return to normal

duties as

directed upon

code blue all


Code BROWN(Fire) Fire, smoke or order of

something burning

R-Rescue patients

A-Activate code number(As per your Institution )

C- Contain the fire

E-Extinguish or evacuate

the area

Attempt to extinguish

the fire

P-Pull the pin

A-Aim the nozzle at

base of fire

S-Squeeze the handle

S- Sweep from side to side

Return to normal

duty after

deactivation of

code as per


Document as


Code YELLOW Medical Emergency

Poly Trauma : a

situation that may

predispose to patient’s

clinical deterioration and

medical emergency

other than cardiac arrest

Call code (As per your Institution ) Response


Inform the treating


Initiate appropriate

treatment urgently

Shift the patient

to ward.

Document as


Monitor total

code call per month

Code GRAY Internal disaster like

1. Building collapse

2. Ceiling collapse

3. Internal pipeline

burst etc.

Call Code : (As per your Institution )

Ask for activation of the

code and initiate Disaster

response team

Personal protection.

Coordinate with

disaster response team.

Take care of staff and

patient safety

Return to normal

once the code is

called off.



Code PINK An infant/child is

missing or is known to

have been


Call code (As per your Institution )

Inform the child’s name and

looks and mention location

carry out accountability


Monitor & seal all

exits for anyone

attempting to leave

the hospital premises

(Infant/Child Abduction – Consider using Code Pink with an accompanying number to differentiate age of the abducted infant / child (e.g., Code Pink 3 ± a three year old). This helps staff adjust to looking for a toddler versus an infant that may be concealed in a bag or suitcase).


Return to normal

duties once code

is called off.



Code PURPLE Patient is missing from

the ward unit

Call code (As per your Institution ).

Inform about the patient’s

looks and location of

missing carry out all

accountability checks

Monitor the location.

Close all exits of

hospital premises

Return to normal

duties once code

is called off.



Code GOLD Security Threat.

Verbal and Physical

escalation situation

work place violence

Call code (As per your Institution )

Protect/defend yourself.

Call security inform


Secure the area, staff

and patient’s from

violence. Attempt to

mitigate in peace

Return to normal

as the code is

called off.

Document as


HAZMAT Hazardous spill which is

likely to cause unknown

effects, injury, illness or

harm to the


Call (As per your Institution )

Secure the area, use PPE

and go eye wash area.

Don’t allow people to step

in the area

Assist those who

have been

contaminated. Take

them to staff clinic if

not so severe or

emergency if severe

Return to normal

duties as

directed. Prevent

future spillage.




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.


Upon discovery of fire (suspected or actual)
1. At origin:
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.


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.


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.


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
• Getting medical assistance if needed.
c. Assault with a weapon – Refer to Code Silver: Person with a weapon /hostage situation policy.


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).





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