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Hospital emergency codes

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For the Icehouse Album, see Code Blue (Icehouse album). For the Code Blue Recovery Drink,
see Code Blue Recovery Drink. For the computer virus, see Code Red (computer worm). For the
Portall Album, see Code Black (album).
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Please help improve this article by adding reliable references. Unsourced material may be challenged
and removed. (April 2010)

Hospital Emergency Codes are used in hospitals worldwide to alert staff to various emergency
situations. The use of codes is intended to convey essential information quickly and with a
minimum of misunderstanding to staff, while preventing stress or panic among visitors to the
hospital. These codes may be posted on placards throughout the hospital, or printed on
employee/staff identification badges for ready reference.

Back of a hospital ID badge showing disaster codes.

Hospital emergency codes are frequently coded by color, and the color codes denote different
events at different hospitals and are not universal.
The fact that different hospitals, even those in close proximity to one another, do not utilize a
consistent coding system leaves room for confusion in the event of an emergency or disaster.
Many physicians have privileges at more than one facility, and the expectation is that he or she
would be well versed in the emergency doctrines of each. However, it seems that without due
diligence in regular review of the codes for each hospital, it would be very possible for confusion
to ensue in the event of a code announcement. The standardization of codes, however, would
diminish the secretive "code" aspect of these announcements, thereby defeating the purpose of
using the codes.


1 Color code standardization

2 Codes by color

2.1 Code Blue

2.1.1 Cardiac arrest

2.1.2 Other meanings

2.1.3 Variations

3 Other codes

3.1 "Doctor" Codes

3.1.1 Dr. Allcome

4 Codes by emergency

4.1 Bomb threat

4.2 Child abduction/missing person

4.3 Combative person/assault

4.4 Evacuation

4.5 Fire

4.6 Internal disaster

4.7 Lockdown/limited access

4.8 Mass casualty incident

4.9 Medical emergency - resuscitation team/imminent death

4.10 Severe weather

4.11 Theft/armed robbery

4.12 Total divert

5 Pop culture references

6 External links

7 References

[edit] Color code standardization

o Australian hospitals and other buildings are covered by Australian Standard 4083
(1997) and many are in the process of changing to those standards.[1]


The various emergency preparedness services of the health regions in Alberta

have also begun to discuss standardization of their color code systems.

United States of America:


In 2000, the Hospital Association of Southern California (HASC)[2][3] determined

that a uniform code system is needed after "three persons were killed in a
shooting incident at an area medical center after the wrong emergency code was
called."[4] While codes for fire (red) and medical emergency (blue) were similar in
90% of California hospitals queried, there were 47 different codes used for infant
abduction and 61 for combative person. In light of this, HASC published a
handbook titled "Healthcare Facility Emergency Codes: A Guide for Code
Standardization" listing various codes and has strongly urged hospitals to
voluntarily implement the revised codes.

In 2003, Maryland mandated that all acute hospitals in the state have uniform

[edit] Codes by color

Note: Different codes are used in different hospitals.

[edit] Code Blue

[edit] Cardiac arrest

Generally is used to indicate a patient requiring immediate resuscitation, most often as

the result of a cardiac arrest. May also be used as a radio call to indicate that a patient en
route to the hospital requires resuscitation. "Code Blue - Adult" or " - Pediatric" are
sometimes used to provide additional information about the patient. HASC have
suggested these codes be replaced by "Code Blue" and "Code White", respectively.
This phrase was coined at Bethany Medical Center in Kansas City, Kansas.[6]

The term "code" by itself is commonly used by medical professionals as a slang term for
this type of emergency, as in "calling a code" or describing a patient as "coding".

In some hospitals, Code Blue has been changed to Code 99. For children is Code 45.[citation

[edit] Other meanings

Adult medical emergency (in contrast to Code White for pediatric medical emergency)
per Healthcare Emergency Codes (New Jersey Hospital Association).
Adult medical emergency in Australia (for instance, VT/VF, fall is GCS 3, bradycardia,
accelerated HTN).
Tornado warning - patients moved to interior corridors, staff and visitors seek shelter
immediately (William Beaumont Hospitals, Royal Oak and Troy, MI)

[edit] Variations

"Plan Blue" is used at St. Vincent's Hospital in New York City to indicate arrival of a
trauma patient so critically injured that even the short delay of a stop in the ER for
evaluation could be fatal; the "Plan Blue" is called out to alert the surgeon on call to
immediately proceed to the ER entrance and take the patient upstairs for immediate
surgery. This was illustrated in an episode of Trauma: Life in the ER entitled "West Side

[edit] Other codes

[edit] "Doctor" Codes
"Doctor" codes are often used in hospital settings for announcements over a general loudspeaker
or paging system that might cause panic or endanger a patient's privacy. Most often, "Doctor"
codes take the form of "Paging Dr. _____", where the doctor's "name" is a codeword for a
dangerous situation or a patient in crisis. e.g.: "Paging Doctor Orange, third floor," to indicate a
possible fire in the location specified.
[edit] Dr. Allcome

Serious emergency. "Doctor Allcome to Ward 5." would indicate that all medical staff not
presently occupied are needed. (The Med, Memphis Tennessee and Abington Memorial
Hospital, Abington, Pennsylvania)

[edit] Codes by emergency

[edit] Bomb threat

Code Yellow: HASC[citation needed]

Code 10: Stanford University Medical Center (old system), Scripps Healthcare San
Diego[citation needed]

Code Black: Markham Stouffville Hospital, University of Chicago Medical Center[citation


Code Blue: Some schools in Western New York and in schools in Volusia County,
Florida[citation needed]

Code 100: Heartland Regional Medical Center[citation needed]

Code Purple: Australian Standard[citation needed]

Code Orange: Oakwood Healthcare[citation needed]

Code B: Superstition Mountain Mental Health Center (SMMHC, Inc.)[citation needed]

Code Grey: Bronson Methodist Hospital

[edit] Child abduction/missing person

Code Adam is sometimes used for missing person.

Code White is used in the IWK Health Centre for a missing person.

Code Yellow: Markham Stouffville Hospital

Code Black: Heartland Regional Medical Center

Code Silver: Iowa Health Systems

Child Abduction

Code Pink can denote child abduction

Code Purple was sometimes also used for Child Abduction

Code Kinder: William Beaumont Hospitals

Code Gold: Calgary Health Region

Code Amber: Alberta health regions

Code Pink: is used in North Carolina, CMC Medical

[edit] Combative person/assault

Code North: Stanford University Medical Center

Code Grey: Combative Person with no weapon (HASC)

Code Silver: Combative Person with a weapon (HASC)

Code Black: Personal Attack (Australian Standard Code)

Code White: Violent Patient (Markham Stouffville Hospital)

Security Stat: Heartland Regional Medical Center

[edit] Evacuation

Code White: Texas Tech University Health Sciences Center.

Code Orange: Australian Standard.

Code Green: Calgary Health Region

[edit] Fire

Usually Code Red.

o Australian Standard.[1]

California Standard.[2]

Sometimes Dr. Red, Dr. Pyro, or Dr. Firestone.

Sometimes "Evacuation Bell"

[edit] Internal disaster

Code Green: Texas Tech University Health Sciences Center.

Code Yellow: Stanford University Medical Center (old system), Australian Standard

Code Triage - Internal: HACS

Code Alert sometimes denotes disaster.

[edit] Lockdown/limited access

Code Orange: Ontario Used in Ontario hospitals to indicate an external disaster with
mass casualties. Lockdown or controlled facility access is often used as part of the
response. Volunteers, Families and Students were denied access during SARS Outbreak
of 2003.
Code Red: Most commonly used by schools.

[edit] Mass casualty incident

Code Yellow: Texas Tech University Health Sciences Center

Code Black: Military Hospitals

MASCAL may also be used

Code 10, Code 20, or Code 99: Heartland Regional Medical Center

Code Orange: Calgary Health Region

Code Triage: Scripps Healthcare San Diego; Hoag Hospital Newport Beach; Seton
Medical Center, Daly City, California.

Code 1000: Fletcher Allen Medical Center; Burlington, VT

[edit] Medical emergency - resuscitation team/imminent death

Usually Code Blue, sometimes Code 99. Because this is the most frequent code, a
patient undergoing cardiac arrest is often referred to as "Coding."
o Australian Standard[1]

Californian Standard[2]

[edit] Severe weather

Code Brown: Texas Tech University Health Sciences Center

Code Black: La Rabida Children's Hospital (Chicago)

Code Gray: Cook Children's Medical Center, Fort Worth, TX

Code Yellow: Heartland Regional Medical Center

Code Green: Schools in Volusia County, Florida

[edit] Theft/armed robbery

Code Amber: Texas Tech University Health Sciences Center

Code Amber: New Jersey Hospital Association

[edit] Total divert

A status sometimes called "Critical Care Bypass" (Ontario),[1] "Total Divert", "triage
situation", "Saturation Alert" or "High Occupancy" (University of Michigan Health
Generally used by hospitals as a status indicator for EMS/ambulance services denoting
that the issuing ER/trauma facility has reached maximum patient capacity and should not
receive any more new patients if at all possible.

This status was featured in the episode "Total Divert" of Trauma: Life in the E.R., set at
San Francisco General Hospital in San Francisco, CA; however, as explained by a trauma
nurse in the episode, the status change does not always keep new patients from arriving.

A variation on "Total Divert", called "Bypass", is used at many U.S. hospitals to indicate
emergency facilities at or over maximum capacity; this variation was featured in the
"Road Warriors" episode of Trauma: Life in the E.R..

Can be denoted as Code Purple or Code Yellow in some hospitals.

[edit] Pop culture references

Code black is a medical term used in the ABC series Grey's Anatomy, in the episode "It's
the End of the World". In this instance, the term refers to the presence or the threat of a
bomb within the hospital.

In the film Johnny Mnemonic a character uses the name Dr. Allcome, claiming it is a
hospital code for "Doctors All Come..."

The hardcore punk band TSOL has a song called "code blue" which is about necrophilia.

Trauma: Life in the E.R., shot at trauma centers throughout the U.S., features different
hospitals usage of the various codes.

A 2004 book based on a teenager finding smallpox scabs is called "Code Orange"

Code Blue, a documentary series about a hospital emergency room, is named for the
commonly-used code blue to indicate a patient in distress

"Code Brown" is a colloquialism used to indicate that a patient has defecated on

themselves and requires cleanup. In addition to being a commonly-used term by rankand-file healthcare workers, it is referenced many times in earlier seasons of "E.R.", as
well as in a webisode of "Scrubs".

In the TV series The West Wing episode In the Shadow of Two Gunmen, the President is
shot and is diverted to a designated hospital. The staff nurse announces "Blue, blue!"
indicating the ER should be evacuated for security reasons.

"Code Pink" is used in the episode "My House" of "Scrubs" when character Turk
mistakes another baby for his own and goes to his wife only to find she has his actual

"Code Gray" is used in the first episode of the sixth season of House "Broken" denoting a
psychiatric incident while Dr. House is in the mental institution.

"Code Blue" is the title of a track within the Trauma Center (series) medical simulation
video games, and is the basic background music heard during surgeries.

[edit] External links

Codes Listing, Texas Tech University Health Sciences Center (pdf)

Stanford Medical Codes (HASC based scheme)

Theda code listing

[edit] References
1. ^ a b c AS 4083-1997 Planning for emergencies-Health care facilities

2. ^ a b c LISTSERV 15.5 - MEDLIB-L Archives

3. ^ California Healthcare Association News Briefs July 12, 2002Vol. 35 No. 27
4. ^ Truesdell A. Meeting hospital needs
for standardized emergency codes--the HASC response. J Healthc Prot Manage 2005;21(1):77-89
5. ^
6. ^ Unplugged: Reclaiming Our Right to Die in America, Wiliam H. Colby, page 63

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