In Case of Emergency. At Met, Western, and Malden Park, any staff member can notify switchboard of an emergency code by dialing: 3333

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1 Emergency Codes INCIDENT NAME RATIONALE FOR COLOUR Fire Code Red Colour of fire Cardiac Arrest Code Blue Cardiac victim is often cyanotic / blue Internal Evacuation Code Green Green (light) means go Missing Patient Code Yellow Bomb Threat or Search Code Black Colour of charred material after an explosion Violent Person Code White White is the colour of restraints Chemical Spill Code Brown The colour of chemical spill Neo-Natal Arrest Code Pink A resuscitated baby pinks up External Disaster Code Orange Colour of ambulance bringing victims In Case of Emergency At Met, Western, and Malden Park, any staff member can notify switchboard of an emergency code by dialing: 3333 When this happens, the appropriate Code personnel will respond. Please state the Code, Campus, and specific location. At all other WRH sites like Regional Children s Centre, and off-site programs, (e.g., Withdrawal Management Service, Residential Rehabilitation) any staff member can access emergency assistance by dialing: 911 Emergency Codes On-Line The most up to date codes policies can be found via the Policy Library on the WRH Intranet. Emergency Codes Kits Located on each unit, the Emergency Code Kit contains important information and/or supplies that may be needed in the case of an emergency.

2 Code Red R A C E ESCUE/REMOVE Remove Person(s) from immediate area (if necessary) Re-assure patients / visitors in area Elevators do not work at this time LARM/ASSESS Pull the nearest fire alarm Remain calm Call switchboard (x. 3333) Met / Western Dial 911 at all other sites ONFINE Close all doors and windows, etc. Call switchboard (x. 3333) Met / Western Dial 911 at all other sites XTINGUISH/EVACUATE Fight fire if possible using the appropriate extinguisher Code Green code for internal evacuation May involve horizontal or vertical evacuation Fire Extinguishers Class A fires include normal combustibles such as paper, wood and plastic. A type A fire extinguisher is silver in colour and contains water. Class B fires include flammable liquids such as gasoline, alcohol, grease, etc. Class C fires involve electrical equipment, machinery, etc. that have caught on fire. Type BC fire extinguishers contain carbon dioxide and can be used for Class B and C fires. Type ABC fire extinguishers contain a dry chemical or halon and can be used for all types of fires. Steps in operating a fire extinguisher: PULL AIM SQUEEZE SWEEP Reminder: If away from your unit/department (ie., Cafeteria) and a Code Red is called in your area, use the stairway to return to the area, if safe to do so

3 Level 1: Department Response Spill is small in volume Spill can be cleaned up with water or disinfectant Can be handled by department/unit staff Poses no threat of irritation Housekeeping can be contacted for assistance, if necessary DO NOT CALL A CODE BROWN Code Brown Chemical Spill Level 2: Code Brown Team Response Spill is generally larger in volume Spill is hazardous or unidentifiable Spill requires special clean up procedures Cannot be handled by department/unit staff May require evacuation of the immediate spill/release area CALL A CODE BROWN LEVEL II Level 3: External Response Spill is considered a health, fire, and/or environmental hazard Safe clean up requires respiratory equipment to be worn Requires evacuation beyond the immediate spill area CALL A CODE BROWN LEVEL III FIRE DEPARTMENT WILL BE CALLED Code Brown Response Team: MRP/Dept. Mgr, Housekeeping Supervisor, Facilities, Security Code Black Bomb Threat Search Protocol General Staff Search Although police are called, the hospital is responsible for the actual search Using the Departmental Floor Plan (located in the Emergency Codes Kit), staff search their own area for anything suspicious Searched areas will be checked off using a highlighter Public areas (i.e. washrooms, cafeteria, etc.) should be checked first Forward completed search grid to the site s Administration Suite Team Search Security and Facilities conduct a thorough search of the premises Using hospital floor plans, searched areas are checked off using a highlighter Reminder: If you see something suspicious, DO NOT: Touch, move, or open it Activate light switches or slam doors Use pagers or two-way radios Code White Violent Person Call a Code White when you witness or are involved with any individual who is not responding to deescalation intervention and is: 1. Threatening, harassing, or being verbally abusive to another individual 2. Attempting to harm themselves or others 3. Attempting to destroy property 4. Displaying threatening behaviour that is escalating 5. Refusing to leave hospital property when requested NOTE: Your first priority in a Code White should be to remove yourselves and others from immediate danger

4 Code Yellow Missing Patient/Client/Resident Level I Search by Security and Unit Staff MRP will assess potential risk MRP calls switchboard 3333 with patient info A full description of the individual will be distributed through the voic system Security and staff from the affected area search all general areas An unusual occurrence report must be completed and submitted regardless if the patient is found Level II In-depth search by ALL staff All general areas will be fully searched by Security and Facilities All staff will conduct a thorough search of their areas using the departmental search grids (located in the Emergency Codes Kit) Search coordination site will be set up in the Administration Suite of the site Searched areas will be checked off on the grid and forwarded to the Search Coordination site Provide Switchboard with a description of the alleged abductor and infant/child Attend to doors with Security Code Yellow Missing Infant/Child General Roles and Responsibilities MRP Security General Staff Notifies the Police Initiates search of the entire facility Notifies guards and parking attendants Immediately search entire unit/area Using search grids, conduct a complete search of the working area Report any suspicious activity to Security Code Blue Medical Emergency in Adult or Child Rescuer # 1 Duties (First Person on the scene) Rescuer # 2 (Second Person on the scene) Determine need for medical attention and/or Respond to the call for help unresponsiveness Bring any emergency equipment available to the Confirm wishes of the victim location of the Code Call for assistance e.g. Help, Code Blue Confirm that the Code has been called Dial switchboard using 3333 Ensure that other patients/people close by, are Check the time and start CPR, if necessary safe and taken care of Remain at the site to assist If necessary, assist Rescuer # 1 with CPR Remain at site to assist Code Blue Team: ED Physician, RNs from ICU/CCU/Cardiology, RRT, 1 st /2 nd Person on scene Met/Western Campus: Code Blue Team will respond and bring crash cart. WRCC: WRCC Staff bring crash cart to site of Code Blue MPCCC/RCC/Off-Site: Notify EMS (911) Outside Building (but on Hospital Property): Dial Switchboard will initiate call to EMS and announcement will be made overhead.

5 Code Blue Met Campus Only: To activate the Code Team Response, utilize the CODE BUTTON. Switchboard will automatically be notified and will announce overhead, an audible alarm will sound on the nursing unit, Emergency lights will illuminate outside the room and the room will be displayed on the Nursing Station monitor. In Paediatrics, Code Blue Paed will be announced. In the NICU, Code Pink will be announced. If the Code Button is activated in error (or the Code is something other than a Code Blue), is the responsibility of staff to notify Switchboard ( ) regarding the correction/change of code Code Pink Medical Emergency in an Infant (<1 month) Rescuer # 1 Rescuer # 2 Rescuer # 3 Dial 3333 and call a Code Pink (Call a Code Blue at Western Campus) Bring equipment to the scene Assist rescuer # 1 with CPR Remain at the site to assist Identify a medical emergency Call for assistance e.g. Help, Code Pink Check the time and begin CPR Remain at the site to assist Confirm that Code Pink has been called (Code Blue at Western) and help is on the way Assist Rescuer # 1 and # 2 with resuscitation Code Pink Team: ED Physician, Neonatologist, RRT, 2 NICU staff, 1 st /2 nd Person on scene Met Campus: Code Pink Team will respond Western Campus: There is no Code Pink Team at the Western Campus call a Code Blue WRCC: Code Pink Team will respond. Directions to Code provided by WRCC Staff MPCCC/RCC/Off-Site: Notify EMS (9-1-1) Code Green Internal Evacuation Level 1 Horizontal Evacuation All persons in a zone/wing are moved beyond a corridor fire separation door to an adjacent area on the same floor Only affected area will move at this point Level II Vertical Evacuation All persons on the affected floor are moved two floors down First and ground floors are moved out of the building Level III Total / Premises Evacuation All persons are moved from the affected building outside or to another building Determined by Fire Dept, CEO, or Medical Officer of Health Note: When clearing rooms during an evacuation, a piece of green tape is placed across the door jam to indicate that a room has been checked and is clear.

6 Code Orange Disaster in the Community Code Code Orange Advisory Code Orange Alert Code Orange Confirmed Level I Code Orange Confirmed Level II Code Orange Confirmed Level III Code Orange Downgraded Follow up will continue Code Orange - Decontam Description Conditions are present which increase the possibility that a disaster could occur in the community (i.e. terrorist threat) Wear ID Badge Hospital has been notified that a disaster has occurred in the community No casualties are arriving yet Each unit completes Code Orange Disaster Inventory Checklist Hospital is receiving LESS than 4 major casualties Departments immediately affected will be involved Hospital is receiving MORE than 4 major casualties Hospital is receiving MANY MORE than 4 casualties with complex injuries All normal hospital routines are disrupted Hospital is no longer receiving casualties Staff continue to care for current casualties Complete Code Orange Operations Report Return to department as indicated by RP in designated area Indicates a chemical, biological, or radioactive disaster May require lockdown and decontamination procedures