2009 STANDARDIZED HOSPITAL OVERHEAD EMERGENCY CODES

Recommendations and Guidance for Policy or Operating Procedure Modification

Prepared by the Florida Society for Healthcare Security, Safety & Emergency Management Professionals

Acknowledgements
The Florida Society for Healthcare Security, Safety & Emergency Management Professionals would like to thank the following organizations for their assistance in the preparation of these recommendations and guidelines:
Florida Hospital Association South Florida Hospital and Healthcare Association Florida Organization of Nurse Executives Florida Society for Healthcare Risk Management and Patient Safety International Association for Healthcare Security and Safety Florida Healthcare Engineering Association

Executive Summary
Background
2002:
A survey of hospitals' emergency codes illustrated the lack of uniformity existing among hospitals and allied healthcare organizations in Florida. Florida Society for Health Security and Safety Professionals (FSHSS), representing over 100 hospitals and health care systems in Florida, recommended a standardized Emergency Code system for hospitals.

Executive Summary

2003:
A working group of healthcare security and safety professionals selected and recommended code identifiers for use in Florida hospitals and other healthcare organizations.

RED - Fire BLUE Cardiac / Respiratory Arrest PINK Infant / Child Abduction BLACK - Bomb ORANGE - Hazmat / Bioterrorism

GREY - Violence/Security Alert WHITE - Hostage YELLOW - Lockdown GREEN - Mass Casualty / Disaster BROWN - Severe Weather

Executive Summary
While the main colors were constant, flexibility was built into the system for individual hospital needs. The goal is to have a common set of base colors allowing for customization.

Executive Summary
Five years have passed since the development of the 2003 Standardized Hospital Emergency Code for the State of Florida. A 2008 Working Group: examined current standard codes being used by Florida and other states hospitals and healthcare systems; assessed the need for additional changes promoting uniformity; and, cross-walked the information with related healthcare associations and groups.

Executive Summary
NOTE: The Working Group combined colors, code number and specific language to an all color system. This system acknowledges that healthcare workers routinely work at more than one healthcare entity but may be required to remember and respond to different codes. Standardizing codes supports employees at all Florida healthcare entities.

2009 Recommendations

Code Black
Bomb Threat
The majority of hospitals are using Code Black as the designation for a bomb threat.

Code Green
Disaster Plan Activation
Code Green was selected because green means go! A disaster plan needs to be activated quickly for effective response.

Code Red
Fire
Code Red is a national standard recommended by the Hospital Fire Marshalls Association and its membership.

Code Orange
Hazardous Materials
There was consensus for the use of Code Orange indicating a hazardous material incident. Not just for the activation of the decontamination team but other incidents involving hazardous materials.

Code Blue
Medical Emergency
A majority of healthcare entities are using Code Blue for cardiac and/or respiratory arrest.

Code Blue 13
Medical Emergency
Code Blue 13 is used in some counties to denote that the Code Blue is for a pediatric code.

Code Pink
Infant / Child Abduction
Code Pink is also used by many organizations to inform employees regarding an abduction attempt.

Code Pink
Infant / Child Abduction
Please consider adding Code Pink with an age to differentiate between a infant and pediatric patient.
Example: Code Pink 2 is a two year old this helps staff adjust to looking for a toddler vs. an infant that may be concealed in a bag or suitcase.

Code Pink
Infant / Child Abduction
The National Center for Missing and Exploited Children has issued Volume 9 of the Healthcare Guidelines. This is the first update since 2005.

Code Silver
Active Shooter
Code Silver is a new code added as hospitals are starting to experience more of these events on their campuses.

Code Silver
This code is similar to the Silver Alert for a missing elderly individual in the community. Why was the same color code used?
Healthcare is a unique environment; Theres a national consensus among hospital codes; It is intended to be used in hospitals primarily to inform healthcare workers about a potential situation not the public.

Code White
Hostage Situation
Question: Is this emergency code the same as a Code Silver? Answer: No!

Code White
An active shooter is "... an armed person who has used deadly physical force on other persons and continues to do so while having unrestricted access to additional victims.
Active shooters have caused a paradigm shift in law enforcement training and tactics, especially as these persons do not necessarily expect to escape or even survive these situations.

A hostage is a person or entity which is held by a captor.

Additional Information
U.S. Department of Justice (DOJ): http://www.usdoj.gov DOJ, Office of Juvenile Justice and Delinquency Prevention: http://ojjdp.ncjrs.org/ Hospital Fire Marshalls Association, Inc.: http://hfma.tripod.com/ National Center for Missing and Exploited Children: http://www.missingkids.com International Association for Healthcare Security & Safety: http://www.iahss.org South Florida Hospital and Healthcare Association: http://www.sfhha.org

Additional Information
Florida Organization of Nurse Executives: http://www.fonexo.com/ Florida Healthcare Engineering Association: http://www.fhea.org/ Association of Womens Health, Obstetric and Neonatal Nurses: http://www.awhonn.org/awhonn/ National Association of Neonatal Nurses: http://www.nann.org/ The Academy of Neonatal Nursing: http://www.academyonline.org/ Florida Hospital Association: http://www.fha.org Florida Department of Law Enforcement (Silver Alerts): http://www.fdle.state.fl.us/Content/getdoc/f7d5482a-571a445a-84b2-f1a1a01f599d/Silver-Alerts.aspx

Questions & Answers

For further information contact:
John Wilgis, MBA, RRT Director, Emergency Management Services Florida Hospital Association 407-841-6230 john@fha.org

Thank you!