Population growth, health-care crunch could lead to more Code Orange alerts on P.E.I.

There have been three Code Oranges called at P.E.I. hospitals in just over three months, compared to the same number in all of 2023. 

With the province’s population continuing to rise and health resources at Island hospitals stretched thin, some health officials say it’s an occurrence that might happen even more frequently in the years ahead. 

A Code Orange is called when multiple potential patients could need emergency care from an accident or other kind of mass-casualty incident, meaning more resources might need to be called in. 

“We traditionally think of them as more traumatic events where you could have a car crash or a fire, as have been the recent cases,” said Dr. Ken Farion, Health P.E.I.’s medical director of hospital services and patient flow.

“You could also envision some sort of poisoning or environmental disaster that could lead to a large number of patients coming — or even an infectious disease outbreak [where] suddenly a large number of patients, say at a nursing home, were suddenly ill. That could prompt the response.” 

Whether a hospital declares a Code Orange depends on how busy the emergency room is and how many staff are on hand at the time, so the criteria will be different for each hospital across the Island. 

Two of the three Code Oranges this year, at Summerside’s Prince County Hospital, involved fewer than five potential incoming patients. 

Farion said other factors include the time of day, how busy the various hospital departments are, and how many staff are on shift with a view to how many might need to be called in to deal with the emergency. 

“What might be quite overwhelming for the Western Hospital [in Alberton], if there were two or three patients coming into their facility that really only has one doctor and a few nurses, would look very different if it was coming here to the Queen Elizabeth [Hospital in Charlottetown],” he said. 

Code Oranges in P.E.I. in the last five years: 

• 2024: QEH: 1 (June 11 Elena Court apartment fire); PCH: 2 (July 7 house fire near Kensington; June 28 four-vehicle crash on Route 2 near Springfield)
• 2023: QEH: 3, PCH: 0
• 2022: QEH: 3, PCH: 1
• 2021: QEH: 1, PCH: 0
• 2020: QEH: 1, PCH: 0

Whether Code Oranges are becoming more frequent or not, the president of the P.E.I. Nurses’ Union said the response by health-care professionals to them is working. 

“When we call a Code Orange there’s a fan out for the phone systems and … [nurses] basically receive the phone call saying, ‘Can you come, yes or no?’ and usually it’s just a quick yes and … we’ve always had enough people showing up,” said Barbara Brookins.

The union head worked as a critical care nurse for decades and saw her share of the alerts. 

“When it happened, you knew that your colleagues were coming and you knew that the resources were coming physician-wise, the ward clerks, just people to handle crowd control. It all worked, and it was the best feeling because you knew you were facing the unexpected and there were people there to have your back.” 

Farion said Health P.E.I. is working to standardize codes and responses across all Island hospitals. 

He pointed to the province’s population boom and the shortages in health care as potential reasons for more frequent Code Oranges, and for hospital staff’s willingness to declare one. 

“As we know, health-care resources and hospital resources have been stretched post-pandemic, and so our threshold for needing additional support might be a little bit lower than it’s been in the past,” Farion said. 

“And so both of those things lead to us calling the event maybe a little more frequently than we would have in the past.

“And that’s OK. It just means that we’re prepared and we know how to respond.”