EMERGENCY PREPAREDNESS

ORIENTATION

What is Emergency Preparedness?

• Hospital’s Emergency Plans

• Based on Standardized System

• Assigns colours to specific incidents

• Standardized approach to all incidents using

the Incident Management System

• Responsibility of every staff member,

physician and volunteer to know

Incident Management System

• Based on experience in California wild fires

where services failed to communicate working

side by side

• Best Practice for Hospitals, Police, Fire, EMS,

Municipalities

• Supported by Emergency Measures Ontario

Incident Management System

Command Center

• Board Room/CEO Office at all sites

• Responsible for coordinating the Hospital wide response

• Incident Manger—CEO/Designate

• Safety Officer—Occupational Health & Safety Officer

• Operations/Site Lead—VP/Patient Care Manager

• Liaison Officer—Quality & Risk Manager

• Information Officer—Communications Officer

IMS Details

• Emergency Department—Red, Yellow, Green

zones

• Visitor/Traffic Flow--Maintenance

• Media Center—Communications Officer

• Human Resources—Staff Center & Worker

Pool

• Family Center—SLP Department

Call In Lists

• Exist for all Departments in the Hospital

• Activated when an emergency situation

requires additional resources and the

implementation of the IMS

• Corporate Fan Out List at Switchboard

• Departmental Fan Out Lists prepared and

should be kept at home

CODES

Staff, Physician, Volunteer

Preparedness

• Know where Emergency Preparedness policies and procedures are located (on line and in binders in Emergency Department, Switchboard & Administration)

• Know your initial responsibility should a CODE be called

• Keep the Hospital informed of your home phone number

• Staff and Physicians—FIT testing up to date

• Bring your Hospital identification with you in any CODE where you are called in

• Enter via the designated staff entryway

Code Yellow—Missing Person

• Requires search of the building and outside

grounds

• Assist with the search of your

Department/Area

• Requires notification of the Police if patient

cannot be found

• Search maps are located in the Emergency

Preparedness Kits in Administration

Code Amber—Missing Child

• Hospital is locked down

• Stop people with suspicious backpacks, bags,

and suspicious behaviour

• Notify the Police

• Search the hospital

Code Orange—External Disaster

• Activate call in lists to get extra staff and physicians

• Automatic staffing shift should occur with Code Orange announcement

• ED Charge Nurse/ED Physician are in charge until Incident Management Team is set up

• Outpatients may be cancelled

• ED is divided into zones for critically ill, seriously ill and minor injuries

Code Orange CBRN—Chemical,

Biological, Radiation or Nuclear

Exposure• Automatic Staffing should occur

• Call in Lists activated

• External company contact for CBRN

management on site with 1-2 hours

• Identify contaminated traffic route and clean

routes

Code Red--Fire

• REACT

�Remove persons in danger

�Ensure door(s) are closed

�Activate fire alarm

�Call Switchboard GMCH dial 3333, NWHC dial 0

(Off hours LMH 2230, PDH 4230)

�Try to extinguish fire and/or start evacuation

Code Red—Fire—Staff Responsibilities

• Know how to call switchboard for Code announcement

• Know where the Pull Stations are located in your work area

• Know where the Fire extinguishers are located in your work area

• Know if you have an oxygen shut off valve in your work area and how to shut it off

• Know your evacuation plan

• Attend Code Red inservice every year

Code White—Violent Situation

• Call switchboard and state Alert Code White

and location

• Nurse in Charge becomes Incident Manager

• Call Police if required

• Attempt to de-escalate situation

• Attend Non-Violent Crisis Intervention

training

Code Blue—Adult Cardiac

Arrest/Medical Distress

• Assess the patient

• Notify switchboard stating “Code Blue and

Location”

• Wear Personal Protective Equipment

• Start CPR

• Bring crash cart to the patient

Code Blue Flow Chart

Code Green

• Evacuation is required

• Horizontal or vertical evacuation

• Precautionary i.e. Flooding

• Stat i.e. Fire, Explosion

• Notify Switchboard Alert Code Green

• Partial evacuation—behind fire doors

• Total evacuation—exit the building

• If total evacuation, dial 911

Code Green Stat

• Evacuation prioritization

– Those in immediate danger

– Ambulatory patients

– Semi-ambulatory patients

– Non-ambulatory stable patients

– Non-ambulatory unstable patients

– Oxygen, Patient Census List, Charts

– Medication Carts

Code Green

Code Pink—Cardiac Arrest/Medical

Emergency Infant/Child

• Call for help

• Initiate CPR

• Bring crash cart

• Follow flow chart in procedure

• Support family

Code Brown—Hazardous Spill

• Small spill—less than 1 litre, no toxic fumes or vapours, trained person can manage spill

• Large spill—more than 1 litre, fumes, vapours, need a team to support the clean up

• Notify Switchboard Code Brown and location

• Check Material Safety Data Sheet (MSDS) for appropriate PPE requirements

• Specialized kit in Chemotherapy rooms at LMH and GMCH

Code Brown

Code Purple—Hostage Taking

• Remain calm and cooperate with hostage

taker

• Establish eye contact but do not stare

• Observe details and speak when spoken to

• Signal for help/assistance

• Notify Police

• Police will assume responsbility

Code Black

• Bomb threat

• If you receive the call, be calm, keep the caller

in conversation and ask details of location of

bomb, explosion time and any other details

• Signal for help, to initiate call to Police

• Notify Administration on call

• Police will respond and search of building will

be initiated

Code Grey—Infrastructure

Loss/Failure or Air Exclusion

• Loss of utilities (heat, electricity, water,

steam)

• Loss of telecommunications

• Hazardous materials in community requiring

air exclusion

• Emergency generators available

• Cell phones and power safe phones available

Code Grey Flow Chart

Code 777—Obstetrical Emergency

• GMCH only

• All Obstetrical On Call Group, Anesthesia, C-

section Physicians, Surgical Suite are paged to

respond to the Hospital immediately

Documentation

• All Codes have

accompanying

documentation forms

for completion by staff

Questions?