code orange, code black: deciphering 'secret' hospital emergency messages

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hospital codes inform staff about emergency events without causing concern or panic among patients and visitors.

by nick beare

published jan 12, 2022

3 minute read

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3 minute read

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code orange, code black: 'secret' hospital emergency messages

generally all canadian hospitals go by the same code list. getty

last week, two toronto-area hospitals declared a “code orange” due to staffing challenges and an increase in patients due to covid-19.just one of the many “codes” used by hospitals to alert staff about various on- and off-site emergencies, a code orange is a rare move usually reserved for an unforeseen disaster happening outside of the hospital, or a mass casualty situation. for example, a code orange was called by toronto’s sunnybrook hospital in 2018 after the toronto van attack, a domestic misogynistic terrorist attack in which 11 people were killed.often communicated through an intercom, or directly to staff using pagers, codes help staff respond quickly to emergencies, while hopefully preventing concern or panic among patients and visitors.

cracking the code

so, what do all the codes mean and how many different codes are there? well, a lot.ontario hospitals use a standardized list of codes that were endorsed in 1993 by the ontario hospital association as a way to cut down on confusion among staff during an emergency.that standardized list has changed some over the years with new colours added periodically, and while a few individual hospitals may deviate slightly from the standard, generally all canadian hospitals go by the same list. certain colours representing more common emergencies are the same across most provinces and territories, however, there are differences based on the individual needs of regions and communities. for example, yukon has a unique code gold for earthquakes as the southwestern part of yukon territory is one of the most seismically active parts of the country.here are some of the other codes that are used across canada.code red. red means fire across the board. this is even the case in the united states, with very few exceptions.code white. a code white is called when there is a violent or aggressive patient in the hospital. this code is also standard across canada.code purple. a code purple represents a hostage situation in many provinces, a but is not used in others such as b.c. and nova scotia that do not have a purple code or a hostage situation code. in quebec, code purple means infant/neonatal cardiac or respiratory arrest.code green. code green means evacuation all across the country, but some provinces such as ontario and nova scotia make a distinction between a precautionary code green and a “code green stat” meaning evacuate in a crisis.

have you ever heard these codes in a hospital? getty

code yellow. yellow means a lost patient or lost person in the provinces that use it.code amber. amber is another standard colour code meaning missing child or child abduction; however, many provinces and territories do not use an amber code or do not have a code specifically for a missing/abducted child.code black. a code black means a bomb threat has been made. this is also standard across the country. black could also mean a suspicious object or package was found.code brown. brown means there has been a hazardous waste or material spill inside the facility — it’s another one that’s used canada-wide.code blue. in the provinces that use a code blue, which is the majority, it means there has been a cardiac arrest in the facility.code orange. as discussed above, orange usually means there has been an external disaster. but orange can also mean there has been an event with mass casualties, depending on the province. it often means that the hospital should initiate protocols to prepare for the arrival of many new patients. in ontario, there is also a more specific “code orange: cbrn,” meaning the disaster is chemical, biological, radiological, or nuclearcode grey. grey varies widely and means system failure in b.c., loss of utility (water, electricity etc) in newfoundland and external air contamination in most other provinces. in ontario, code grey means infrastructure failure, but “code grey button-down” means external air exclusion.code pink. pink means there is a pediatric emergency or pediatric cardiac arrest in the provinces that use it.code silver. not used by many provinces or territories, code silver means there is an active shooter or person with a weapon in the ones that do, such as ontario and newfoundland.code aqua. in some ontario hospitals, code aqua means there is a flood.

nick beare is a toronto-based freelance writer. he can be reached here.