Hospital Emergency Codes: Full List of Color Codes and Meanings

Hospital emergency codes are short overhead or mobile alerts that tell staff what kind of emergency is happening and where, without alarming patients and visitors. The most common examples are Code Blue (cardiac or respiratory arrest), Code Red (fire), Code Black (bomb threat), Code Grey (combative person), Code Silver (person with a weapon), and Code Pink (infant or child abduction). Colors are not standardized nationally, so the same color can mean different things in different hospitals.

This guide lists the hospital codes nurses hear most often, explains where meanings differ between the United States, Canada, and Australia, and shows what to do when a code is called. Always confirm the definitions in your own facility’s emergency operations plan, because your employer’s policy is the one that applies to you.

Hospital Emergency Codes List: Colors and Meanings

Why Hospital Code Colors Are Not the Same Everywhere

No federal law sets one national list of color codes in the United States. Hospitals build their codes into their own emergency operations plans, and many follow guidance from their state hospital association. That is why one hospital can use Code Grey for a combative patient while another uses it for a utility failure. In Canada, many Ontario hospitals follow the Ontario Hospital Association list, and in Australia many hospitals base their codes on Australian Standard AS 4083.

Because of this variation, several state hospital associations, such as the Hospital Association of Southern California, now recommend plain-language alerts (for example, “Security alert: combative person, 4 West”). Plain language reduces confusion for float nurses, travel nurses, and staff who work at more than one facility.

Security Codes: Code Grey, Code Silver, and Code Black

Security codes are the ones nurses most often confuse. In many US hospitals, Code Grey means an unarmed person is becoming aggressive or violent and the behavioral response or security team is needed. Code Silver escalates the response because a weapon is involved, and staff are expected to run, hide, or barricade rather than intervene. Code Black usually means a bomb threat or suspicious package, which triggers a search of your area and possible evacuation.

• Code Grey: stay with your patients, use de-escalation, keep an exit route, and wait for the response team.
• Code Silver: do not approach; secure patients and yourself and follow run-hide-fight training.
• Code Black: look for unfamiliar objects without touching them, avoid using radios near a suspicious item, and prepare to evacuate.

Medical Codes: Code Blue, Rapid Response, and Code Stroke

Code Blue calls the resuscitation team to a patient in cardiac or respiratory arrest. Many hospitals also use a Rapid Response call for a patient who is deteriorating but not yet in arrest, plus condition-specific alerts such as Code Stroke, Code STEMI, Code Sepsis, and Code Trauma. These alerts start a time-sensitive protocol, so know the activation criteria on your unit.

Environmental and Facility Codes: Red, Orange, Green, and Grey

Code Red (fire) is the most consistent code across hospitals: rescue anyone in danger, activate the alarm, contain the fire by closing doors, and extinguish or evacuate (RACE). Code Orange often means a hazardous material spill, while Code Green or an “external disaster” code activates the hospital incident command system for a mass casualty event. In Ontario, Code Grey means a loss of essential services such as power, water, or IT systems, which is why Canadian news reports describe cyberattacks as a hospital “code grey.”

What Nurses Should Do When an Emergency Code Is Called

• Listen for the code and the location, and check whether it affects your unit.
• Follow your assigned role in the emergency plan; do not leave patients unattended unless you are part of the response team.
• Keep hallways and fire doors clear and close patient room doors when instructed.
• Use your facility’s communication system and avoid calling the operator for details during the event.
• Document what happened, including times, actions, patient status, and any injuries, once the code is cleared.
• Join the debrief so the team can fix gaps in the response.

Emergency Code Training for Nurses

The Joint Commission’s workplace violence prevention requirements for hospitals, in effect since January 2022, expect organizations to train staff on de-escalation, reporting, and response to violent events. Most hospitals cover emergency codes during orientation and annual competencies. Nurses can also complete continuing education on workplace violence, ethics, and domestic violence; check your state CE requirements to see whether these topics count toward renewal. The OSHA workplace violence guidance for healthcare is a useful free resource.

Frequently Asked Questions