![\"Dr.](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/04\/eisen-01.jpg\")
<\/a>Photo: Paul Joseph<\/p>\nDR. JEFF EISEN
clinical associate professor, faculty of medicine<\/p>\n
Code Orange<\/p>\n
The Code Orange was called at 12:37 p.m. A group of resident doctors and paramedic trainees pushed out the front doors of Camosun\u2019s new Alex and Jo Campbell Centre for Health and Wellness, which served as the mock emergency department, and waded into a chorus of cries and shouts coming from all directions. They were volunteer actors, dozens of them, who had received envelopes that morning containing information about their assigned characters: name, age, physical symptoms, and instructions for what to say to doctors. Many had received prosthetics and makeup from Camosun College visual arts students and the Island Health trauma services program to bring their injuries to life. They lay on the ground, propped themselves up against concrete pillars or wandered in a daze.<\/p>\n
During a Code Orange, caregivers triage patients using a simple algorithm, or decision-making tree. The aim is to identify in 60 seconds or less who needs immediate care. The trainees quickly assessed patients\u2019 ability to walk, their breathing, pulse and mental state, then labeled them with coloured triage tags indicating their destination zone within the emergency department: green for the walking wounded; yellow for serious but not fatal injuries; red for lives in danger; and black for those who sadly cannot be saved.\u00a0<\/p>\n With tags attached to their patients, the trainees then paired up to hoist those who couldn\u2019t walk into wheelchairs and maneuvered them between the other injured patients toward the building and their destination zones.<\/p>\n Inside the emergency department<\/p>\n The yellow zone received its first patient at 12:53 p.m., six minutes after the Code Orange was called. She was Lisa Murphy, pregnant in a wheelchair, with a penicillin allergy and a gaping wound in her thigh. Her instructions, unknown to the residents: \u201cIf no tourniquet applied, please lose consciousness and then quietly bleed to death.\u201d <\/p>\n They got the tourniquet on. She lived.<\/p>\n Two more patients arrived by 12:58: a man with an injured ankle and another with burns to his upper body and arms. Carlos Ruiz arrived at 12:59 with severe abdominal pain and bruising across his abdomen. He would lose consciousness within 10 minutes, but not before two more patients arrived. They were coming fast.<\/p>\n \u201cSituational awareness\u201d is a term that comes up a lot in emergency medicine. A physician who is repositioning a bone or inserting a chest tube cannot monitor a patient\u2019s vitals at the same time, so a colleague does that. During a Code Orange, the need for situational awareness broadens. Each zone needs a leader to monitor comings and goings. Then there\u2019s incident command, which manages the big picture: Where are beds available? Is blood supply running low? How many ambulances are still on the way?<\/p>\n Dr. Tristan Jones, a UBC clinical assistant professor and emergency physician with Island Health, was overseeing the yellow zone, so third-year resident Dr. Hannah Minnabarriet approached him to report that Mr. Ruiz had collapsed and needed to get to the red zone. Dr. Jones radioed incident command.<\/p>\n Incident command was buzzing with calls from all four zones: requests to send patients to the operating room, for CT scans, and with orders for oxygen and blood units. They gave Dr. Jones the green light to send Mr. Ruiz to the red zone, but told another caller, \u201cICU does not have space. Continue to resuscitate for now. We are expecting ICU space in 10 to 15 minutes.\u201d Incident command was balancing all of this against what they knew about the condo collapse, and what was happening outside in triage. Occasionally, they were interrupted by a woman who was trying to find her son.<\/p>\n The actors brought a level of realism that was essential to the exercise. Their pre-incident briefing included instructions to fully embrace their roles. They wanted to throw the trainees off balance. Triaging a patient is one thing. Doing it while others clamour for your attention is another. \u201cThe way everything was organized made it very high-fidelity, so it felt very real for us,\u201d reflected Dr. Rod Vafaei, a fifth-year resident based in Victoria, after the event. \u201cWe were in the moment, and it really helped us identify things we can do better if a real event happens.\u201d<\/p>\n Lessons learned<\/p>\n<\/a>The doctors\u2019 first contact with patients came on the plaza outside, where they aimed to triage cases in 60 seconds or less. Photos: Paul Joseph\/UBC<\/p>\n<\/a><\/p>\n<\/a>Dr. Sophie Thomas tends to a patient who has suffered a leg injury. Photo: Paul Joseph\/UBC<\/p>\n<\/a>Dr. Morgan Haines (centre) updates Dr. Alex Senger (left) and Dr. Riley Reel (right) on the status of patients and beds. Photo: Paul Joseph\/UBC<\/p>\n<\/a>Dr. Jessica Timmings debriefs with trainees at the end of a long day in the simulated emergency department. Photos: Paul Joseph\/UBC<\/p>\n