Code Alerts.

Called the instant someone stops breathing or their heart stops — anywhere on the premises, not only in a clinical ward. The nearest staff member starts CPR immediately and calls the code; a dedicated resuscitation team responds with a crash cart within minutes.

Responding departments:

NABH tracks this as a live indicator — "Code Blue Drill" is cited in the book's own Key Performance Indicators section (PSQ 3d) as an example of the mock-drill variations every organisation should measure and record.

R.A.C.E. — what every staff member does the moment fire or smoke is seen:

P.A.S.S. — how to use a fire extinguisher, if the fire is small enough to fight:

Responding departments:

NABH's FMS chapter requires the organisation to safely manage hazardous materials — including a documented spill-management plan that's actually implemented, not just written (FMS.5 area, asterisked elements). Code Orange is how most hospitals name that response.

Minor spill — small volume, low-hazard, staff-manageable with a spill kit and PPE, no evacuation needed (e.g. a broken mercury thermometer, a small reagent splash). The department's own trained staff contains and cleans it up using the on-site spill kit.

Major spill — large volume, or a toxic / flammable / corrosive substance, that threatens people beyond the immediate spot. The area is evacuated and cordoned off, and a trained HAZMAT response team (sometimes with the external fire department) manages containment and clean-up.

Chemicals that most often trigger Code Orange in a hospital:

Responding departments:

HAZMAT management, in practice, means: chemicals labelled with hazard pictograms, incompatible chemicals stored apart from each other, PPE and spill kits stationed right where the chemical is used (not locked away elsewhere), a trained response team, and disposal that follows biomedical/hazardous-waste rules — not the regular bin.

MSDS (Material Safety Data Sheet) — NABH's own glossary defines it as a formal document describing a substance's hazards, including first-aid, spill, and safe-storage instructions. The internationally standard MSDS/SDS format has 16 sections:

Called the moment an infant, child, or at-risk patient goes missing. All exits are monitored or locked down, and everyone on shift is briefed on a description within minutes — the first few minutes matter most.

Called when a patient, visitor, or staff member becomes verbally or physically aggressive and de-escalation isn't working. A trained response team moves in to protect staff and other patients while calming the situation — matching NABH's requirement (HRM.9) that the organisation has real measures in place for preventing and handling workplace violence.

Triggered by a bomb threat call or an unattended, suspicious item. Staff avoid touching the object, evacuate the immediate area, and hand off to security and, where warranted, the police bomb squad.

Called when the hospital needs to activate its internal disaster plan — a sudden surge of patients that exceeds normal capacity. Elective work pauses, extra staff are called in, and triage areas expand.

Called for a large-scale external event — an accident, natural disaster, or mass-casualty incident — that's about to send a wave of patients to the hospital from outside. The disaster plan activates ahead of patient arrival, not after.

Called for a critical utility failure — power, water, medical gas, or IT systems — the kind of event NABH's FMS chapter requires a documented back-up and downtime plan for, tested and not just written.

The most serious security code — someone on the premises is armed or holding hostages. Areas are locked down, uninvolved staff and patients are moved away, and police are engaged immediately.