The Color of Safety

The Color of Safety • Emergency Codes • Schuylkill Medical Center • South Jackson Street

Categories and Colors

CodeRED- Fire STAFF RESPONSIBILITIES: R - RESCUE/REMOVE- PATIENTS/VISITORS/STAFF FROM IMMEDIATE DANGER A - ALARM- SOUND THE NEAREST PULL STATION, PHONE SWITCHBOARD x6200 C - CONFINE/CONTAIN-CLOSE ALL DOORS AND WINDOWS E - EXTINGUISH OR EVACUATE EXTINGUISH FIRE IF POSSIBLE- IF UNABLE- CONTAIN IT AND EVACUATE Remember PASS when using fire extinguishers- P – PULL A – AIM S – SQUEEZE S - SWEEP MOVE PEOPLE TO CLOSEST AREA OF SAFE REFUGE. (HORIZONTAL WHENEVER POSSIBLE, VERTICAL IF NECESSARY)

CodeRED– Fire (continued) Work areas, corridors, walkways, stairways, and equipment should be kept clear of loose materials, trash, scraps, etc. Never block corridors, fire exits, emergency equipment, alarm pull stations, or fire extinguishers with equipment or materials. Storage is not allowed in corridors and stairwells. A cluttered hallway could slow down emergency evacuation. Storage must not be within 18 inches below sprinkler heads or smoke detectors. Storage that breaks this plane may prevent sprinkler heads from fully covering a room during a fire. Don’t use unapproved electrical devices- three-prong plug adapters and heaters are not permitted. Avoid improper uses of power strips. Do Not wedge or block open doors. EVACUATION IN THE EVENT OF A FIRE When evacuating patients, those who are in immediate danger need to be evacuated first. Patients not in immediate danger should be evacuated in this order: - Ambulatory patient & visitors. - Semi-ambulatory patients. - Bed bound patients.

Code BLUE – Cardiopulmonary Arrest STAFF RESPONSIBILITIES: • CONTACT SWITCHBOARD AT x6200 AND STATE SLOWLY AND DISTINCTLY: • CODE BLUE • PATIENT UNIT • PATIENT ROOM NUMBER • THE CARDIOPULMONARY RESUSCITATION (CPR) PLAN SHALL BE ACTIVATED BY THE PERSON FINDING AN UNCONSCIOUS, BREATHLESS, PULSLESS VICTIM PRIOR TO BEGINNING RESUSCITATIVE MEASURES OR BE THE SECOND PERSON WHILE THE FIRST BEGINS BASIC LIFE SUPPORT MEASURES.

CodeORANGE – Combative Person • IF YOU ARE INVOLVED IN A DANGEROUS/VIOLENT SITUATION OR WITNESS A DANGEROUS/VIOLENT SITUATION, CALL OUT: • “CODE ORANGE” • YOU OR A CO-WORKER SHOULD CALL SWITCHBOARD AT x6200 AND STATE SLOWLY AND DISTINCTLY: • CODE ORANGE • PATIENT UNIT OR AREA • PATIENT ROOM NUMBER (IF APPLICABLE) IF THE PERSON HAS A WEAPON, “CODE SILVER” SHOULD BE CALLED.

Code GRAY – Missing Adult Code Gray is the designation to be used to denote an emergency situation involving a missing adult 18 years of age or older. A Code Gray should be called for: - A missing person (patient or visitor) who is operating in a diminished capacity (Alzheimer's patient) - A patient who has been committed to the hospital under the Mental Health Act, who has eloped or is missing. Code Gray is not to be used for patients who have a legal right to terminate their own treatment and who do not wait to sign “Against Medical Advice” paperwork. To call a “Code Gray”- - Call Switchboard at x6200 and state “Code Gray” - State Department or unit and give a full description of the missing person to include sex, height, weight, and clothing they were wearing. Upon hearing a “Code Gray”, staff should immediately institute their department’s response as it pertains to a “Code Gray”. The Security Department should be notified if the individual is located or of any other suspicious activity.

Code CRIMSON – Obstetrical Emergency Code Crimson is the designation to be used to denote an obstetrical emergency situation. It will primarily be utilized for an obstetrical emergency situation in Labor and Delivery, Postpartum, and Emergency Department, but it is not limited to these areas. STAFF RESPONSIBILITIES: CONTACT SWITCHBOARD AT x6200 STATE “CODE CRIMSON” AND AREA OR UNIT INVOLVED. INSTITUTE YOUR DEPARTMENT’S RESPONSE AS DIRECTED IN THE POLICY.

Code LOCK – Facility Lockdown A lockdown may be ordered to prevent a threat (violent person, biological, chemical or nuclear agents) from entering the facility, or to prevent personnel from exiting the facility in the event a hazard exists outside of the facility. The lockdown system at the Medical Center consists of two levels of security: ED LOCKDOWN: The lockdown is activated in the Emergency Department, and affects ED access doors only. FACILITY LOCKDOWN: The lockdown is activated by security and affects the entire Medical Center exterior access doors. PROCEDURE: 1. Authorization for activation can be given by the Administration, Nursing Supervisor or Incident Commander. “Code Lock” will be announced three times. 2. The primary responsibility of staff is to protect the safety of patients, visitors and themselves. Evacuation of an area, taking cover behind solid objects, moving away from windows or doors or other steps may need to be taken depending upon the reason for the lock down and perceived threat. 3. The Incident Commander will direct staff as to the appropriate response to the lockdown situation.

CodeYELLOW – Chemical/Radiation Event Code Yellow denotes a hazardous material event requiring the activation of the decontamination team and other response personnel. When the Medical Center is notified of an event involving biological, chemical or radiation occurrence, the administrator or their designee will initiate one of the following Code Yellow conditions: “Code Yellow, Condition R” (Radiation event) “Code Yellow, Condition B” (Biological event) “Code Yellow, Condition C” (Chemical event) Staff members will respond according to the “Procedure for Chemical Radiation Event” located in the Health and Safety Manual. Decontamination team members will assemble and prepare the appropriate decontamination equipment as per the Incident Commander’s orders.

Code SILVER– Person with a Weapon or Hostage Situation WEAPON IN THE WORKPLACE: AN INDIVIDUAL BRANDISHING OR USING A WEAPON (FIREARM, KNIFE, OR OTHER WEAPON) IN A THREATENING MANNER. IN THE EVENT OF AN ACTIVE SHOOTER INCIDENT: • If possible, contact 911 first and provide them with as much information as possible. Next, call Switchboard at x6200 and announce “Code Silver” and location of shooter. • Close doors and secure in place. Tell patients and visitors to stay in rooms with doors closed. • Do not evacuate rooms or buildings if you are safely secured unless told to do so by Police. • If you must flee the immediate area of gunfire, run in a zigzag pattern and try to utilize any obstructions between you and the shooter. • Try to remain calm. • If you are in an open area, move away from the sound of gunfire and find a safe cover position. Try to get inside or behind a building. • Wait and listen for directions from Police. IF YOU SUSPECT A PATIENT, VISITOR, OR ANOTHER EMPLOYEE HAS A WEAPON REPORT IT TO SECURITY IMMEDIATELY.

CODE PINK – Infant or Child Missing or Abducted STAFF RESPONSIBILITIES: • NOTIFY SWITCHBOARD- x6200 • SWITCHBOARD WILL ANNOUNCE “ATTENTION- CODE PINK” WITH THE AREA INVOLVED AND A DESCRIPTION OF THE CHILD THREE TIMES • IMMEDIATELY BEGIN SEARCH OF YOUR WORK AREA • STAFF WILL MOVE TO THEIR PREDETERMINED AREA AND MONITOR ALL ENTRANCES AND EXITS • REPORT ALL SUSPICOUS ACTIVITY TO SECURITY • BE PREPARED TO DESCRIBE ANY SUSPICOUS PERSON(S) TO SECURITY • SECURITY WILL INVESTIGATE SCENE/REPORT TO LOCAL AUTHORITIES

Code BLACK – Bomb Threat STAFF RESPONSIBILITIES: ATTEMPT TO KEEP THE CALLER ON THE LINE ASK WHERE THE BOMB IS LOCATED ASK WHAT TIME IT WILL GO OFF ASK WHAT TYPE OF BOMB IT IS ASK WHAT THEIR NAME IS DOCUMENT ANYTHING SAID ON THE BOMB THREAT INFORMATION SHEET OR A PIECE OF PAPER NOTE ON THE FORM: TONE OF CALLER’S VOICE BACKGROUND NOISES IF YOU RECOGNIZE THE CALLER’S VOICE TIME THE CALLER HUNG UP CONTACT SWITCHBOARD AT x6200 AND NOTIFY THEM OF THE THREAT IMMEDIATELY BEGIN SEARCH OF YOUR WORK AREA- REPORT TO INCIDENT COMMAND WHEN COMPLETED REPORT ALL SUSPICOUS ITEMS TO SECURITY- DO NOT TOUCH THE OBJECT! BE PREPARED TO EVACUATE YOUR AREA IF NECESSARY

Code MRT- MEDICAL RESPONSE TEAM Communicate that an immediate response and assessment is needed for a patient whose medical condition is declining. This team provides additional support to the bedside nurse prior to the cessation of cardiac or respiratory function. Calling the Medical Response Team serves as a second pair of eyes and support for the patient’s nurse. If the patient’s heart or breathing stops, a CODE BLUE should be called. To call a Code MRT- CONTACT SWITCHBOARD AT x6200 STATE “CODE MRT” AND AREA OR UNIT INVOLVED. INSTITUTE YOUR DEPARTMENT’S RESPONSE AS DIRECTED IN THE POLICY.

Purpose When the code situation has been addressed or resolved, the hospital operator may page “Condition Green ” to indicate the emergency situation has ended. CONDITION GREEN

How to Call a Code South Campus- Dial 6200 on any hospital phone, Switchboard will answer-state your emergency three times- Ex.- Code Orange, Emergency Department; Code Orange, Emergency Department; Code Orange, Emergency Department. East Campus- Dial 4040 on any hospital phone, Switchboard will answer-state your emergency three times- Ex.- Code Orange, Emergency Department; Code Orange, Emergency Department; Code Orange, Emergency Department.

ABUSE SAFEGUARDING AND SURVEILLANCE POLICY All staff members are required to report actual and/or suspected patient physical abuse under the following circumstances: When an incident is observed that reasonably appears to be physical abuse When a physical injury is observed where the nature of the injury, its location on the body, or the repetition of the injury, clearly indicates that physical abuse has occurred When a staff member has been told by a patient that he or she has experienced behavior constituting physical abuse During the investigation of abuse/neglect complaints, steps will be taken according to policy to assure the safety of the patient and other patients on the unit.

ABUSE INVESTIGATION AND REPORTING POLICY A full investigation will be initiated when an allegation of abuse has been reported to determine if the allegation can be substantiated. During the investigation, both the patient and the accused perpetrator shall be protected to ensure that the investigation remains impartial and unbiased. The State Department of Human Services (and other agencies as necessary such as the Police Department, appropriate Certification and Licensing boards) shall be notified on learning of the alleged abuse or neglect.

ABUSE INVESTIGATION AND REPORTING POLICY Licensed and other certified staff that have substantiated abuse charges against them will be reported to the appropriate licensing/certification board specific to their discipline and immediately terminated according to policy. No staff member shall be prohibited from making a direct report to appropriate authorities. All staff members will maintain confidentiality regarding such incidents.

Campus Response Team The Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to provide emergency treatment to any individual who presents anywhere on the hospital campus who: Requests emergency services Or Would appear to a reasonably prudent person to be in need of medical attention

Campus Response Team The Hospital Campus is defined by the EMTALA as the 250-yard distance from the main hospital building which houses the Emergency Department.

Campus Response Team The Campus Response Team will respond to individuals needing medical assistance in any non-patient areas in and around the Medical Center such as: Lobbies ~ Hallways ~ Parking Lots ~ Sidewalks ~ Cafeteria ~ Driveways ~ Etc

Campus Response Team An Example of when to call the Campus Response Team Someone who falls on the sidewalk outside of the hospital and requests help An individual who is walking on the sidewalk near the entrance of the hospital and collapses

Campus Response Team Remember the Campus Response Team does not supersede the Code Blue or Medical Response Team (MRT) policies. The purpose of the Campus Response Team is to provide emergency treatment within 250 yards of the main hospital building

Campus Response Team Members of the Campus Response Team include: Registered nurse from the emergency department Emergency room technician from the emergency department Orderly/Nurse aide from the emergency department Security officer Nursing supervisor Responsible to lead the medical team in managing the incident

How Do I Activate the Campus Response Team? Call the switchboard to have the Campus Response Team paged overhead Remember to provide the location of the incident Team members are to respond to the incident location and determine if 911 should be called

What is the Responsibility of Team Members? Team members should: Provide life saving measures Determine if no medical treatment is required or if individuals want additional medical assistance Obtain appropriate transportation for the individual Remember staff members are not to imply that the medical center will cover the financial cost of treatment

Summary and Review Do I know the emergency code definitions? Do I know what number to dial and when it is appropriate to call each emergency code? Do I have a clear understanding of my hospital’s policy and procedures?

The Color of Safety