Primer on Hospital Alert Codes

Primer on Hospital Alert Codes

Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg

January 13, 2012

Edited: January 15, 2012

Introduction

January 8, 2012 was the day that triggered me to do an in-depth study and analysis and eventually forced me to write a primer on hospital emergency alert codes today, January 13, 2012.

It all started with a call at around 11 am that day from DOH-HEMS Director Carmencita Banatin who requested me to activate the Code White Alert for Manila Doctors Hospital (MDH) as there was an intelligence report of a terrorist plot during the Black Nazarene Feast on January 9, 2012.

After I facilitated the activation of the Code White Alert for Manila Doctors Hospital as well as for Ospital ng Maynila Medical Center (OMMC) on the same day I received the intelligence report from Dr. Banatin, I started analyzing every aspect of Code White Alert  such as when is it indicated, the steps by steps in activating it in a hospital, what would made it an effective Code White Alert, etc.  I communicated with people in MDH and OMMC from January 8 up to January 12, 2012.  I asked them how they went about activating the Code White Alert.  I probed and analyzed what transpired during the Code White Alert in these two hospitals.

Today, January 13, 2012, I am more or less ready to write a primer on hospital emergency alert codes in the Philippine setting.  Here it is.  I hope this primer will benefit emergency managers in all hospitals in the Philippines, both private and government, both DOH and local government.

 

The Primer

What are hospital emergency and disaster codes?

Hospital emergency and disaster codes are codes, usually using colors, being used in hospitals worldwide to convey essential information quickly to staff during times of potential and actual emergencies and disasters.  The other reason why codes are being used is to prevent stress or panic among patients and visitors in the hospitals during response to actual emergencies and disasters.

What are the uses of hospital emergency and disaster codes?

Hospital emergency and disaster codes are being used for two purposes, one, to convey need to be alert or ready and two, to convey type of emergency or disaster occurring in the hospital that needs a corresponding response.

What are the advantages of having a standardization of hospital emergency and disaster codes and what is the current situation worldwide and in the Philippines?

To facilitate collaborative networking and responses during emergencies and disasters in the community, ideally, there should be uniformity of the codes being used by all hospitals.

There is currently no universal standardization of the emergency and disaster codes being used by hospitals. There is no uniformity worldwide, countrywide, and metropolis wide.

In the Philippines, for the hospitals under the Department of Health (DOH), because of the Administrative Orders 182 s 2001 and 2008 – 0024, there is a standardized code alert system which consists of Code White, Code Blue, and Code Red.   Outside DOH hospitals, in the local government and private hospitals, there are variable usages and connotations for the three codes, if ever they are used and there are other codes being used aside from these three.

There is really a need to standardize the emergency and disaster codes being used in government and private hospitals in the Philippines to facilitate collaborative networking and responses during emergencies and disasters in the country and in a specific community.

Off-hand, the easiest thing to do is for all hospitals in the Philippines, both government and private, to adopt the three basic color codes being used by DOH, namely, white, blue, and red, and use them as alert codes for surge or sudden influx of patients to their hospitals.

How are hospital emergency and disaster codes classified?

Hospital emergency and disaster codes can be classified into alert codes and response codes.

Hospital alert codes are mainly used in anticipation of surge of patients from an emergency or disaster occurring outside the hospital.  However, they can also be used for anticipated emergencies and disasters involving the hospital itself, such as when there is a forecast typhoon.

Response codes are mainly used in response to emergencies and disasters occurring within the hospital such as fire, earthquake, flood, and sudden cardiopulmonary arrest of patients, staff, and guests.  However, they can also be used in response to external. emergencies and disasters.

As mentioned above, for alignment purposes, the recommendation is for all hospitals to adopt the alert codes being used by DOH hospitals, as long as the word “Alert” is incorporated in the code, like so, Code White Alert, Code Blue Alert, and Code Red Alert.

Color codes without the word “Alert” being used in hospitals shall be considered as response codes.   Response codes can make use of colors also. If there are two similar colors being used in the alert and response codes, the presence of “Alert” makes for the distinction.  Example, Code Red is a response code in cases of fire in the hospital. Code Red Alert is an alert code for more manpower and supplies in preparation for an anticipated extensive surge of patients.  Code Blue is a response code in case of sudden cardiopulmonary arrest in the hospital.   Code Blue Alert is an alert code.

 

From hereon, discussion will be confined to alert codes as this is the primary objective of this primer.

What are the DOH alert codes and the codes that are being recommended for all hospitals, both government and private, to adopt for alignment purpsoes?

Color White Alert

Code Blue Alert

Code Red Alert

What are the conditions in which the different alert codes can be adopted?

DOH has spelled out conditions for adoption or activation of each code.  These DOH guidelines can be used as guide by all hospitals, both private and government.

Conditions in which Code WHITE Alert can be adopted:

• Strong possibility of a military operation within the area/region, e.g., coup attempt

• Any planned mass action or demonstration within the catchment area

• Forecast typhoons (Signal No. 2 up) the path of which will affect the area

• National or local elections and other political exercises

• National events, holidays, or celebrations in the area with potential for mass casualty incidents

• Any emergency with potential 10-50 casualties (deaths, injuries)

• Any other hazard that may result in emergency

• Unconfirmed report of reemerging diseases, e.g., bird fl u, SARS

 

Conditions in which Code BLUE Alert can be adopted:

• When 20-50 casualties (red tags) are suddenly brought to the hospital.

• Any internal emergency/ disaster in the hospital which brings down their operating capacity (i.e., vital areas) to 50% or which would require evacuation of patients and setting up of a Field Hospital.

• For conditions other than mass casualty incidents, the influx of patients is beyond the capacity of the hospital to handle.

• Confirmed/documented report of reemerging diseases (SARS, human to human avian flu) within the catchment area.

 

Conditions in which Code RED Alert can be adopted:

• When more than 50 (red tag) casualties are suddenly brought to the hospital.

• An emergency wherein the services of the hospital is paralyzed since 50% of the manpower are themselves victims of the disaster.

• Hospital is structurally damaged requiring evacuation and/or transfer of patients.

• Conditions requiring mandatory quarantine of hospital and its personnel (e.g.,

SARS, avian fl u); uncontrolled human to human transmission of SARS/avian flu

within the catchment area.

What are the general sequential steps in the activation and deactivation of alert codes?

  1. Monitoring of news of potential emergency and disaster that may create a surge of patient incident or event in the hospital.
  2. Assessment of the potential incident or event with a determination on what alert code to activate.
  3. Securing of permission for activation of an alert code from the Hospital Director by the Hospital Disaster Control Director.
  4. Activation of an alert code approved by the Hospital Director to be implemented through the Hospital Disaster Control Director.
  5. Surveillance for occurrence of actual emergency and disaster with corresponding response.
  6. Maintenance of readiness of out-of-hospital stand-by staff  such that they  proceed promptly to the hospital when needed.
  7. Securing of permission for deactivation of an alert code from the Hospital Director by the Hospital Disaster Control Director.
  8. Deactivation of an alert code approved by the Hospital Director to be implemented through the Hospital Disaster Control Director.

What are main targets of readiness in the alert codes of the hospitals?

The main targets of readiness in the alert codes of the hospitals consist of having enough manpower and enough supplies to handle anticipated surge of patients to the hospital.

What are recommended guidelines in ensuring manpower readiness under each code alert?

Determine the composition of the Hospital Alert Teams as well as Department Alert Teams.

Determine which teams and who should be physically present and which teams and who can be on stand-by outside the hospital in each alert code.

Use the checklist on essential steps in responding to a surge of patient emergency as a guide to determine who, how many staff, and what teams should be available and made readily available when needed.

Essential steps in responding to surge of patients Who How many staff Teams
Declaration of disaster
Creation of an incident command
Notification ofDisaster Control Officer
Chair, Disaster Preparedness Committee
Hospital Director
Concerned Division and Department Heads
Mobilization and organization (task assignment and authorization) of staff
Mobilization of ancillary services (laboratory, x-ray, pharmacy, etc)
Control of disasterTriage  
Treatment
Referrals / Transport
Traffic control
Patient log
Relatives Information Area
Press conference
Decongestion and post-disaster reconstruction
Post-disaster evaluation and reporting

Use  the following checklist as a guide in determining who, how many staff, and what teams should be available and made readily available when needed.

Hospital  / Department Alert Teams Who /Person-in-charge How many staff Teams / Person-in-charge
Administrative Team
Corporate Communication Team
Medical Team
Nursing Team
Institutional Worker Team
Security Team
Telephone Service Team
Admitting Team
Information Team
Ambulance
Emergency Room
Operating Room
Record Team
Pharmacy
Dietary
Finance
Others

Use the following manpower stand-by monitoring sheet as a guide:

XYZ Hospital / Department Alert Team Members Stand-by Monitoring Sheet

Alert Code:  White /  Blue  /  Red  (encircle one)

Date and Time of Activation:

Name of Event / Incident:

Name of Consultants / Residents / Interns / Staff Cellphone Nos. / Residence (City) Time SMS on Activation / Deactivation Time SMS response (copied / noted) Whereabout / Time Remarks

 

What are the recommended guidelines on communication system that will ensure adequacy and prompt response of manpower?

The primary communication device shall be the cellphone as this is readily available and will facilitate documentation of all activities that transpire which in turn will facilitate evaluation, particularly, on activation and deactivation messages and responses and whereabout messages of members of the surgical teams.  The cellphone can be complemented with telephones and other means of communication.

Templates for text messages shall be used.

What are examples of templates of SMS messages that can be used during the activaiton and deactivation of alert codes?

Templates for SMS (text) messages:

Messages – Types

Templates with Examples

Announcing activation of alert code Code (COLOR) Alert; Date; Time; Event – Hospital Director / Hospital Disaster Control DirectorEx: Code WHITE Alert; January 9, 2012; 1300H; Black Nazarene Feast – HD / HDCD
Repeating announcement of activation of alert code Txt  # – Code (COLOR) Alert; Date; Event – Hospital Director / Hospital Disaster Control DirectorEx: Txt 2 – Code WHITE Alert; January 9, 2012; 1300H; Black Nazarene Feast – HD / HDCD
Announcing deactivation of alert code Deactivation – Code (COLOR) Alert; Date; Time; Event – Hospital Director / Hospital Disaster Control DirectorEx: Deactivation – Code WHITE Alert; January 9, 2012; 1300H; Black Nazarene Feast – HD / HDCD
Responding to announcement of activation of alert code Noted or Copy.  WhereaboutEx:

Noted.  Am now at home in Malabon.

Copy. Am now in Mall of Asia.

Responding to announcement of deactivation of alert code Noted or Copy.
Requesting update on whereabouts of members of surgical team on stand-by:  Whereabout Update #?Ex:

Whereabout Update 1?

Whereabout Update 2?

Updating status of alert code Code Update # – still or now Code (COLOR) Alert; Date; Time; Hospital Director / Hospital Disaster Control DirectorEx:

Code update 1 – still Code WHITE Alert; jan9; 2000H; HD / HDCD

Code update 2 – now Code BLUE Alert; jan 10, 2000H; HD / HDCD

 

What are recommended guidelines in ensuring there are enough supplies to handle anticipated surge of patients to the hospital?

Determine the supplies needed for each level of alert code.

Use the following supplies monitoring sheet as a guide:

XYZ Hospital / Department Supplies Stand-by Monitoring Sheet

In Emergency Room / Operating Room / Other Departments (specify)

Alert Code:  White /  Blue  /  Red  (encircle one)

Date and Time of Activation:

Name of Event / Incident:

Item

Quantity Needed

Current Quantity

Remarks

Red Blue White

Use the following checklist as a guide also.

Hospital  / Department Alert Teams Supplies Needed Other Logistics Needed
Administrative Team
Corporate Communication Team
Medical Team
Nursing Team
Institutional Worker Team
Security Team
Telephone Service Team
Admitting Team
Information Team
Ambulance
Emergency Room
Operating Room
Record Team
Pharmacy
Dietary
Finance
Others

What are the ultimate criteria to be used in evaluating an alert code activation?

Evaluation of an alert code activation shall be based on whether there is adequate preparation in anticipation of an emergency and disaster and the quality of response when there is occurrence of the anticipated emergency and disaster. The minimum criteria to be used during the evaluation will be adequacy and response time (to be in the Hospital) of manpower on stand-by outside the hospital and the adequacy of prepared supplies based on a must-have list.

What are the general parameters and criteria that can be used in evaluating a hospital alert code system?

Presence of policies and procedures on alert code system

General steps followed during activation and deactivation

Specific guidelines and instructions followed during activation and deactivation

Presence of exercises at least once a year

Presence of evaluation after every activation of an alert code (see evaluation checklist)

Presence of continual review and improvement activities

During actual activation of an alert code:

Presence of adequate manpower on alert stand-by based on activated alert code

Response time (being in the hospital) of at least 80% of manpower on stand-by outside the hopsital within 30 minutes

Presence of adequate prepared supplies based on activated alert code

 

What is an example of a checklist that one can be used in evaluaitng the quality of an alert code activation and deactivation?

XYZ Hospital Alert Code Activation and Deactivation

Evaluation Checklist

 

Alert Code:  White /  Blue  /  Red  (encircle one)

Date and Time of Activation:

Name of Event / Incident:

  Required-activity Statements for Evaluation Yes / No Remarks (areas for improvement)
1 The alert code was activated by the Hospital Disaster Control Director with the approval of the Hospital Director.    
2 All members of the Hospital / Department Alert Teams were texted announcing the activation of the alert code.    
3 The alert code was texted within 30 minutes after a decision to activate the code right away or it was texted promptly (within 30 minutes) at a time determined by the Hospital Director / Hospital Disaster Control Director.    
4 The texted message activating the alert code was concise with inclusion of names of the Hospital Director / Hospital Disaster Control Director, official date and time of start of alert, and the object or trigger of the alert.    
5 All members of the Hospital / Department  Alert Teams receiving the activation text replied with “copy” or “noted” and current exact whereabouts, within 30 minutes after the code activation text was sent.    
6 There was a repeat texting of the code activation until at least 80% of the members of the Hospital / Department Alert Teams replied with “copy” or “noted” and current exact whereabouts. This was achieved within 60 minutes after the code activation text was first sent.    
7 There was an update report on the status of the alert code at least one every 8 hours from time of activation to time of deactivation or at a shorter interval as deemed necessary by the Hospital Disaster Control Director.    
8 There was a repeat texting inquiring on the whereabouts of the members of the Hospital / Department  Alert Teams who are staying outside the hospital at least every 8 hours from time of activation to time of deactivation or at a shorter interval as deemed necessary by the Hospital Disaster Control Director.    
9 There were update reports on whereabouts of members of the Hospital / Department Alert Teams who were on stand-by outside the Hospital at least every 8 hours from time of activation to time of deactivation or at a shorter interval as deemed necessary by the Hospital Disaster Control Director.    
10 The preparation for securing the supplies prescribed within each alert code was completely done within 60 minutes from the official time of activation of the code.  Completely means complete in quantities based on the list prescribed under each alert code.    
11 The Hospital Disaster Control Director coordinated with hospital administration and other departments, Emergency Room, Operating Room, and Anesthesiology, in particular, in the preparation and implementation of plans for the Hospital’s readiness for the anticipated emergency / disaster.    
12 All the members of the Hospital / Department Alert Teams who were on stand-by outside the Hospital were able to arrive to the Hospital within 30 minutes after elevation of a lower code alert to a higher level such as from Code White to Code Blue or Code Red.    
13 The alert code was deactivated by the Hospital Disaster Control Director with the approval of the Hospital Director.    
14 All members of the Hospital / Department Alert Teams were texted announcing the deactivation of the alert code.    
15 The deactivation message was texted within 30 minutes after a decision to deactivate the code.    
16 The texted message deactivating the alert code was concise with inclusion of name of the Hospital Disaster Control Director, official date and time of stand-down and the object or trigger of the alert.    
17 All text messages from start of the activation of the alert code to stand-down (deactivation) were preserved in the cellphones of all the members of the Hospital / Department Alert Teams for purposes of documentation, monitoring and evaluation.    
18 There was an evaluation of the alert code activation within 72 hours after deactivation.    
19 Areas of improvement were identified during the evaluation.    
20 Action plans for areas of improvement were formulated within 7 days after the evaluation.    

 

Appendix:

PH DOH – HEMS Guidelines on Early Warning and Alert Systems (For DOH Hospitals)

From Guidelines for Health Emergency Management – Hospitals, Philippines, 2nd edition, 2008, DOH, HEMS

ROJoson’s Notes: These guidelines may be adapted to city government hospitals and private hospitals.  The target is all hospitals to use the same early warning and alert systems as much as possible so that there will be alignment, avoidance of confusion, and effective networking.

The Code Alert System of the Department of Health is a mechanism for the provision of health services during emergencies and disasters which describes the conditions that govern the expected levels of preparation and the most suitable responses by all concerned, particularly during mass casualty situations.

The first code alert system provided by A.O. 182 s. 2001 was directed to the Department

of Health hospitals given that “most emergencies and disasters are unpredictable

but are not totally unexpected.” The tri-color system has been revised to expand beyond the hospital, paving the way for the harmonization of the code alert of the hospitals, regional offi ces, key central offi ces and the HEMS Central offi ce. The code starts its lowest level of alert at Code White, then Code Blue and Code Red.

The Integrated Code Alert System of 2008 (Administrative Order No. 2008 – 0024)

describes the conditions for adopting the alert status, the human resource requirements

and other requirements (e.g., logistics) with the procedure in implementing the Code Alert.

Alert Signals

 

It is a known fact that the occurrence of all hazards cannot be predicted.

• Earthquakes may occur without warning.

• Some hazards can be predicted as to

❍ Occurrence

❍ Impact on the community

❍ Outcome whether emergency or disaster

❍ Consequences or risks

• Hazards such as typhoons, volcanic eruptions, or threats of civil disorders, can be anticipated several hours before they occur, giving at least ample time to get ready to respond before emergencies or disasters are foreseen and/or declared.

Guidelines for Effective Early Warning and Alert Systems

Basic considerations in understanding a warning and alert system are described below

(Carter, 1991; SDP, 2000).

Timely warning of an imminent or probable hazard with a potential to cause an emergency or a disaster will possibly prevent the occurrence or lessen the severity of its

consequences. The extent of such reduction depends upon the interaction of three elements, namely:

• Accuracy of warning

• Length of time between the warning being raised/declared and the expected onset of the event

• State of Emergency/Disaster Preparedness

Requirements for Effective Warning include the capability to:

Receive international warning

Example: cyclone warnings from Tropical Cyclone Warning Centers in various locations;

meteorological indications from weather satellites of possibly developing threats

Initiate in-country warnings necessary in cases such as floods, landslides, volcanic

eruptions, earthquake

Transmit warning from national level and other key government levels; mostly done by radio links or broadcast systems

Transmit warning at local community level; may be done by local radio stations, sirens, loud hailers, bells, messengers

Receive warning and act upon it. This requires:

❍ possession of or access to a radio receiver or similar facility

❍ being in hearing/seeing distance of signals

❍ knowing what various warnings mean

Alerting consists of a number of response phases, namely:

Alert – The period when it is believed that resources may be required to enable an increased level of preparedness

Standby – The period normally following an alert when the controlling organization believes that deployment of resources is imminent – personnel are placed on standby to respond immediately

Call-out – The command to deploy resources

Stand-down – The period when the controlling organization has declared

that the emergency is controlled and that resources may be recalled

To implement these phases, there needs to be:

• A protocol of which organizations to alert for which emergencies and what tasks;

• A contact list for all organizations;

• Duty officer rosters in all organizations to ensure that the organization can be

contacted during off hours; and

• A description of the type of information that should be supplied in the various

phases of alerting.

Warnings should be transmitted using as many media as available. These may originate

from:

• The scene or the potential scene of the emergency and passed upwards; or

• The national government and passed down to the scene of the impending emergency

A community warning should cause appropriate public responses to minimize harm.

Warning messages should:

• Provide timely information about an impending emergency.

• State the action that should be taken to reduce loss of life, injury and property

damage.

• State the consequences of not heeding the warning.

• Provide feedback to response managers on the extent of community compliance.

• Be short, simple and precise.

• Have a personal context.

• Contain active verbs.

• Repeat information regularly.

Code Alert Levels (White, Blue, and Red)

Code White

1. Conditions for adopting Code White:

• Strong possibility of a military operation within the area/region, e.g., coup attempt

• Any planned mass action or demonstration within the catchment area

• Forecast typhoons (Signal No. 2 up) the path of which will affect the area

• National or local elections and other political exercises

• National events, holidays, or celebrations in the area with potential for MCI

• Any emergency with potentially 10-50 casualties (deaths, injuries)

• Any other hazard that may result in emergency

• Unconfi rmed report of reemerging diseases, e.g., bird fl u, SARS

2. Human Resource requirements for responding to the Code:

• First response team ready for dispatch to include the following:

✔ 2 doctors preferably Surgeon, Internist, anesthesiologist, etc.

✔ 2 nurses

✔ First Aider/EMT

✔ Driver

• Second response team should be on call

• The following should be available for immediate treatment of incoming patients:

✔ General Surgeons

✔ Orthopedic Surgeons

✔ Anesthesiologists

✔ Internists

✔ O.R. Nurses

✔ Ophthalmologists

✔ Otorhinolaryngologists

✔ Infectious Specialists

• Emergency service personnel, nursing personnel and administrative personnel residing at the hospital dormitory shall be placed on call status for immediate mobilization.

3. Other requirements:

• The Hospital Operations Center should be activated. It should continuously report and coordinate with the Regional and DOH Central Operations Center.

Medicines and Supplies

• Ensure that emergency medicines (especially for trauma needs) be made available at the emergency room.

• Medicines and supplies in the operating rooms should likewise be reviewed and in

creased to meet sudden requirements.

• Other needs such as X-ray plates, laboratory requirements, etc. should be made available and not required to be purchased by victims.

• Personnel department to prepare for mobilization of additional staff.

• Finance department to ensure availability of funds in cases of emergency purchases and the like.

• Logistics department to coordinate with possible suppliers for additional requirements.

• Dietary department to open and meet the need of the victims as well as the health personnel on duty.

• Security force to institute measures and stricter rules in the hospital.

• Activate Bird Flu Plan/ SARS Plan, etc.

• Enforce and monitor use of personal protective equipment (PPE) for all health personnel.

• Triage system should be activated.

Code Blue

1. Conditions for Adopting Code Blue:

Any of the following conditions:

• When 20-50 casualties (red tags) are suddenly brought to the hospital.

• Any internal emergency/ disaster in the hospital which brings down their operating capacity (i.e., vital areas) to 50% or which would require evacuation of patients and setting up of a Field Hospital.

• For conditions other than MCI, the influx of patients is beyond the capacity of the hospital to handle.

• Confirmed/documented report of reemerging diseases (SARS, human to human avian flu) within the catchment area.

2. Human Resource requirements for responding to the Code:

• HEMS Coordinator to be physically present at the hospital.

• On-scene Response Team

• Medical Offi cer in charge of the Emergency Room

• All residents of the Department of Orthopedics

• Medical Offi cer in charge of the Operating Room

• Surgical Team on duty for the day

• Surgical Team on duty the previous day

• Mental health professionals

• All anesthesiology residents

• Toxicologist, chemical experts for poisoning and/or chemical cases (if available)

• All third and fourth year residents

• Administrative Officer or designate

• Nursing supervisor on duty

• All OR nurses

• Social workers

• Dietary personnel

• Offi cer in charge of supplies at the CSR

• The entire security force

• Institutional workers on Duty

3. Other requirements:

All those mentioned in Code White plus:

• Activate Hospital Emergency Incident Command System (HEICS).

• Other needs of victims apart from medicines and supplies depending on the disaster should as much as possible be made available.

• The Chief of Hospital/ Medical Center or his designate should make proper coordination with other hospitals for networking and/or possible transfer of patients.

• Incident Commander should assign a Safety Officer, Liaison offi cer to coordinate with other agencies, and Public Information Officer to serve as the spokesperson of the hospital.

• Social Service section should prepare assistance to victims in coordination with mental

health professionals of the hospital, if available, and the Department of Social Welfare;

in addition they should lead in providing information to relatives of victims.

• Mortuary section should anticipate dead victims brought to the hospital for proper care and identification.

• The security team, in anticipation of possible influx or patients, relatives, responders,

police, press, etc. should ensure smooth flow of traffic inside the compound especially for the ambulances.

• Should report regularly to HEMS OpCen and as much as possible have regular press

releases or briefings.

 

Code Red

1.Conditions for Adopting Code Red:

Any of the following is present:

• When more than 50 (red tag) casualties are suddenly brought to the hospital.

• An emergency wherein the services of the hospital is paralyzed since 50% of the manpower are themselves victims of the disaster.

• Hospital is structurally damaged requiring evacuation and/or transfer of patients.

• Conditions requiring mandatory quarantine of hospital and its personnel (e.g.,

SARS, avian fl u); uncontrolled human to human transmission of SARS/avian flu

within the catchment area.

2. Human Resource requirements for responding to the Code:

All personnel enumerated under Code Blue

All medical interns and clinical clerks

All nurses

• All nursing attendants

All institutional workers

All administrative Staff

3. Other requirements:

All those mentioned in Code Blue plus:

• The Chief of Hospital/Medical Center Chiefs can cancel all types of leaves and can order all personnel to report to the hospital.

• The Chiefs of Hospital/Medical Center Chiefs can temporarily stop all elective admissions and surgeries and network with other hospitals.

• The Chief of Hospital/Medical Center Chiefs should anticipate requests for additional

manpower and specialists not available in his hospital.

He is further authorized to accept medical volunteers and other professionals to augment the hospital’s manpower resources rather than transferring patients based on

some agreements.

• Networking with other hospitals for augmentation of resources and transfer of patients

in special cases.

• Answer all queries of the media pertaining to patients in the hospital.

• Anticipate evacuation and/or use of field hospital; closure and/ or quarantine of the

hospital.

• The Chief of Hospital/Medical Center Chief to specifically be concerned with safety and security, not only of the patients but of the personnel as well.

Guidelines in implementing the Code Alert

• The Hospital Code Alert shall be declared by the Secretary of Health or by the Director of HEMS for external emergencies; by the Medical Center Chiefs; Chiefs of Hospital; HHEMS Coordinator; or Head of the Disaster Committee of the Hospital emergencies within their catch ment area.

• Chiefs of hospital/medical center to automatically declare Code White during national events and activities especially with the potential of an MCI.

• Each hospital shall prepare its own procedures in declaring and lifting the Code.

✔ The alert level is raised, lowered or suspended by the Secretary of Health, Director of HEMS for external emergencies and national events; the respective Medical Center

Chiefs/Chiefs of Hospital or their designates for emergencies within their catchment

area.

✔ Conditions to raise or suspend the alert level depends on the threat – whether it is increased or is no longer present.

✔ Arrival of patients in the hospitals warrants the raising of the alert level; likewise alert can be suspended when no significant incident is monitored and the hazard or condition (typhoon, election, bombing, etc.) is finished and/or contained.

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One Response to Primer on Hospital Alert Codes

  1. Pingback: What usually happens during an activation of a Code White Alert in a hospital setting? | ROJOSON's FACEBOOK NOTES

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