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

2. Categories and Colors Code Name Emergency Situation Code Red Fire
Code Blue
Cardiopulmonary Arrest
Code Orange
Combative Person
Code Gray
Missing High Risk Patient (18+ years old)
Code Crimson
Obstetrical Emergency
Code Lock
Hospital Lockdown
Code Yellow
Decontamination Team Activation
Code Silver
Person using or brandishing a weapon
Code Pink
Infant and Child Abduction
Code Black
Bomb Threat
Code MRT
Medical Response Team
Campus Response Team
Condition Green
To Signal “All Clear”

3. Code RED - 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)
Reason Red Was Selected for Fire
The color red was selected because it is the universal color for fire and easy for staff to remember. The American National Standards Institute (ANSI) has designated red to communicate “Stop!” or “Danger!” It is also consistent with states that have already standardized emergency code calls.
Supporting Information
Code RED should be immediately initiated if a fire is suspected or observed. This may include:
seeing smoke or fire;
smelling smoke or other burning material;
feeling unusual heat on a wall, door or other surface; or
notification by a physician, staff member, patient, or family of a fire.
A Code RED alarm may also be initiated automatically by electronic fire detection equipment in the facility.
Fire response procedures must be implemented upon suspicion of a fire.
Notification of co-workers for a timely, effective and efficient response is critical to keeping safe and preventing damage.
Other buildings of the medical center which are not part of the hospital itself will dial 911 for response.

4. Code RED – 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.

5. 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.
Reason Blue Was Selected for Cardiopulmonary Arrest
Code Blue is the second most frequent name for this situation among hospitals.
Supporting Information
Code Blue is to be initiated immediately whenever an adult or child is found in cardiac or respiratory arrest. If a “Code Blue” is called in an area without a crash cart, the designated area will bring the cart.
Other buildings on the hospital campus that are not part of the designated hospital will dial 911 for response.

6. Code ORANGE – 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.
Reason Orange Was Selected for Combative Person
Orange was selected in order to be consistent with the many other states that have standardized emergency code calls.
Supporting Information
CODE ORANGE is initiated when staff are concerned about their own safety or the safety of others.
Combative or abusive behavior can be displayed by patients, families, visitors, staff, or physicians. Recognizing early warning signs are critical. These may include:
direct or verbal threats of harm
intimidation of others by words and/or action
carrying a concealed weapon or flashing a weapon to test reactions
intentional disregard for the safety of others
destruction of property; and
generally, a Code ORANGE is announced overhead to notify the response team. The responding team will assist staff in managing and/or de-escalating the situation.
Other buildings on the hospital campus that are not part of the designated hospital will dial 911 for response.

7. 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.

8. 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.

9. 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.

10. Code YELLOW – 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.

11. 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.
Reason Silver Was Selected for Weapon or Hostage Situation
Silver is the color of a gun which makes it easy for staff to remember for a person with a weapon or hostage situation. It was also selected in order to be consistent with the other states that have standardized emergency code calls.
Supporting Information
Anyone can engage in hostile or violent behavior: Patients, family, visitors, staff or physicians. When staff are concerned about their own safety or the safety of others and suspects that someone has a weapon, they are to call a CODE SILVER.
When possible, staff members should not attempt to intervene or negotiate, but wait for the emergency team to arrive.
The definition of a weapon is any firearm, knife or instrument than can cause bodily harm or injury.
When Code Silver is activated, a response from internal security, and external law enforcement, should be requested.
Other buildings on the hospital campus that are not part of the designated hospital will dial 911 for response

12. 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
Reason Pink Was Selected for Infant or Child Abduction
Pink is the color most often associated with infant and children and is easy for staff and visitors to remember. It is also used by many of the states that have standardized emergency code calls.
Supporting Information
The following information is taken from “For Health care Professionals: Guidelines on Prevention of and Response to Infant Abductions,” published by the National Center for Missing and Exploited Children. The typical abductor profile includes the following characteristics:
Frequently visits nursery and maternity units initially at more than one health care facility prior to the abduction; asks detailed questions about procedures and the maternity floor layout; frequently uses a fire exit stairwell for her escape.
Usually plans the abduction, but does not necessarily target a specific infant; frequently seizes on any opportunity present.
Frequently impersonates a nurse or other allied health care personnel.
The abductor can be a stranger to the child, or a family member, such as a non-custodial parent.
Children can often verbally let someone know when they face a threatening situation.
Other buildings on the hospital campus that are not part of the designated hospital will dial 911 for response.

13. 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
Reason Black Was Selected for Bomb Threat
Black was selected in order to be consistent with the many other states that have standardized emergency code calls.
Bomb threats do occur in health care facilities; however, it is unlikely that an actual bomb is placed. The facility will usually make a thorough search when a bomb threat is received (people who normally work in an area are more likely to notice something is wrong or out of place). IF A BOMB OR SUSPICIOUS DEVICE IS FOUND, IT SHOULD NOT BE TOUCHED.
Report the device to your supervisor or building manager. The handling of bombs and bombing investigations is solely an official police function. At no time should the health care facility security staff try to touch or move a bomb, suspected device or package. The role of the facility security staff is to help the police find the bomb and to evacuate patients, visitors and facility personnel.
When the police enter the health care facility, they will need trained personnel who are familiar with the facility to direct them quickly to a potentially suspicious device or package, or to assist them in searching for a possible bomb. Security personnel should be completely familiar with all areas of the building, including closets, restrooms, storage areas, trash bins, etc. All security officers should have keys to these areas so a complete search can be made. The facility may choose not to evacuate unless a suspicious device has been identified, and then proceed under the direction of the local authority. Safety procedures take precedence
over all other activities by health care facility employees, except for the provision of immediate medical assistance to patients in life-threatening circumstances. It is important to remember that a bomb can be placed anywhere; therefore, a complete
search should be made. Depending on available time, make as complete a search as possible.
General Search Guidelines for Bomb Threats
1. Launch search promptly.
a. Initiate simultaneous assessment and search.
b. The depth and nature of the search can vary based upon the threat assessment and information updates as
applicable, working with local law enforcement.
c. If something is found, do not touch it. Secure the area and notify a supervisor.
2. The question of evacuation is a challenge that is best resolved by consultation between the police department
and the health care facility administration.

14. 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.
Triggers of deteriorating condition:
Staff member is worried about the patient
Acute change in heart rate <40 or >130 BMP
Acute change in systolic BP <80 mmHg
Acute change in RR <8 or >28
Significant change in level of consciousness
Acute change in urine output
Acute change in SpO2 <90%
Significant bleeding
Other signs of rapid deterioration
Concerns expressed by the patient and/or patient’s family

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

16. 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.

17. 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.

18. 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.

19. 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.

20. 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

21. 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.

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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? 28