Student Orientation Centre for Education Modified September 2017 Emergency Codes Student Orientation Centre for Education Modified September 2017

Learning Objectives At the end of this module, students should be able to: Have a basic understanding of our 11 emergency codes. Know where to get further information regarding codes. Know how to call a code.

Emergency Codes Each code has a policy which indicates the type of emergency, who responds, roles of various staff, and processes that need to be followed. Codes are used to activate processes in a timely manner to deal with the Emergency. Each code has a specific team that is dispatched to help manage the situation. Codes are represented by a colour.

Resources Every unit or department has an Emergency Response Manual. Information on Emergency Preparedness activities and Codes can also be found under the “Emergency Preparedness” link on the NYGH Intranet home page as well as under “By-Laws, Policies & Procedures/Emergency Preparedness Manual” (Chapter XIII)

Emergency Response Codes Code Pink Impending or Actual Cardiac Arrest - child Code Blue Impending or Actual Cardiac Arrest - Adult

Seniors’ Health Centre Dial 14-5555 How to call a code: General site Dial 5555 Seniors’ Health Centre Dial 14-5555 Know which code you are calling – which colour. Know the location of the code

Branson site: How to call a fire, cardiac arrest, hostage taking, person with a weapon or bomb threat Person who identifies the emergency will: In case of fire, activate the fire alarm All codes above, call 911 and follow directions from 911 operator All codes above, call Security by dialing 2222 on a North York General Hospital phone In case of fire, follow REACT: R Remove those in immediate danger E Ensure doors are closed A Activate the fire alarm C Call 2222 to give exact location and nature of fire and call 911 T Try to extinguish the fire

Branson site: violent patient, facility emergency, missing person/child The person who identifies the emergency will: Call security by dialing 2222 on a North York General Hospital phone.

Impending or actual respiratory and/or cardiac arrest Code Blue: 18 years of age and over Code Pink-Adolescent: 13 to 17 years of age Code Pink: newborn or child up to the age of 12 years (to the 13th birthday)

CODE RED Code Red – A situation in which the fire alarm system has been triggered into alarm. Code Red “All Clear” – Announced overhead when all areas are able to resume normal duties. Code Red “In Effect” – Announcement made by telecommunications to alert staff that the facility remains in a Code Red Alert. All areas are required to: Implement their area specific Code Red procedures and their relevant contingency plans. Prepare for evacuation in the event Code Green is announced.

Fire Alarm System North York General Site, Branson Site and Seniors Health Care Center are equipped with 2 stage fire alarm systems. 4000 Leslie is equipped with a single stage fire alarm system. If you hear the fire alarm in this building you must evacuate immediately. Never assume that the alarm sounding is “just a drill” or a “false alarm”.

What are the different sounds of our Fire Alarm… First Stage – alert stage The first stage sounds at 20 beats per minute and will be accompanied by an overhead page; “CODE RED”…. “location”. Second Stage – evacuation stage The second stage fire alarm sounds at 120 beats per minute and will be accompanied by an overhead page with evacuation instructions.

What to do if you discover fire…

What to do if the alarm is NOT in your area… Remain where you are to await further instruction over the emergency paging system. If in transit and close to your department, return promptly and listen for updated announcements. Traffic is to be kept to a minimum but any traffic necessary must be kept to the right hand side of the hallways and staircases. Turn on all lights, close all doors, to keep smoke confined to the fire area and out of the halls.

Code Green - CODE GREEN – Horizontal Evacuation -horizontal move to an adjacent fire zone. CODE GREEN – Vertical - evacuation of staff, patients and visitors down stairs.

Remove people in immediate danger first. Order of Evacuation… Remove people in immediate danger first. Remove the easiest patients and visitors. Ambulatory. Wheelchair. Non-Ambulatory. Resistive or patients in intensive care.

Code Yellow Code Amber CODE YELLOW: inpatient/resident or outpatient who cannot be accounted for. CODE AMBER: infants and children up to the age of 18 that cannot be accounted for.

Roles and Responsibilities Inform your Preceptor/Clinical Instructor/Charge Personnel Call a code and provide assistance as required If you first identified a Code Yellow you will need to complete a SLIP (on-line) within 48 hours. If you are injured, you must be seen in Occupational Health and Safety or in the Emergency Department and complete a SLIP (on-line) within 48 hours.

SLIP (Safety Learning Incident Process) A process developed to report Good Catches and Incidents in a timely manner. Upon submission of a SLIP, a summary will be sent to the appropriate manager(s) for prompt follow-up. An On-line form is available under Quick Links on the Intranet page. Reports can be submitted anonymously except if reporting a personal injury.

Code White A term used to alert staff when a violent or potentially violent patient who is unmanageable by any other means presents a danger to self or to others. This does not include a hostage situation or where a weapon is involved (Refer to Code Purple).

Non-Patient Violence Incident – What to do? If non-patient (person who is not considered a patient/resident/or client ) General or Branson notify Telecommunications at 5555 to request STAT Security and indicate exact location Seniors’ Health Centre notify Telecommunications at 14-5555 to request STAT Security call Police 9 -911

Post Event Documentation Person who first identifies a Code White will complete a SLIP electronically within 24 hours. If you are injured, you must be seen in Occupational Health or in the Emergency Department. A SLIP regarding the injury needs to be completed within 24 hours.

Code Purple - Your Role: Ensure your safety. Ensure that a staff member is aware of the situation. Notify security x 4444 (General), x 2222 (Branson), X 14-4444 Seniors Health Centre. There will not be an overhead page. Call 911 and provide necessary information

Code Grey - An infrastructure essential systems failure such as: Loss of electrical power, normal or emergency Internal Flood External air exclusion Loss of domestic water Loss or leak of natural gas Loss of steam, heating Loss of medical gas systems(s) OR the implementation of intervention measure (i.e. air exclusion) that constitute a health or safety risk to patients, visitors, staff, volunteers, students and physicians.

Code Black The person that receives notification of a bomb threat by telephone will: A) Remain calm B) Treat the call seriously C) Speak in a normal voice D) Not interrupt the caller E) Take notes F) Observe the telephone display (if available) and note the number calling you or any other information on the display G) Attempt to ask questions and prolong the conversation. Try to get information about whom or what the threat is directed against H) Whenever possible, alert a staff member to contact Security STAT to respond to your location

Bomb threat by mail/fax or email If letter or parcel Handle the item as little as possible. Do not allow anyone else to touch it in order to preserve fingerprints or other evidence. Notify Security at the General Site or 4000 Leslie or Branson at 5555, SHC at 14-5555. Isolate the area and prevent anyone from entering the area. If by email Don’t delete the email. Notify Security as above.

Bomb Threat By Personal Contact Remain calm Note characteristics of informant Take the threat seriously and conduct self in a manner similar to being taken as a hostage (refer to Code Purple) Gather as much information as possible about the individual and the nature of the bomb If possible notify Security at the General Site or 4000 Leslie at 5555, SHC at 14-5555 and the Branson Site at 5555 When possible, document all information on the Bomb Threat Information Checklist Form(Appendix “A”) and take the completed checklist in person to the Incident Manager in the Emergency Operation Centre Not leave the facility until authorized to do so

Code Brown The term used to alert staff to an unmanageable accidental release of a hazardous or potentially hazardous substance or gas. Manageable spill: the release of material, which can be contained, cleaned up and disposed of using standard housekeeping procedures (little to no risk) Unmanageable spill: the release of material which, identified by the worker discovering the spill, cannot be immediately identified (clear or immediate hazard)

Upon discovering a spill… Notify a staff member. Responsibilities of staff: S- safely evacuate everyone from the immediate area and secure area P- prevent the spread of fumes by closing doors I- Initiate appropriate spill procedure L- leave all electrical equipment alone. Do not turn on or off L- locate any information regarding the chemical, if possible, and act accordingly Call Code Brown.

Post Event Documentation Person who first identifies a Code Brown will complete a SLIP electronically within 48 hours Any injured students should go to the occupational health department or emergency for treatment immediately and complete a SLIP within 24 hrs.

CODE ORANGE Alerts all staff in hospital that NYGH has been notified of an external disaster that has/may result in mass casualties Hospital operations will increase availability of staff and beds to manage number of casualties Command Centre will be established as needed that will provide support to families of casualties of external disaster

Code Orange CBRN CBRN is an acronym for Chemical, Biological, Radiological & Nuclear event. A select number of clinical and non-clinical staff at NYGH are especially trained to manage actual and potential CBRN events. CBRN equipment used for screening and decontamination of casualties stored adjacent to the point of entry (Emergency Department).

Your response in an emergency situation could save someone’s life! Remember… Please BE PREPARED! Your response in an emergency situation could save someone’s life!