A Code White is one of the most emergency codes you’ll hear over the hospital intercom. It’s not a fire or a cardiac arrest, but it does require staff attention and action.
In the United States, a Code white in a hospital refers to a situation when a patient or visitor is being violent or aggressive.
In this article, I’ll break down the details of a Code White, how staff should react, and the training involved.
Code White Hospital Meaning
A Code White in the hospital is an emergency response code designated for aggressive patient behavior.
Unlike other codes, such as Code Yellow for an external weather event or Code Blue for a cardiac arrest, a Code White is unique to violent patient incidents.
This code is in place to protect both staff and patients from harm.
The primary goal of a Code White is safety and security.
When a Code White is called, it means the situation is out of control and needs immediate attention. Knowing what triggers a Code White and how to respond is critical to creating a safe environment for patients and staff.
This code allows hospitals to mobilize resources quickly to manage violent situations.
Common Triggers
A Code White can be triggered by any aggressive behavior from a patient, visitor, or family member. This can include:
- Physical altercations
- Verbal threats
- Escalating behavior
- Any situation that could lead to injury or harm
Whether a patient is a danger to themselves or others, or a visitor becomes belligerent, these situations can quickly spiral out of control and require immediate attention.
Steps to Take During a Code White
When a Code White is called, hospital staff should spring into action and follow their hospital’s protocol for responding to the code. The goal is to ensure everyone’s safety, and this involves evaluating the level of threat and quickly contacting security.
Staff should follow the guidelines set for the level of threat. I’ll explain the different levels of threat in a minute.
Here’s a step-by-step guide to responding to a Code White:
Evaluate the patient’s behavior and potential threat level. Is the patient violent or agitated? Are they a threat to staff or others?
Immediately contact security and let them know you need assistance. Provide any relevant information about the situation, such as the patient’s location and behavior.
Security will give you specific guidelines for managing the situation based on the level of threat. I’ll explain the different levels of threat in a minute.
Unless you’re in immediate danger, stay with the patient and provide support until security arrives.
Remember, security is trained to handle these situations. Let them do their job and follow their instructions.
Initial Response
When a Code White is called, the initial response involves notifying security and evaluating the situation. Trained staff should be notified immediately to help de-escalate the situation.
De-escalation training is critical for healthcare staff. It involves calming techniques to reduce a patient’s agitation and prevent violence.
Some of the most effective techniques include:
- Staying calm and composed
- Using verbal negotiation
- Active listening
- Redirecting the patient’s attention
These techniques are critical in reducing the threat of violence and creating a safe environment.
With quick and appropriate responses, you can help de-escalate aggressive situations and keep everyone safe.
Communication is Key
Staff should use established communication protocols to share information and avoid confusion.
This ensures the right team members are notified and involved in de-escalation efforts.
Using specific language is critical.
Avoid using vague terms like “he’s being difficult” or “she’s acting out.” Instead, focus on observable behaviors like “agitated,” “aggressive,” or “violent.”
This helps staff respond appropriately and de-escalate the situation more effectively.
Alerting security quickly while starting de-escalation techniques is also critical.
Restraints
Restraints should always be avoided, but in rare situations, they’re necessary to ensure patient and staff safety.
Hospital protocols should be followed when considering restraints, and verbal interventions and de-escalation techniques should be attempted first.
If restraints are necessary, they must be applied according to facility guidelines.
Security is not trained in violent interventions, but they can use restraints if necessary to protect everyone involved.
Role of Hospital Security in a Code White
Hospital security is responsible for maintaining a safe environment during a Code White.
They respond to Code White situations and manage patients who are a threat to themselves or others.
Security staff:
- Control access to the affected area
- Monitor for additional threats
- Assist with restraining patients if necessary
- Follow hospital protocol for managing violent patients
Working with Medical Staff
Security and medical staff work together to manage Code White situations.
Medical staff focus on de-escalation techniques and providing any necessary care, while security ensures the situation doesn’t escalate and everyone is safe.
Post-Incident Procedures
Security staff should complete an incident report after a Code White, documenting as much detail as possible about the situation.
Security and medical staff work together to prevent violence in the hospital.
Medical staff identify potential problems and alert security, while security takes proactive steps to manage situations before they escalate.
Code White Training
Security and medical staff receive specialized training for Code White situations.
This training is critical for responding appropriately to violent patients and maintaining a safe environment for everyone in the hospital.
With this training and coordination, you can help create a safer environment for patients and staff.
Debriefing and Improvement
After a Code White, security and medical staff should discuss their response and evaluate what worked well and what didn’t.
This debriefing is critical for identifying areas for improvement and adjusting procedures.
If restraints were used, documentation should be completed promptly and thoroughly.
Training and Preparedness for Code White
Code White training is designed to prepare staff for responding to aggressive patients.
This training is critical for creating a safe environment and preventing injuries.
Staff Training and Drills
Hospital staff, including security and medical personnel, receive specialized training for responding to Code White situations.
Regular drills and simulations help staff refine their response skills and prepare for real situations.
Evaluation and Feedback
Evaluating staff response to Code White situations, including simulated drills and real events, is critical for improving training and response.
Ongoing Training and Education
Ongoing training and education are critical for creating a safer environment. This training should include:
- De-escalation techniques
- Verbal intervention
- Active listening
- Redirecting patient attention
With regular training and education, you can help reduce the risk of violent incidents and create a safer environment for patients and staff.
Non-Aggressive Crisis Intervention
Security staff are trained in non-aggressive crisis intervention techniques to handle Code White situations.
These de-escalation methods, like verbal interventions and physical restraint, are critical for managing patients who may become combative.
Also Read: Code 3 In Hospital + Hospital Code 8
Code White vs. Other Hospital Codes
It’s essential to understand the different hospital emergency codes to ensure the right response from staff and emergency personnel.
Each code has a unique purpose and requires specific procedures and actions.
Let’s compare Code White with other common hospital codes, like Code Yellow, Blue, and Orange.
Code Yellow: External Disaster
A Code Yellow is announced if there is an external disaster, such as a natural disaster or a multi-casualty situation.
This is different from a Code White, which is specifically for internal hospital emergencies involving aggressive patients.
Code Yellow involves evacuating the hospital due to an external threat.
Code Red
Hospital Code Red specifically refers to a fire emergency in hospitals across the United States, Australia, and Canada.
Code Blue: Medical Emergency
A Code Blue is called for patients experiencing a severe medical emergency, such as a cardiac arrest or respiratory distress.
This code is for life-threatening medical conditions, whereas a Code White is for potential aggression or violence.
Code Orange: Child Abduction
As well, A Code Orange is declared if a child who is a patient in the hospital disappears or is abducted.
This code is specific to pediatric patients and requires a swift response to ensure the child’s safety.
Code Brown: Wipe Down
A Code Brown is announced when there is a massive gastrointestinal spill.
This code is specific to hazardous waste and requires a specific response from environmental services and custodial staff.
Code Pink: Elderly Dementia Patient
A Code Pink is called when a elderly dementia patient wanders from the secure area. This code is specific to Alzheimer’s unit patients and requires a specific response from security and staff.
Bottom Line
At the end of the day, understand and manage Code White calls to keep our hospital safe. Code White is for violent or uncontrolled visitors or patients.
We need to protect our patients, families, staff and visitors.
Make sure you know how to respond and what to do. Know your hospital’s Code White protocol and follow it. By doing so, you’ll help keep our environment safer for everyone.
