It is no secret that at any given moment, hospitals are flooded with people. From patients, to doctors to nurses to visitors and anywhere in between, it is safe to say it’s a zoo most of the time. This can be particularly difficult and even a little annoying when you are sitting in the delivery room, attending an appointment or there with your sick little one. Like airports, malls, concert halls and other places where people congregate in big numbers, hospital use secret words to let staff know when an emergency situation is occurring. Even big department stores such as Walmart, for example, have developed their own system of codes. The concept behind having codes is to elude fear, but also to signal any kind of hazard to those trained and assigned to handle difficult situations.
Although there are some differences in regions or even individual hospitals, many codes are international in application. The United States and Canada use very similar codes for hospital crises– and this is made pretty clear by television and media (I’m sure you’ve all heard a “code blue” called on Greys Anatomy, for example). But some codes are a lot more obscure or are rarely used, leaving you in the dark, wishing you knew what was going on. This is especially relevant in a hospital emergency situation, when everyone seems to spring into action and you as a new mom or mom-to-be are feeling dumbfounded. The best thing you can do when a code is called is step aside and let hospital staff get to where they need to be faster (although it doesn’t hurt to know what’s going on). To help fill you in, here is a list of 15 secret emergency codes you’re not supposed to know.
15 Code Omega
If you hear a “code omega” being called, it is normally a code that is applicable to the obstetrics department. This is, of course, the wing of the hospital where babies are born and pregnant women come for checkups. This code is for a peripartum woman who has sustained enough blood-loss to be life-threatening. Peripartum is a fancy word for a woman who is either in the middle of giving birth or has just finished giving birth.
This code is very serious because blood loss during birth is the leading cause of maternal death worldwide. It accounts for 25% of all deaths of moms during child birth and it also puts babies at risk of death as well. If you hear this code being called and you are in the obstetrics wing (hopefully visiting and not the one giving birth), you will probably notice hospital staff burst through the doors with IV bags full of blood at an attempt to help the patient maintain adequate blood supply. This is scary stuff but is necessary to save the mom’s life.
14 Code 33
Similar to “code omega”, “code 33” is used in some hospitals to signify an obstetric critical situation. This is any sort of emergency situation in the obstetrics department of a hospital (the wing of the hospital where babies are being born). This code may include a medical situation like code omega, but is not simply limited to blood loss. Obstetric emergencies include fetal or mom distress, like dangerous changes in heartbeat or blood pressure, lack of oxygen to mom or baby, just to name a few. A “code 33” can result in a quick emergency c-section, where mom is quickly wheeled to an operating room.
Although this situation can bring on feelings of anxiety and panic, it is important to know that nurses and doctors know what they are doing. They can deliver babies in record time, normally ending the crisis or emergency situation.
13 Code OB
“Code OB” is again very similar to a “code 33” but is potential reserved for situations that are little more serious. “Code OB” is used when a diverse team is needed urgently, to respond to a life-threatening situation involving a pregnant woman or new mom, where the fetus is at substantial risk of not making it out alive. “Code OB” should not be used if the new baby doesn’t need to be resuscitated, meaning it is normally used only when a newborn is not breathing or doesn’t have a heartbeat and likely when a baby is about to be or in the process of being delivered.
The use of this code would bring together a team who is ready to resuscitate a new baby or both new baby and mom. It is important to keep in mind these codes may be different in your region or hospital that some may use the obstetrics codes interchangeably or just stick to one code for all obstetric emergencies. But you can be sure that if any of these codes are called, it indicates an emergency situation.
12 Code Rapid Response
“Code rapid response” is a code that is used in many hospitals with what they call a “rapid response system” in place to call for a team of experts to respond quickly to a dangerous situation. This team is of course generally made up of doctors, nurses, and nurse technicians, who head straight to a patient’s bedside, giving them medical attention to hopefully stop that patient from escalating to a “code blue” (which normally indicates respiratory failure).
“Code rapid response” is generally called when there is some sort of negative change in the patient’s mental state or vital signs or if he or she starts having a seizure. The interesting thing about this call is that in most hospitals with a rapid response team in place, the code can be called by anyone, like a concerned family member, and not just a staff member. This code is meant to be proactive, it is called at the first sign of a significant change to prevent a patient getting worse and needing to be escalated to a higher more dangerous code.
11 Code Pink
If you hear a “code pink” being called, it is time to step aside and get out of the way. A “code pink” is called only in the NICU and signals a newborn with cardiac danger, or in other words often premature baby, whose heart stops beating or has an issue maintaining a normal sinus rhythm (normal heart beat).
This is perhaps one of the scariest codes to hear being called, especially if it is pertaining to your little one. Although it is a mom’s worst nightmare, it is important to remember that these codes are necessary for staff to assemble in a way to potentially safe lives. Codes are extremely beneficial for the survival of these tiny and fragile babies and are their to help save their lives. Although much easier said than done, it is important to remain as calm as possible and let nurses and doctors do their jobs.
10 Code Red
This is one of the most universal codes used internationally. A “code red” means that there is a fire somewhere in the hospital. The calling of this code will normally be followed by the location like a room number, floor number, wing or unit type. An example would be “code red, second floor” or “code red, obstetrics wing”. Just because there is a fire doesn’t necessarily mean they are going to evacuate the entire hospital because it may be a relatively small fire that can be extinguished by a fire extinguisher or other measure.
The important thing about this code is where it is being called. If it is on a floor you are on, it’s a good idea to keep an eye out for smoke or flames and potentially make the decision to leave the area, if you are able. Keeping an ear open for further calls is also a good idea. A hospital wide evacuation would have a different code or the “code red” could be called off in a few minutes, reassuring you that the fire has been put out and everything is fine.
9 Code White
A “code white” is another code that is very universal. This code alerts hospital staff that there is a person who is being violent. This code will also be followed by a room number, floor or unit in the hospital, so that security and maybe even doctors and nurses of stronger stature can help with the situation.
A “code white” could be used for anyone, so in other words it could indicate a patient being violent but also a hospital visitor. The interesting thing is that beyond the use of “code white”, there are also normally hospital specific secondary codes to indicate the same thing or to give more specific details. So, if you hear something like “paging Doctor Strong to the ER”, it could indicate there is a violent person in the emergency wing. Other name variations could include Mrs. Strong, Dr. Armstrong or Dr. Heavy.
8 Code Blue
A “code blue” could in fact be a code that you’ve already heard of before. There are many hospital dramas that have been on television over the years. Everyone remembers the sexy George Clooney who stared in ER as Dr. Doug Ross or the ever-loved McDreamy from Grey’s Anatomy, just to name a few. In between drooling over these doctor hotties, you probably saw them dealing with a “code blue”. A “code blue” means respiratory arrest (someone has stopped breathing) or more specifically the respiratory arrest of anyone who is 30 days old to adulthood (under 30 days old is normally a “code pink”).
Some hospitals have different codes to indicate children in repertory arrest or tack on words like “pediatric” or “child” to alert medical staff that it is a child that is not breathing, but for the most part a “code blue” is used for the majority of people in this situation.
7 Code Black
Unlike “code blue”, a “code black” is probably one that you haven’t heard of, particularly in a hospital setting. Yes, this code is pretty rare to hear in a hospital but it is also used in other places such as schools, airports and malls and its use there is unfortunately more common. A “code black” indicates a bomb threat and alerts hospital staff to activate whatever bomb threat protocols they have in place. This may require evacuation or it may not, depending on the nature and severity of the threat. Police are always called in and made aware of this threat and will likely take over the situation.
It is also important to note that in some regions the term “code black” isn’t used at all and “code yellow” is used instead because it is more ambiguous, with the intention of bringing less attention to the fact that it’s a bomb, minimizing the state of panic.
6 Code Green
You’ve heard me talk about evacuation in case of a fire or possibly a bomb threat; well a hospital evacuation has its own code and is called a “code green”. This code is called if the hospital needs to be evacuated for any reason. In some hospitals, the “code green” is often followed by the term “STAT” or “precautionary” (i.e. “code green STAT” or “code green precautionary”). The term STAT means that there is a crisis and the evacuation must happen quickly. The term precautionary, still indicates an evacuation but the reason for the evacuation may not be as threatening or imminent. This would be important for doctors to know if there is a patient in severe distress or a surgery is in the middle of being performed.
5 Code Purple
A “code purple” is a code you hope you will never have to hear. This code indicates that someone has been taken hostage in the hospital. This could mean any one person has taken another person hostage with some sort of weapon. This hostage-taking doesn’t have to be with the use of a more standardized weapon like a gun, but could also indicate someone being held hostage with a needle or sharp instrument routinely found in the hospital.
This code is also normally followed by the room number, wing or area of the hospital where the hostage situation is taking place. Because taking someone hostage is a criminal offence, the police would also be called in this situation and could take over with the own hostage negotiations, depending on the severity of the incident. If you hear a “code purple” being called, hang tight and wait for further instructions as parts of the hospital may also be evacuated for your safety.
4 Code Orange
A “code orange” is a code used to request a hospital lock-down, or rather that everyone must stay where they are, and are not allowed leave the hospital. There could be several reasons why this code would be called and one would be if there is a child who is lost or a mentally unstable patient who is missing from their room. A lock down could also be requested if there is some sort of immediate danger outside of the hospital and police have determined that everyone would be safer inside.
Often essential services like hospitals remain open during weather emergencies but remain on lock-down, to shelter everyone inside from outside conditions. This would have likely happened during the recent hurricane events in the United-States. A lock down could also be called with the code “lima delta” which stands for “LD” as an alternative code word.
3 Code Sepsis
“Code sepsis” is a very specific code that is only called when there is a patient who is experiencing sepsis or entering into septic shock. Sepsis is a condition when a foreign invader like a virus, bacteria or fungus enters the blood stream and causes a bad infection that is life-threatening. This infection attacks the body’s immune system, causing inflammation in the body, which effects heart rate, body temperature, while blood cell count, and respiratory function.
Sepsis is a medical term for a blood infection. Once the infection enters the blood, it can be very difficult to cure. You may not hear this code being called in the obstetrics wing very often but this is a very good thing! Sepsis can be extremely dangerous for moms and babies and could be life-threatening to both.
2 Code Heart
This code is meant to be used the way it sounds: to alert hospital staff that there is a patient who’s in cardiac arrest (having a heart attack) and needs immediate medical intervention. This code could be used on any floor and in any wing but is more often heard in the emergency department. This patient may not have lost consciousness or respiratory function yet but have all the signs indicating a heart complication.
An example of a use of this code would be for if a patient is having an MI (myocardial infraction), which is basically a medical term for when the arteries of the heart are clogged, blood cannot flow to the heart and it stops working properly. A team of doctors and nurses rush together to help the patient be stabilized and are on stand by for resuscitation if it is deemed necessary.
1 Code Clear
This code is (most of the time) the best code you could ever hear while in a hospital (and yes, it means exactly the way it sounds). “Code clear” means that the danger accompanied by whatever code has recently been called has passed and the situation warranted by the code is no longer a threat. Like some of the other codes, this could be accompanied by a floor or room number, especially if multiple codes are called at the same time.
Although in most cases this would be a good thing, a “code clear” does not indicate if doctors or nurses were successful at resolving the reason for the code. So in the case of a patient emergency, this could unfortunately mean that the patient has passed away but it also mean that their vital signs are back to normal and the patient has been stabilized. I would like to think in most cases it would be the latter scenario and that codes are in place to increase emergency response times, which results in more lives being saved.
Sources: WebMD, OntarioHospitalAssociation, CaliforniaHealthcareAssociation, SaigGlobal
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