We’ve all seen it. Late night visitors are strolling through a hospital’s halls to see loved ones there. Or leaving for the night. Suddenly, there’s a cryptic message blaring overhead. Medical staff rush into a patient’s room, conversation frantic yet controlled as they view the room’s medical computer and its EMR. A few anxiety-filled minutes later, they come out, one by one, with either relief on their faces or are looking down. 

What brought them all together? How’d they even know there was a problem? And why that particular team? The answer is hospital emergency codes. Today we will discuss them in depth with special focus on code blue. What’s their purpose, how they work, and why they’re important in healthcare. 

What is Code Blue

Most hospitals use codes to communicate some form of urgent situation or emergency on the premise. They quickly alert medical personnel about:

  • What is the emergency
  • What is expected at the scene
  • Who is needed to deal with the situation

Code Blue is the most well-known hospital emergency code. It alerts staff that a patient is in possible life-threatening distress. This can be:

  • Cardiopulmonary arrest
  • Changes in mentality
  • Chest pain
  • General worries about a patient’s health status ‌ (Example: turning an unnatural shade of blue due to lack of oxygen.)
  • Presyncope or sensation of about to faint

The examining medical personnel, usually a nurse, calls a Rapid Response Team to evaluate and treat the patient. 

Call the Code

If the team cannot stabilize the patient, the hospital operator is contacted to start the Code Blue. The announcement is usually composed of the code followed by its location (“Code Blue in ICU”. “Code Blue in NICU”.) 

Hospitals may have different variations of Code Blue. A Code Blue Pediatric means the patient is a child (under the age of 18) while Code Blue Neonate is an infant (4 weeks or younger). 

Respond to the Code

A Code Blue team converges on the scene. It is typically composed of medical personnel selected by the hospital specifically for the code. Most are led by an anesthesiologist.    

Treatment during the code varies on the patient’s condition. Intubation, or the insertion of an endotracheal tube (ET) through a patient’s mouth or nose and into their trachea, may be needed. This is performed by the anesthesiologist. An automated external defibrillator (AED) may be used if their heartbeat is irregular. Powerful drugs like naloxone may be injected to reverse any overdoses.

Did You Know?

Hospitals originally developed emergency codes so staff could deal with emergency situations like distressed patients or on-site fires without alarming visitors and patients. 

Unfortunately, hospitals were left to develop their own codes. Misunderstanding of one such code contributed to the deaths of three medical staff members in September of 1999. Dung Trinh, apparently distraught at the death of his mother in California-based West Anaheim Medical Center, shot and killed an on-site nurse’s assistant, a pharmacist, and a hospital maintenance worker. Later investigation of the tragedy showed a misunderstanding of the hospital’s Code Grey – Combative or violent patient – had staff rushing to the scene instead of taking cover to wait for law enforcement. Code should have been Silver, instead. 

The following year, the Hospital Association of Southern California (HASC), based on the investigation’s results, released new emergency code guidelines and standards which it encouraged hospitals to adopt throughout the nation. 

Code Red and Other Hospital Emergency Codes

Code Blue alerts the hospital staff of emergencies as they’re happening. Generally, codes are sent out through the hospital’s public address system. 

Note not all codes are medical events. They can also notify them to prepare for an incoming urgent situation like a storm or an earthquake. Also, emergency hospital codes are not standardized. They can vary widely between states and even within the same community. Their exact meanings may be found on placards throughout the hospital for ready reference. They may also be placed on employee identification badges or checked on a medical tablet

Below are a mix of codes hospitals may use and their meaning.

Code Red 

Fire or Smoke. Smoke, the smell of smoke, or an active fire sighting. Even the sound of a fire or active smoke alarm may bring a call for this code. 

Code Red is the second most well-known alert after Code Blue. 

Code White or Orange

Missing infant or child. Hospital staff’s usual response is to monitor all exits and doors.

Code Yellow or Black

Bomb Threat. Hospital staff goes on the alert for any suspicious items. 

Other codes and their meanings include:

  • Code Brown: severe weather like an incoming snowstorm
  • Code Clear: emergency is over
  • Code Gray: combative or abusive behavior on-site by patients, families, visitors, staff, or physicians 
  • Code Green: activation of emergency operations plans like mass evacuation of the facilities
  • Code Orange: spill or release of hazardous material alert
  • Code Pink: infant abduction or pediatric emergency alert
  • Code Silver: a combative person on-site with a weapon. Contact law enforcement asap

These and other codes like “doctor codes” and “resus codes” will be covered more in depth in the future. 

Closing Thoughts

Hospital emergency codes like Code Blue are used to alert hospital staff of specific, urgent situations. They are a vital part of healthcare as they prevent panic from visitors and patients. 

Contact an expert at Cybernet Manufacturing if your hospital is interested in how medical computers can aid with hospital emergency codes from making them easier to understand to reaching the right staff quickly. 

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