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Published in CenterView on October 21, 2013

UMMC’s clinical emergency communications system gets help where it’s needed – fast

By Bruce Coleman

Batson Children’s Hospital employees are well versed on how to call for emergency support when a patient is in need of immediate resuscitation.

Stephen
Stephen

But when the person found in medical trouble is an adult staff member, it might give his or her colleagues some pause: just what would be the appropriate code to call?

That momentary dilemma was resolved recently in Children’s Hospital when the Code 13 team – which responds to cases of pediatric cardiac arrest – provided the necessary assistance to a Children’s Hospital employee until the Code Blue team could arrive.

Because of the swift action taken by colleagues, the employee is expected to make a full recovery and report back to work soon.

“The value of our code system has never been more evident,” said Jennifer Stephen, clinical director of pediatric emergency and lab services. “We are very fortunate to have this system in place to get help, regardless if it’s for a patient or not.

“Even with this particular response, we are always evaluating to see what would make events run smoother. We’ve taken this opportunity to add more adult supplies to our Code 13 response team.”

Not all codes are for individual medical emergencies – some are intended to alert staff about dangers to their safety, such as when a fire breaks out or a patient becomes potentially dangerous to others. But the Children’s Hospital staff member’s fortunate recovery illustrates the value of the Medical Center’s code system, which conveys essential information to UMMC employees over the institution’s public address system without creating undo stress or panic among patients and visitors.

Jones
Jones

Although all hospitals and health-care institutions worldwide have a fairly standardized set of codes to alert employees to various emergencies, it is important for individual staff to understand the specific codes that could be called at their respective institutions, according to Dr. Alan E. Jones, professor and chair of emergency medicine.

“It’s helpful for employees to have some idea of what these codes mean,” Jones said. “We have a lot of visitors and patients, and there unfortunately are situations that arise when someone does need to know what to do or what these codes mean.” 

Jones, who has responded to countless codes during his career, said the worst he has experienced came while he was serving as director of emergency medicine critical care services at Carolinas Medical Center.

“When I lived in Charlotte, a pedestrian bridge at a large NASCAR event suddenly collapsed,” Jones said. “There were 150 people or more on that bridge, which was 35-40 feet high. We had a lot of victims from that.”

Then there was the time he had to initiate a disaster code himself – for a plane crash in the Charlotte area.

“The codes you hate to hear are the disaster codes,” he said. “That means there’s a significant catastrophe, that there’s some significant amount of loss of life or an injury event that’s going to require a lot of resources.”  
 
Stephen said hospital employees receive training on emergency codes during their initial employee orientation sessions and again once a year afterward.

“We run mock codes once a month in the Children’s Hospital,” she said. “The staff never know whether they’re getting a mock code or a real code. No matter what it is, they are always ready to respond.

“We want to make sure any systematic problems are worked out before anything happens. That’s why we do the training.”  

Over time, procedural changes have led to a more efficient emergency management system. For example, not long ago, Stephen said clinical staff used to have distinct telephone numbers to call depending on the code required.

“We used to have to wear them (telephone numbers) behind our I.D. badges to remind us of what to call in,” she said.  

To limit the confusion, hospital leadership consolidated the numbers into two: 4-1111 for medical emergencies and 911 for police or fire emergencies.

Arnold
Arnold

“We want to give our staff the least amount of numbers that can be easily remembered so that they can quickly notify the appropriate team to respond,” said Amber Arnold, patient safety officer in the Department of Chief of Staff who is credited with championing the telephone number consolidation effort. “Having to remember or refer to multiple numbers before dialing only delays the timely response that we expect for our patients and for our staff.”  

Stephen said the Medical Center’s switchboard operators also play a critical role in making sure the appropriate code is called. The operators also receive ongoing training.

“We have a very collaborative relationship with the switchboard operators and work with them to evaluate each call and look for opportunities to improve this critical piece of our system,” she said.

Jones said the system is only as effective as employees are diligent to know the codes at their respective health-care institution.

“It’s good for employees to know them all, even though most of the time for the general hospital employee, there’s not a lot to do because there’s designated people who are to report to the area,” he said. “But in the case of child abduction, for instance, everyone needs to be on the lookout for suspicious people that might be carrying a child or moving quickly.

“Of course, in a disaster, it might be helpful for staff to report to the ER to see if there’s any need for help in that situation.”

In certain cases, Jones said it’s actually better for staff not to respond to code calls.

“In medical emergencies, if they’re not a staff person who’s designated to report, it’s best not to respond to the code at all. Otherwise, it may create a chaotic situation where onlookers could make administering effective treatment more challenging.”

  

Common emergency codes

Common emergency codes used in clinical areas at
the University of Mississippi Medical Center:


Code BLUE:
adult cardiac arrest

Code 13:
pediatric cardiac arrest

Code WHITE:
potentially dangerous patient

Code PINK:
infant or child abduction

Dr. RED:
any type of fire

Immediate medical attention

The telephone number clinical staff call to request immediate medical attention is 4-1111. To report a fire in any area, staff 
can call 4-6666 or 911.