HospitalCodes

North York General HospitalStudent Orientation revised Sept 2013

Attention AttentionCode……Now what??

Refer to the Code Manual or Intranet

Code RED FIRE

Code WHITE VIOLENT PATIENT

Code PURPLE HOSTAGE TAKING/PERSON WITH A WEAPON

Code BLACK BOMB/SUSPICIOUS PKGE

Code YELLOW MISSING PATIENT

Code GREEN EVACUATION

Code GREY AIR EXCLUSION

Code ORANGE External DisasterCode AMBER Missing Infant/ChildCode BROWN Hazardous Spill/Leak

What about Code Blue? and Code Pink?

Code Blue and Code Pink…..

A respiratory or Cardiac ArrestCan be actual or impending

Code Blue 18 yrs of age or olderCode Pink 0-12yrsCode Pink Adolescent 13-17yrs

Staff and Students…#1 Responsibility

If Code Blue is announced on your unit, all staff and students should

return to the unit immediately

#2 Responsibility Protect yourself and others

Code Blue is considered a“HIGH RISK” procedure.

Equipment

If you don’t use it you will lose it!

Initiating A Code Blue

Initiating a Code Blue

Push the “code button” in the roomOR

Dial 5555

Seniors’ Health Center dial 9 and then 911

Okay so I dialed 5555 now what?

Information they need to know:

– Type of Code

– Where are you? Unit, Room, Bed Number

Codes & Who Responds

Second floor up: CrCU staff (excluding pediatrics)

First floor, ground floor (including the cafeteria), lower level: ED Staff

Codes & Who Responds

Hospital Grounds/Parking Lot: ED staff respond as well as 911 is called simultaneously

4000 Leslie Street & Seniors’ Health Center: 911 is called

Code Blue Team Members

Responsibilities

MD on Scene

Internal Medicine Physician or the Emergency Room PhysicianResponsible for running the Resuscitation

Anesthetist/RRT

Establishes or assists in securing and maintaining a patent airway

Anesthetist is on call if needed

CrCU or ER nurseDelegates & Coordinates:- C-A-B- IV access/ Medication - Documentation/Monitoring - Ensures room is not overcrowded- Accompanies patient during transfer- Defibrillation according to ACLS standards (certified RN only)

Nurse & Lab Technician

Nurse (most skilled in the room) ensures patent IV route is established if not already in place (16-20G preferable)

Lab Technician provides ECG/Venipuncture as needed

Charge Nurse/Unit Co-ordinator

Notify most responsible physician & call familyConsult Chaplaincy/Social Worker as neededEnsure Crash Cart equipment and drugs are replenished immediately after codeFacilitate completion of Cardiac Arrest Record

What about me the student?

What do I have to do??

Primary Nurse/First Qualified Person on Site

Stay where you are – don’t leave the patientCall for HELP!!Check the patient’s CAB’s– Circulation – Check for a pulse– Airway/Breathing- look, listen, feel– Participate in compressions if you are CPR

certified

Oh No I can’t feel a pulse?Now what??

Start chest compressions

Nurse #2/Second Qualified Person on Site

Initiate Code Blue if not already doneDon mask, gloves, gown and goggles before entering roomPlace backboard under patientRelieve First Nurse to don 4 point PPE & grab ambu-bag/orange roll1 person – CPR1 person – Bagging with Ambu Bag –hook up to oxygen

3rd and 4th RN/Qualified Person

Bring the Crash Cart if not already thereEnsure patient’s chart and MAR are readily available

Ensure other patients are being cared for**especially in the same room (Students to remove patients from room if possible)

Do not forget the Family

Every patient has someone who loves them. They need your support.

Family and loved ones should be present during the resuscitation whenever possible

Code is done now what?

Call someone who cares…– Preceptor/ Nurse Educator– Your Clinical Advisor– Fellow Student

Participating in the Debriefwill be helpful to you.

Talking is the best medicine!

Name these Codes!

1. A gunman has entered the ED and is threatening staff.

2. A pregnant woman is about to give birth in the elevator- she is only 6 months along!

3. A patient chokes in the cafeteria.4. A visitor slips on ice outside the main entrance

and is bleeding profusely from their head.5. An unknown caller tells you that “something

bad is going to happen. And they have left us a gift”.

Name these Codes!6.There has been a large pile up on the 404 due to

an ice storm. Large numbers of victims are expected.

7. A nurse has spilled chemotherapy on the floor.8. You have not been able to find your patient

despite searching for him.9. A chemical plant upwind of the hospital is on

fire. Toxic fumes are headed our way.10.There has been a fire on an inpatient unit.11. The fire has now spread and staff are unable

to contain it.