Code red policy in health care services for MHA course.pptx

CODE RED POLICY IN HOSPITAL SERVICES

1. Code red policy in health care services DR.ANJALATHI MUTHUKUMARAN M.SC (N)MD(AM)MBA(HA) ERA UNIVERSITY

2. Type of disaster in hospital In July 2000, the committee adopted the following standardized code names: Š RED for fire Š BLUE for adult medical emergency Š WHITE for pediatric medical emergency Š PINK for infant abduction Š PURPLE for child abduction Š YELLOW for bomb threat Š GRAY for a combative person Š SILVER for a person with a weapon and/or hostage situation Š ORANGE for a hazardous material spill/release Š TRIAGE INTERNAL for internal disaster Š TRIAGE EXTERNAL for external disaster

3. Learning objectives To introduce the topic To define the code red policy To list out the purpose of code red To describe the code red policy To discuss the code red procedure To explain the code red alert system in hospital To understand action taken by various department of hospital team Training and education Documentation and reporting Summary Conclusion References

4. Meaning Code Red' is used as a code word to  alert employee and fire-fighting team on un-expected detection of fire or possibility of fire anywhere within hospital's premise . .

5. PURPOSE To provide an appropriate response in the event of an actual or suspected fire in order to protect life, property and vital services.

6. Code red alert system in hospital Code red is an emergency code which is used to alert employee and fire-fighting team in case a fire or possibility of fire is detected within the hospital premise. Unexpected fire is considered as an emergency situation and code red system is used to urgently activate a set of action intended to control the fire and prevent any major mishap. The system may slightly vary from hospital to hospital, depending upon how the hospital is structured and organized. Here is a code red system that can be used as a reference by hospitals.  ( Other codes  -  Code Blue ,  Code Pink )

7. CODE RED POLICY ‘ Code Red’ is used as a code word to alert employee and fire-fighting team on un-expected detection of fire or possibility of fire anywhere within hospital’s premise. All employees are expected to know the ‘Code Red’ system and must adhere to the action plan and guidelines to be followed under this system. The intercom line with number 1111 is dedicated for calling and activating code red. This number can be called from any intercom device and should be used only in the event of fire. Employees are also expected to know the location of the nearby fire-extinguisher and emergency exit route to be used for the area where they work. A new employee in the hospital must be oriented to the code red system on first day of the work. Following system shall be used for Code Red.

8. POLICY A. Due to the potentially devastating effects of a fire and the non-ambulatory nature of many patients, all employees have a responsibility to respond quickly to a suspected or actual fire. B. Code Red should be immediately initiated whenever any one of the following indications are observed: 1. Seeing smoke, sparks or a fire. 2. Smelling smoke or other burning material. 3. Feeling unusual heat on a wall, door or other surface. 4. In response to any fire/life safety system alarm.

9. Continued C. The Code Red Task Force shall perform only basic fire response operations for beginning stage fires that can be controlled or extinguished by portable fire extinguishers without the need for protective clothing or self-contained breathing apparatus. D. All employees must complete an annual safety training that includes appropriate fire/life safety procedures. The Code Red Task Force shall also receive appropriate annual training in accordance with their duties. E. Each department must develop individual protocols that support the organization’s overall Code Red response.

10. PROCEDURES A. Upon discovery of fire (suspected or actual) 1. At origin: a. R.A.C.E. Remove patients, visitors and personnel from the immediate fire area. Consider removing patients and staff from the adjoining rooms/floors. Disconnect exposed oxygen lines from wall outlets. Activate the fire alarm and notify others in the affected area to obtain assistance. Follow your organization’s emergency reporting instructions. Contain the fire and smoke by closing all doors Extinguish the fire if it is safe to do so. (see P.A.S.S.)

11. Fire fighting signage

12. Continued b. S.A.F.E. Safety of life Activate the alarm Fight fire (if it is safe to do so) Evacuate (as necessary or instructed) c. P.A.S.S. – Fire extinguishing techniques: Pull the pin Aim the nozzle of the extinguisher at the base of the fire Squeeze the trigger Sweep the extinguisher’s contents from side to side

13. PASS image signage

14. Continued 2. Away from origin: a. Listen to overhead paging system. b. Prepare to assist, as needed. Do not automatically evacuate unless there is an immediate threat to life. Wait for instructions. c. Nursing personnel are to return to their assigned units.

15. CODE RED ALERT ACTIVATION Code red shall be activated by any employee of the hospital who detects or is informed about unexpected fire flames, smoke, smell of smoke, unusual heat or any other indication of fire. The fire or fire like situation could be observed in any part of the hospital, including hospital’s exteriors and terrace. Code red should be activated even if it is uncertain, if the situation is caused because of fire or not. For activating code red the intercom number ‘1111’ should be called from the nearest intercom device and ‘ Code Red ’ followed by the location details shall be spoken . For example, if the fire is observed in the hospital’s main kitchen, the employee should call 1111 and say, ‘ Code Red alert – Hospital’s main kitchen’ . This should be repeated thrice in clear voice so that the receiver at the other end understand the code and location.

16. Continued The intercom line ‘1111’ is manned by a telephone operator round the clock, who has access to public announcement system. As soon as code red alert call is received, he/she immediately uses public announcement system to announce ‘ May I have your attention please. Code Red at ….. area ’. This activates code red system in hospital. The announcement shall be repeated 3 times initially in clear voice and then shall be repeated intermittently after that.

17. ACTION PLAN FOLLOWING CODE RED ALERT As soon as code red alert is announced, employee should follow the action plan as described below Employee near to the area where fire is detected –  As soon as code red is announced, all employee who are near the location where fire is detected, should immediately assess the severity of fire and follow R.A.C.E  Rescue all patients, visitors and staff from immediate danger   Alarm others in the nearby area and call for help Confine the fire in the area by closing doors and windows   Extinguish the fire if the fire is small, by using fire extinguisher. Fire extinguisher should be used   as per P.A.S.S. protocol, which is o   Pull the pin of fire extinguisher o   Aim the stream at the base of the fire o   Squeeze the lever slowly and gently o   Sweep from side to side

18. Continued Employee near the fire area must also   Keep themselves safe from fire   Wait for direction from hospital’s authority or fire-fighting team in-charge for any further actions   The doctor or head nurse of the area must decide, if the central oxygen supply of their area, shall be shut. The valve of oxygen supply can used for this purpose or the technician from maintenance department can be asked for this   Shut all the fire doors in nearby areas to prevent spread of smoke. These doors shall only be used for passing through them                

19. Hospital administrator  – He/she will immediately reach the place and taking care of his/her own safety, assess the situation.   He/she shall ensure that R.A.C.E protocol is initiated and shall also take decision on whether patients and others needs to be evacuated and whether to call fire brigade immediately, without waiting for hospital’s fire-fighting team to arrive. Any situational decisions shall be taken by him/her till the time of reaching of fire-fighting team after which the situation shall be handed over to them. In absence of hospital administrator the in-charge of the area where fire is detected shall perform these functions.

20. Employees who are away from the fire location  – All other employee shall must note the location where fire has been announced and shall do following  Do not go towards the area where fire has been detected, unless and until specifically called upon or required   Listen for additional instructions and be ready to help in case required   Prevent and other outsiders in their vicinity from going towards the fire affected area    Keep all fire doors closed except while passing through them, to prevent spread of fire and smoke     Be ready to evacuate if directed       Do Not use elevators

21. Incharge of central oxygen supply In-charge of Central oxygen supply:  He/she shall wait for instruction on whether Oxygen supply shall be closed to the area where fire is detected and do according to the instruction. He/she shall be available for any further instruction

22. Fire-fighting team  – The fire-fighting team is composed of 4 personnel from security and maintenance. The members of fire-fighting team are trained on fire-fighting measures. Three teams are constituted and it is ensured that one team is present in all shift. There is an in-charge of each team. The firefighting team must do following on listening code red alert  Reach to the place where fire has occurred on an urgent basis   Take charge of fire-fighting measures from the employees on sight   Pass on necessary instructions to the people present over there for safety     Start controlling the fire as per the training given to them

23. Fire fighting team incharge Fire-fighting team in-charge:  The in-charge should also reach the place along with other team members. The in-charge will lead the fire-fighting team and will also do following   Assess the situation and determine, if the fire is severe enough to call for external help Decide whether evacuation plan needs to be initiated   Decide whether Fire Brigade needs to be called     Any other decision that needs to be taken

24. Fire brigade and evacuation Fire Brigade  – In case fire brigade is called, the fire-fighting team should continue their effort till the time it reaches. Focus should be on safety. As soon as the fire brigade arrives, the situation should be handed over to them and their direction should be followed Evacuation  – In case evacuation needs to be done, hospital’s evacuation plan for each area shall be followed. This should be supervised by the fire-fighting team.

25. CODE RED – ALL CLEAR The fire-fighting team in-charge has the authority to declare if the situation has been tackled and is safe from fire. For this the in-charge calls back ‘1111’ and says ‘Code Red – All Clear’. On getting this information, the operator then announces the same on public announcement system. Employee on listening ‘Code Red – All Clear’ can assume that the fire emergency has been taken care of and they can resume back to their normal work. The employees, patient and visitors of the area where fire occurred shall be instructed, if the area can be used or not. Also, any patient or employee if injured during the incident shall immediately be taken to hospital’s emergency for treatment.

26. E. Training and Education 1. All employees should be familiar with the basic Code Red response plan and know the location(s) of the nearest fire alarm pull stations and fire extinguishers. Employees working in areas with specialized extinguishers or extinguishing systems (e.g., Halon , FM-200, non-magnetic) should receive specific training for those devices. 2. The Code Red Task Force shall receive annual training specific to their response procedures, including additional training for the potential team leaders.

27. DOCUMENTATION  Code red event whenever occurred (real or mock) must be documented to keep a record and for further improvement. This shall be done by preparing a report within 3 days of occurrence of the incident. The report shall be prepared by the in-charge of fire-fighting team in consultation with the employee of area where fire was detected . The report must contain following points and shall be submitted to CEO Date and time of code red activation   Severity of fire   Measures taken for controlling fire (both by employee and team)   Whether fire brigade was called?     Whether evacuation was done?    Losses – injuries, death, damage of property etc.     Probable causes of fire     Problems identified and corrective actions to be taken

28. Summary What are some of the Fire Prevention tips mentioned. What is CODE RED and when do you use it? What is the top priority during a fire emergency? What does the acronym P.A.S.S. stand for? What were some of the types of carries. Who calls 9-1-1 and what do you tell them?

29. REFERENCES California Code of Regulations, Title 22. The Hospital Incident Command System (HICS) Guidebook, accessible via the Internet at www.emsa.ca.gov/HICS. National Fire Protection Association (NFPA) 101 and 99, NFPA website located at www.NFPA.org . Occupational Health and Safety Administration, (OSHA) 29 CFR 1510, 1910, 1915 The Joint Commission requirements, accessible via the Internet at www.jcrinc.com/Joint-Commission-Requirements.