Hospital Emergencies

Emergencies in hospitals are categorized into Hospital Codes which are paged overhead. McMaster staff in these hospital sites are to take Hospital Fire/Code training on Mosaic/Avenue. This training is to be repeated annually.

Posters

Posters have been created for MUMC for Emergency Code Response and have been posted throughout the building. Download and print for your own area.

Individualized Emergency Response Plan

This plan is required by Accessibility for Ontarians with Disabilities Act. Please see more information here. The form for this plan is found here.

Downloadable Resources

Please click this link to access our Emergency Response MacDrive for files related to emergency response (SJHH and HHS) for Faculty of Health Sciences at these locations.

General Principles

• Complete Hospital Fire/Code training on Mosaic/Avenue.
• Report emergencies according to the instructions below.
• Know your area staging location for internal assembly during code drills.
• Know your external assembly location for building evacuation.
• Supervisors - Ensure your fan-out communication lists are up to date.
• On notification of a code, assemble at your area staging location for instructions from the person in charge.
• For announced codes listen and follow the directions of the person in charge. Avoid elevator and phone use unless urgent or part of code response, respect secured zones and carry your ID badge with you at all times.
• Code Stages in a hospital code announcement mean the following:
  • Code X Alert is used if a code is uncertain. Staff are to await further information and confirmation.
  • Code X Standby is used if a code is certain to occur and there is time to prepare for response.
  • Code X In-Effect is used if a code response is to be implemented immediately.
  • Code X All Clear is used if a code is over and staff can resume normal duties.

Code Drills

Code drills are carried out monthly by our hospital partners at all hospital locations. Please see the FHSSO MacDrive for code schedules and code red info sheet.

If you do not have an HHS or SJHH code captain managing your area, use the Emergency Codes Information Form to review your actions.

Hospital Code Details

Code Aqua- Flood

ON DISCOVERY
Call your emergency number and report.
Assess the area for occupant safety.
Assess equipment safety and the need to protect from water damage.
Place spill barriers around areas to contain water.

ON NOTIFICATION
Avoid the area in question.
Assess impact on your local operations and act to protect human and physical assets.
Otherwise, there is no action to take.

Code Black - Bomb Threat / Suspicious Object

Code Black is for bomb threat and is to be taken seriously. A visual search of a building should be completed to clear or validate the threat. Emergency Responders and the Fire Department require each room of a building to be searched and the information relayed to them. Evacuation of an area or building occurs when there is imminent danger. If evacuation is deemed necessary a Code Green "Stand by" or "In Effect" would be announced.

REPORTING
Occupants -> Security** -> Emergency Responders / Hamilton Fire Department
Occupants -> Supervisor

**Or other communication process specific to your building. (MacDrive)

ON DISCOVERY
If you discover a suspicious package, do not touch or disturb it. Call the Emergency Number for your building and describe your concern and your location.

ON NOTIFICATION
Perform a search and sweep of your location and report positive or negative findings to your Supervisor and Security (or other reporting mechanism used by your building - MacDrive) for your building. Note the rooms or areas covered.

There is currently an Emergency Codes Information Form to record your sweep results for which the information is shared with the HHS and SJHH Emergency and Disaster Management Specialists.

Clinical occupants are to follow their local procedures.
Non-clinical occupants are to follow the above procedures, or any site-specific procedures which may be different (i.e. Library)

Code Brown-In-facility Hazardous Spill

Code brown is an in-facility hazardous spill. Note: University laboratory workers, must be competent to clean up spills of hazardous materials they routinely use and gain assistance from their local supervisor. Code brown is reserved for extra-ordinary circumstances (which may include an immediate lack of ability to clean up the spill safely) or discovery of unidentified substances which have been assessed to pose a threat to hospital occupants.

ON DISCOVERY
On discovery of any hazardous material spill that cannot be contained or safely cleaned by available resources, ensure spill area access is restricted before leaving the scene. Call the emergency number for your location and report your name, concern and location.

ON NOTIFICATION
Avoid the area and follow any instructions from your Manager or Area Charge Person.

Code Blue- Cardiac Arrest or Medical Emergency

Code Blue is for cardiac arrest or medical emergency. At HHS, Code Blue is for adults whereas at SJHH Code Blue can be called for adult (Code Blue Adult) or pediatric (Code Blue Pediatric) patients.

ON DISCOVERY
On discovery of this code blue situation where a person requires immediate medical attention, initiate basic life support if trained.
Call or ask someone to call the emergency number and report code
Remain at the scene until Security/EMS arrive and follow their instructions

ON NOTIFICATION
Clinical Occupants are expected to follow their Area charge Person’s instructions.
Non Clinical Occupants are expected to avoid elevators and hallways in the event the code is called in your area. There is no action for you to take.

Code Green- Evacuation

Code Green is for evacuation and may accompany any another code. When accompanying Code Red you will hear bells. When accompanying any other code, you will not hear bells.

CODE GREEN ALERT/STANDBY
Return to your workstation and prepare your area for an eventual evacuation. Turn off all equipment, make the area safe, be aware of escape routes (fire stairwells are at the exterior of the building)

CODE GREEN IN-EFFECT

Clinical occupants are to follow their in-house protocols, which may include horizontal or vertical evacuation.

Non-clinical occupants are to wait to evacuate in a manner as instructed by the overhead announcement. Elevators are reserved for the disabled or patients in beds. If possible, your team should meet in a predetermined location to take attendance.

The overhead page will identify what level of Code Green has been initiated.

Code Grey- Infrastructure Loss or Failure

Infrastructure losses or failures include an unexpected loss of power, water, heating, ventilation, cooling or medical gases.

ON DISCOVERY
Call the building services number for your building and report the type of service lost and your location.

ON NOTIFICATION
Review the essential service lost and what the potential impact might be to your operations. If a hazardous situation will arise, report it to a Supervisor immediately. Take steps to protect assets and implement area-specific contingency plan if applicable. Pay attention to any overhead pages.

Code Purple - Hostage Taking

ON DISCOVERY
If a hostage situation has been observed, call the emergency number for your location and report the code. Be prepared to answer descriptive questions.

ON NOTIFICATION
Do not disturb area or approach hostage – takers. Avoid the code area, remain in a safe location during the event until notified of all clear.

Code Red - Fire

Code Red is for fire or visible smoke. If Code Green is also initiated it will be called overhead.

ON DISCOVERY
If you see fire or see smoke, R-E-A-C-T.

If you smell smoke, but do not see smoke or fire, call the local Emergency Number and report smell of smoke, your name and exact location

ON NOTIFICATION
First Stage Fire Alarm is an alert signal to occupants of a potential fire situation. The alarm consists of slow ringing bells and will accompany an overhead announcement Code Red and Location. Alert stage provides the opportunity for those located in the area of the alarm to prepare for possible evacuation.

Clinical occupants may have extra instructions from their Area Charge Person.

Non-Clinical Occupants must wait, listen for and obey overhead instructions.

ON NOTIFICATION
On notification of Second Stage Fire Alarm the alarm rings/sounds at a rapid rate; there is a very distinct difference between First and Second Stage alarms. This alarm alerts staff to prepare to evacuate as directed.
Wait for an overhead announcement of Code Green for your area. Hospital evacuations are done in an orderly manner under the direction of emergency response professionals.

Code Silver- Active Shooter

ON DISCOVERY or ON NOTIFICATION
If discovering or on notification of a person threatening with or discharging a firearm, or possessing a weapon:
Seek cover. Warn / assist others of situation if safe to do so. Call 9-1-1 via external phone line. Call hospital emergency number, if able to report the code. Evacuate / escape if you are able to do so safely. If unable to evacuate / escape find a secure shelter and barricade yourself. Wait for Police or Security to arrive – ensure they verify their identity.

Code White - Violent Situation

Code White is a situation in which there is violence to self or others where additional resources are required to safely manage the situation.

ON DISCOVERY
Where a violent situation is unable to be de-escalated and the threat of injury or harm exists, contact the emergency number for your building. Give your name and location.

If you are at SJHH West 5th location, your first line of calling is your Personal Alarm Device.

ON NOTIFICATION
Avoid the location of the code.

Clinical occupants will have additional, specific procedures they must follow as directed by their Area Charge Person.

Code Yellow- Missing Adult

ON DISCOVERY
On discovery of a lost person, notify Security for your building.

ON NOTIFICATION
If details are given, sweep your area for the person in question and report negative or positive findings to security.
If details are not given, remain on alert until the "All Clear" is announced.

Code Amber- Missing or Abducted Infant or Child

ON DISCOVERY
If you have discovered a lost infant or child, call Security for your building.

ON NOTIFICATION
If details are given, sweep your area for the person in question and report negative or positive findings to security.
If details are not given, remain on alert until the "All Clear" is announced.

Code Pink - Cardiac Arrest / Medical Emergency

Code Pink is for cardiac arrest or medical emergency. At HHS Code Pink is for pediatric cardiac arrest or medical emergency. At SJHH Code Pink is for neonatal cardiac arrest or medical emergency.

ON DISCOVERY
On discovery of this code pink situation where a person requires immediate medical attention, initiate basic life support if trained.
Call or ask someone to call the emergency number and report code
Remain at the scene until Security/EMS arrive and follow their instructions

ON NOTIFICATION
Clinical occupants are expected to follow their Area charge Person’s instructions.
Non-clinical occupants are expected to avoid elevators and hallways in the event the code is called in your area. There is no action for you to take.

Code Orange - External Disaster

A Code Orange is activated when a community disaster event or a series of events has resulted in a large number of people requiring emergency treatment, impacting the hospital's immediate response capabilities.

ON NOTIFICATION
Continue normal duties but remain on alert for instructions from your Manager or Area Charge Person.

Code Lockdown

Access Control and Code Lockdown may be considered at any of the Hamilton Hospitals under the following circumstances: 
Evidence of potential threat to the hospital; 
An external threat; 
Surge of patients; 
Any situation that could impact the operations of the hospital including safety of patients, visitors or staff. 

ON NOTIFICATION
Upon hearing Code Lockdown all Clinical and Non-clinical occupants are to remain within their current location and await further direction from the Manager, Area Charge Person or overhead paging