1. SAFETY AWARENESS: LRHS EMERGENCY CODES & PROCEDURES

2. Fire Safety in healthcare facilities presents a specialized response. Patients and families have trusted you with the safety of people who, in many cases, cannot help themselves. Healthcare facilities are divided into “smoke compartments” –areas that are closed off by “smoke barrier doors” to prevent the spread of fire and smoke. The greatest danger in hospital fires is panic due to fear and smoke,so it is important to remember these guidelines: DR RED: Indicates a suspected or actual fire in the building Will be announced three times over the intercom, along with fire location. If away from your work area, return by stairway; never use elevators in a fire. If evacuation of an area is necessary, evacuate horizontally. Restrict family and visitors from entering an affected area until the “all clear” has sounded. Clear the hallways and exits of all obstructions Familiarize yourself with departmental fire procedures, location and use of fire alarms, oxygen shut-off valves, and exits.

3. Remember if there’s a fire, it’s a R-A-C-E: RESCUE: any individual directly threatened by fire ALARM: Activate the fire alarm by pulling down on it; dial 400 and give location of the fire. Respond to any signs of smoke as you would flames. CONFINE: Close all exterior doors. In general, patients are safer in a closed room than a smoke-filled hallway. EVACUATE OR EXTINGUISH: extinguish the fire only if the fire is small.

4. Remember, to use a portable fire extinguisher: P.A.S.S. Hold upright, Pull ring pin; Stand at least 10 feet back; Aim at the base of the fire; Squeeze lever and; Sweep side-to-side.

5. CODE BLUE Is used to indicate a patient requiring immediate resuscitation, most often as a result of cardiac arrest. When discovering a person in cardiac or respiratory arrest, dial 400; state to the operator- Code Blue, Room_____ The hospital operator will page “Code Blue, Room________” twice using an overhead announcement.

6. CODE GRAY Indicates the initiation of LRHS’s internal (ie: Fire, explosion, tornado, etc.) or external ( ie: Massive auto, bus, or boat wreck incident; Massive exposure to hazardous chemicals, etc.) “Code Gray” will be announced over the intercom three times at five second intervals. Report to your work area and await assignment from supervisory personnel. The departmental disaster call lists will be initiated to call-in additional needed personnel.

7. OPERATION WEATHER WATCH Indicates a tornado alert or severe weather conditions. If you are a patient-care staff member: Move visitors and ambulatory patients to interior corridors; close room doors. Move non-ambulatory patients away from windows; close blinds; cover patient with blankets; close room doors Move to an interior corridor If you are a non patient-care staff member: Move to an interior corridor or office If in waiting room area, ensure visitors are moved away from windows to an interior corridor. Close room doors.

8. EARTHQUAKE Staff, volunteers, visitors, and patients will remain in the building; do not use elevators. If you are a non patient-care staff member: Move yourself and others in danger from outside walls and windows and get under a solid object. If you are a patient-care staff member: Assist ambulatory patients and visitors to get under a solid object and stay away from outside walls and windows. If possible; instruct non-ambulatory patients to cover head with a pillow; move bed away from outside walls and windows. Following the quake, the priority will be treating injuries; maintenance will return the facility to operational standing.

9. DR. DOOR/LOCKDOWN Instituted when a mass-casualty event has occurred relating to a biological or chemical attack. The policy 112-20-36 Patient Biohazard Incident/Lock-down will go into effect immediately. Hospital personnel will report to assigned entrances and direct incoming traffic to the Emergency Department entrance. Security will lock all doors except the Emergency Department entrance, with signs placed at each locked entrance directing individuals to the Emergency Department entrance. Once entrances are secured, staff will return to their work stations.

10. BOMB THREAT (by phone) Bomb Threat by phone: Prolong the conversation Listen for background noises, try to identify the sex of the caller, as well as any distinguishing voice characteristics; determine if you recognize the voice. Stay calm and ask: –Where bomb is located? –When it is set to detonate? –Why it was planted? If possible, have someone else listen to the conversation and take notes, including time the call was received. Notify security and appropriate key staff members Document everything remembered concerning the call; utilize the bomb threat check list on the FISH under Fire/Disaster techniques and procedures. Report suspicious looking or acting persons to Security and House Supervisor

11. Bomb Threat (in writing) Avoid handling the note or envelope and place it in a large envelope or folder Notify Security and House Supervisor Record the names of those handling the correspondence for fingerprint identification Document time note was found or delivered, method of threat delivery in addition to messenger description, if known, on the Bomb Threat Check List.

12. HOSTAGE SITUATION The first employee identifying a hostage-taking situation: Secures the immediate area by removing all nonparticipating patients and/or staff, visitors/family/volunteers. Notify Security and House Supervisor Observe and document: –Time of incident –The number of hostages –The type of disturbance and any weapons –Any demands by the perpetrator Do not speak to the media unless authorized to do so Nursing personnel are responsible for securing their units.

13. ADULT, CHILD, INFANT ALERT Indicates an adult, child, or infant is missing from LRHS; The person discovering a missing or abducted person will dial 400, informing the operator of an “Alert: & whether it is an adult, child, or infant; which will then be announced three times over the intercom. A computer message will be sent to all employees with a full description of the missing patient. Staff will immediately man all exit doors with these responsibilities: –Observe all persons who exit the building. –Note detailed description of person(age, weight, height, clothing, hair/eye color) –Note direction of travel, vehicle and license number –Do not try to stop anyone from exiting the building. If you see a suspicious person, –Call security.

14. DR. HUNTER Indicates an unauthorized firearm has been brought into the hospital Witness instructions: Immediately leave the area, stay calm, do not confront person with the firearm. Patient Care areas: Ensure the safety of patients by removing them from danger. Once safe, dial 70, & announce ‘DR. HUNTER’ and location, three times over the intercom. Dial 400- & report to the operator what you witnessed and location. Operator will call security and local police department. Use silent panic alarm if available Do not return to the involved area until you hear “All Clear” over the intercom. Alarm Instructions: –Secure your area after hearing “Dr. Hunter” announce4d. –Find a safe place to hide for yourself and those in your care. –Clear all hallways of visitors, patients, families. –If there is no safe place to hide, move carefully to the nearest exit.

15. EQUIPMENT INCIDENTS/SAFE MEDICAL DEVICES ACT Initial actions upon finding defective equipment: Identify the item as defective, remove it immediately from service along with cabling and disposable attachments. Attach “Lockout/Tagout” warning tag on equipment. Notify Clinical Engineering department. If the item is involved in patient, visitor, or employee injury, or potential injury, complete an Event Report and a Medical Device Reporting form. Use of patient-owned electrical equipment is prohibited.

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