Unspeakable Times

Next Time You Find Yourself In The Emergency Room, Listen For These Codes Over The Loudspeaker

From intelligence operatives to sex workers to healthcare professionals, many organizations require the use of codes to help keep order. In particular, hospitals all around the world use emergency room codes to quickly communicate any problems that need immediate attention without causing panic among patients and visitors.

For example, if you hear “Code Red, South,” it most likely means that a fire has broken out in the south wing of the hospital you’re in. Likewise, if you hear “Code Silver” over the PA, it means that someone in the hospital is armed with a weapon, and might even be holding someone hostage. 

Interestingly, while a handful of codes are fairly universal, most of them can differ greatly from country to country, state to state, and even hospital to hospital. A Code Green in Florida could signify an impending storm, while that same code in California means that a patient has fled. Some hospitals have even implemented unique codes specific to their operational procedures, such as the Sunnybrook hospitals in Canada - they use the ominous-sounding Code Omega to signify catastrophic blood loss.

No matter where you are, knowing what emergency codes mean could be the difference between life and death.

  • Code Red: Fire

    Code Red: Fire
    Photo: Los Angeles Fire Department / Flickr / CC BY-NC-ND 2.0

    Ubiquitously, in hospitals all over the globe, Code Red signifies the breakout of a fire on hospital grounds. It often comes with a secondary word or phrase to tell emergency responders where to go. It could be a number, cardinal direction, room number, floor, etc. The purpose is simply to state where the fire is. For example, “Code Red, Surgery” would mean that a fire has broken out in the surgery wing of the hospital.

  • Code Blue: Cardiac Or Respiratory Arrest

    Code Blue: Cardiac Or Respiratory Arrest
    Photo: Province of British Columbia / Flickr / CC BY-NC-ND 2.0

    In most hospitals, a Code Blue signifies that a patient has gone into cardiac arrest, and needs immediate attention from emergency personnel. But it can also mean that the patient has gone into respiratory arrest - in other words, they’ve stopped breathing.

    Similar to Code Red, Blue is quite universal, but a few countries and states differ somewhat. For example, in California, a Code Blue is relegated specifically to medical emergencies surrounding adults. Though it still signifies that someone is going through cardiac or respiratory arrest, California has specific teams to handle adult versus pediatric health emergencies.

  • Code Orange: Hazardous Spills

    Code Orange: Hazardous Spills
    Photo: Elvert Barnes / Flickr / CC BY-SA 2.0

    A Code Orange often alerts the hospital’s staff that something potentially toxic has been inadvertently released. But it isn’t quite so cut-and-dry as there are many levels to what is considered hazardous. In California, there are three levels to Code Orange, and they signify which cleanup crew to send. For example, a small spill is a Level One, and regular staff members can clean it up themselves using the proper tools. Meanwhile, a Level Three spill is either too large or too deadly for the hospital’s HAZMAT team to handle, and must reach out to an outside agency to clean up.

    In British Columbia, however, a Code Orange signifies mass casualties. Basically, in the event that a disaster has occurred, such as an earthquake, the hospital uses this code to prepare for a rush of patients who need care.

  • Code Silver: Weapon Or Hostage Situation

    Code Silver: Weapon Or Hostage Situation
    Photo: USAG- Humphreys / Flickr / CC BY 2.0

    Code Silver is what hospitals use to alert emergency personnel that a violent individual armed with a weapon is in the hospital. It might also mean that this person has taken a hostage or is actively threatening someone with bodily harm. Though the weapon could be anything, such as a knife, in this day and age it is most commonly a gun. The California Hospital Association has even put together a procedure and checklist in the event that there is an active shooter involved.

    Hospitals in Canada often use Code Purple to signify that a weapon or hostage situation is at hand while Australian hospitals typically use Code Black.