1. Emergency Measures Training MNI September 24, 2012 revised April, 2015
MUHC Emergency Measures Services

2. MUHC Emergency Measures Services
Agenda
1.0) Welcome
2.0) Introduction and course objectives.
( 5 minutes)
3.0) Presentation of emergency situations
( 45 minutes)
4.0) Wrap up. Questions and completion of evaluation (10 minutes)
50 minute session with a bit of time at the end to complete evaluation form.
No break
MUHC Emergency Measures Services

3. Introduction
A 1 hour course of theory and open discussion to better prepare employees and students
of the Montreal Neurological Institute
in their response to
emergency situations.
Introduce yourself as the MUCH trainer in emergency measures.
20 years of experience as a first responder.
20 years experience in the field of hospital security.
Please ensure that you sign in
MUHC Emergency Measures Services

4. At the end of this training, the participant will:
Training Objective
At the end of this training, the participant will:
Be able to identify the various emergency codes
Have an understanding of their roles and responsibilities
Focus is really on SAFETY. Knowing your limits and what to do.
This is an introduction . More detailed training on Code red and white is available.
MUHC Emergency Measures Services

5. MUHC Emergency Measures Services
Emergency Codes
Code Red
Code Flood
Code Black
Code Brown
Code Grey
Code Green
Code Orange
Code Yellow
Electrical Failure
Code White
Code Blue
Code Pink
Elevator shutdown
Medical gas
Extreme Heat
Water Shutdown
Heat Shutdown
Code Flood
More detailed review of code brown and red as is the one that you will most likely be involved with.
MUHC Emergency Measures Services

6. MUHC Emergency Measures Services
Site Response
Applies to all emergency situations
represents the levels of response
That you are not working alone , that support is available
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7. MUHC Emergency Measures Services

8. MUHC Emergency Measures Services
Code Red
Code Red refers to events linked to a possible fire. It represents the alert process, intervention and re-establishment of services
Emergency codes are used to transmit information on emergencies to personnel and first responders.
In the case of fire we do not shout fire. Imagine the panic.
Code red all clear will be announced at the end of the alert.
Codes are used over the PA to alert the MUHC community.
Codes are for employees not staff or visitors.
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9. Code Red Activation and response
An overview of the events that occur during a code red so there is a better understanding when a code red is declared.
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10. Code Red Departmental response
You discover a fire!
Move people in immediate danger
Activate manual fire alarm
Contact 55555
Close windows and doors
Attempt to extinguish fire
Remain available
Code Red (elsewhere)
Listen to instructions
Return to work station.
Clear exit routes
Shut doors and windows
Prepare to evacuate
Wait further instructions.
Actions in code red will depend on the location of the alert i.e. pavilion.
Return to work area if possible!
More detailed code red instruction is available. Again introductory.
MUHC Emergency Measures Services

11. Types of portable fire extinguishers
Code Red
Classes of fire
Types of portable fire extinguishers
How to use
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12. Code Red Classes of fire
Ordinary combustibles
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13. Code Red Classes of fire
Flammable liquids & gases
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14. Code Red Classes of fire
Electrical equipment
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15. Code Red Classes of fire
Combustible metals
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16. Code Red Classes of fire
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17. Code Red Fire extinguishers
Water : 30 – 50 s
CO2: 8 – 30 s
Powder: 8 – 25 s
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18. Code Red Fire extinguisher use
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19. Code Red Fire extinguisher use
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20. Code Red Fire extinguisher use
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21. MUHC Emergency Measures Services
Code Brown
Code Brown is an accidental spill of a
hazardous material that may include
chemicals, cytotoxic agents, gases,
bio-hazardous substances,
mercury and radioactive substances.
MUHC Emergency Measures Services

22. Code Brown Departmental response
Code Brown (Elsewhere)
Listen for additional instructions.
Evacuate area if experiencing negative health affects.
Await the “all clear”.
Create or witness to !
Move person in immediate danger.
Contact 55555
Advise other occupants in immediate area.
Remain available to provide assistance/information.
Location is important. If experiencing side affects leave area
Seek medical attention.
If attempting to clean up ask: 1) Do I have the competency, Do I have adequate material, Is the quantity to great, is the toxicity to great? Answer no then declare a code brown.
Provide MSDS sheets to the first responders.
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23. MUHC Emergency Measures Services
Code Orange
Code Orange a disaster or external
cataclysm which may generate a sudden
increase in patient flow.
A disaster that occurs outside the facility. Critically hurt people showing up in the EDs
Recent example was the Dawson shooting.
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24. MUHC Emergency Measures Services
Code Orange
Three levels of a code orange:
Pre ( alert)
1 ( 6-11 patients)
2 ( 11 and over)
When heard
Does it affect you?
If so, follow your dept plan
No affect
Carry on normal activities
Three levels may be declared and could also change from pre to 1 to 2,.
Code is based on the EDs curent capacity.
If not affeected by the alert you may experience a slowdown in services. i.e. mail, housekeeping, t ransport, lab services etc…
Elevators may be slow, some areas may be restricted. Difficulty moving around.
MUHC Emergency Measures Services

25. MUHC Emergency Measures Services
Green Code
Code Green refers to the immediate evacuation of a portion of or the entire complex due to circumstances that cannot assure the safety of patients, staff or visitors. Includes the alert process, intervention and recovery of services.
Due to fire, chemical spill in climate weather, flood, bomb threat.
May start off as a partial evacuation, and expand.
The advantage is that portions of the building can be evacuated one at a time as opposed to the entire complex; imagine the panic and confusion.
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26. MUHC Emergency Measures Services
Code Green
Ordered to evacuate.
Initiate local plan
Local
Horizontal
Vertical
Off site
Evacuate according to local plan
Re group at designated meeting place.
Evacuation ordered elsewhere
Listen for additional instructions.
Prepare to evacuate
May be asked to assist with evacuation of other areas.
If ordered to go you must go. There is no second guessing
Follow your departmental plan
Three attempts. Local, horizontal, vertical, off site.
If elsewhere pay attention as your area may be effected soon.
2004 Neuro explosion people asked over the PA to assist with patients
Also a reduction in service . Other services may be no longer able to function.
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27. MUHC Emergency Measures Services
Code White
Code white is an emergency response which is initiated in order to subdue a patient who is expressing extreme anxiety and anger which may escalate into a potentially violent situation.
Code white stat a situation that escalates in violence and the patient is armed.
Code white applies to patients.
For staff, visitors etc.. This is handled through a call to security.
A weapon can be defined as a gun, knife, pole ,chair etc…
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28. MUHC Emergency Measures Services
Code White
On Hearing a “ Code white”
Listen for location
If you are in the proximity remain attentive to further messages.
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29. MUHC Emergency Measures Services
Code Yellow
Code yellow is an emergency response that is initiated to assist in the search of a missing in-patient.
Code yellow stat is an emergency response that is initiated due to the abduction of an in-patient.
All possible actions have been made to find the patient have been unsuccessful so additional assistance is required.
Stat cases usually apply to children, when children are hospitalized and a custody dispute arises or has been on-going.
However, can apply to adults. Dispute between siblings.
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30. MUHC Emergency Measures Services
Code Yellow
When advised of a Code yellow:
Have a look around your immediate work area, sitting rooms, lounges etc..
If a patient is found or seen, contact site security and advise. Nursing personnel will be sent to escort the patient back to their unit.
May not concern you directly, but be aware that patients could wander into restricted areas
Be alert to the code and make an effort to have a look around.
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31. MUHC Emergency Measures Services
Code Black
Code Black is an emergency response that is initiated to assist with a received bomb threat or suspicious package.
One of the most infrequent and most challenging emergency codes.
May be a phone call, fax,
Possible target areas: Animal use in research, abortion clinics, stem cell etc..
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32. MUHC Emergency Measures Services
Code Black
Not affected!
Remain attentive for further instructions.
Continue normal activity.
Search Requested!
Initiate local plan.
initiate search of your work area.
Report findings to security.
Remain attentive to further instructions.
Until advised of the alert and a required search of your area. Continue routine functioning.
Please do not call security.
Obviously more training will have to follow. A complicated code that does not occur frequently.
Note that areas are not evacuated until an object is found or that there high evidence of the probability of detonation.
Security is lead in this code and police involvement is limited until object found .
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33. MUHC Emergency Measures Services
Code Grey
Code Grey is an emergency response to an external event that may imply an external gas leak, or an external hazardous chemical/biohazardous/radioisitope spill or leak.
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34. MUHC Emergency Measures Services
Code Gray
When advised of a Code gray!
Close exterior windows.
Remain within the building.
Wait for further instructions or the “all clear”.
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35. MUHC Emergency Measures Services
Code Blue/ Pink
“Code Blue/ Pink” is an emergency response to an unconscious person. ( Adult/ Child)
Differentiate between adult and child. Will the response team respond to an adult at the MCH?
Not only for in-patients
If team can get to you they will respond.
Perhaps not in the parking lots.
MUHC Emergency Measures Services

36. Code Blue/Pink An unconscious person is discovered! No impact on you
Contact local 55555
Site
Location i.e. room
Number where you can be reached.
No impact on you
Continue routine activities.
If you know CPR initiate it
Be specific in your details to
Send some one out to meet the crash team.
Not always easily known where the research groups are.
MUHC Emergency Measures Services

37. Medical Emergency Procedures Conscious Individual
Ambulatory
Non-Ambulatory
Minor injury:
Administer first aid
Follow up as necessary
Needing medical attention:
Go to Emergency at the Montreal General Hospital
Be accompanied by a co-worker
Call 911
Give location (Building, Pavilion, Floor, Room number), your name and a phone number to contact you
Inform Neuro Security by calling
Arrange escort for Urgence Santé to location
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38. MUHC Emergency Measures Services
Other Codes
“Code Flood” uncontrolled release of water within the facility.
“Elevator shutdown” emergency shutdown of elevators due to
mechanical problems.
“Medical Gas shutdown” an unscheduled interruption in the
distribution of medical gases.
“Water shutdown” an unscheduled closure of the domestic water supply.
“Extreme heat” condition where the exterior temperature is having a negative impact on operations and measures must be put in place.
Codes that you may hear that may not have an immediate impact on you.
Forgot to include heat shutdown. Loss of heat in a portion of or complete building.
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39. MUHC Emergency Measures Services
Thank you!
Please complete the evaluations.
MUHC Emergency Measures Services