Emergency codes

Code orange in the hospital: the mass arrival of casualties

Code orange signals the arrival of casualties or disaster victims. The department's definition, 10 facilities compared and what staff do.

November 2, 2026 · By the Agent Santé editorial team · Lire en français

Emergency codes

In the 10 Quebec facilities whose full list of codes was reviewed on October 28, 2026, code orange signals the arrival of casualties or disaster victims. It is one of the hospital colour codes. Quebec's health department describes it as the situation where reception resources no longer match the number of victims.

What code orange means

The Guide de gestion des urgences (emergency management guide) of the ministère de la Santé, de la Prévention et des Aînés says that code orange is used to signal "the mass arrival of patients or disaster victims exceeding the regular capacity of a facility" (translation of « l'arrivée massive d'usagers ou de sinistrés provoquant le dépassement des capacités régulières d'une installation »).

The guide also defines it as a situation where the resources normally available to receive patients are inadequate, given the number of victims and the severity of their condition. It gives as examples an earthquake, an armed person or a road accident with many victims.

Each facility designs its own plan according to its resources, its geography and the risks in its territory.

What code orange means by facility

All ten facilities whose full list was reviewed define code orange. All of them link it to the arrival of casualties or disaster victims.

Facility	What code orange signals	Document
CISSS de Chaudière-Appalaches (integrated health and social services centre)	Major external disaster	Emergency codes, hospitals, 2024
CISSS de la Gaspésie	Mass reception of casualties	Colour codes poster
CISSS des Laurentides	Disaster victims	Emergency measures, March 2024
CISSS de Laval	Reception of disaster victims	Student guide, June 15, 2018
CHUM	Mass reception of disaster victims	Guide to services and resources, July 2026
CUSM (Montreal General Hospital)	External disaster or mass reception of casualties	Volunteer guide
CIUSSS de l'Est-de-l'Île-de-Montréal	Mass reception of patients or casualties	Emergency measures, October 18, 2021
CIUSSS de l'Ouest-de-l'Île-de-Montréal	Mass reception of patients or casualties	Presentation of the colour codes
CIUSSS du Centre-Ouest-de-l'Île-de-Montréal	Reception of a large number of patients following an external disaster	Emergency measures guide, ambulatory sites, 2022-2023
CIUSSS du Centre-Sud-de-l'Île-de-Montréal	Mass arrival of patients or disaster victims	Introduction to emergency measures

Sources: documents published by each facility, reviewed on October 28, 2026. The full list of links is at the bottom of the page.

The CIUSSS de la Capitale-Nationale gives the same meaning in its July 2019 leaflet: mass reception of casualties. The CHUM adds a code orange-brûlé (burn), the mass reception of victims of severe burns.

What staff do when the code is announced

The CIUSSS de la Capitale-Nationale gives four instructions:

Return to your workstation when the code is triggered
Apply the internal protocol
Listen to the instructions of the responding manager
Stay alert and available

The CIUSSS de l'Ouest-de-l'Île-de-Montréal asks staff to get to their workplace as quickly as possible and wait for instructions from the head of their area. Staff's role is to return to their usual work area and suspend non-essential activities. Physicians at the hospital go to the emergency waiting room.

The CIUSSS de l'Est-de-l'Île-de-Montréal repeats these instructions. In a CLSC (local community service centre) or a CHSLD (long-term care centre), code orange means receiving disaster victims.

In the hospitals of the CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, emergency patients are moved to the units or sent home to free up space. Unit staff get ready to receive patients. Employees return to their workstation and wait for instructions from their supervisor.

Who triggers code orange

According to the department, the decision to activate code orange affects the whole operation of the hospital. It follows a strict, pre-established protocol and involves pre-authorized people. A facility can set alert levels, such as a level 1 or 2 pre-alert, that mobilize only part of the resources.

At the CIUSSS de l'Ouest-de-l'Île-de-Montréal, any call announcing the probable or imminent arrival of disaster victims is sent to the emergency department. The person in charge of the emergency department on site must validate the call.

What the hospital's plan covers

The department's guide asks that the plan mobilize the whole hospital. Each department must have its own plan to support the emergency department. The plan covers access management, communications, a command centre, security and an up-to-date staff call-back list.

In the emergency department, staff are divided into three teams: patients already present, new patients and the administrative management of the code. After the code, the return to normal activities must include a debriefing with staff.

The patient care attendant and code orange

In the documents consulted, the instruction that applies to all staff is to return to your workstation and wait for instructions from the head of your area. Your facility's plan then sets out your role.

The other codes

Our articles on the other codes: code white, code blue, code pink, code purple, code yellow and code red.

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Frequently asked questions

What is code orange?

It is the code that signals the mass arrival of casualties or disaster victims. According to Quebec's health department, the facility's regular capacity is then exceeded. The 10 facilities whose full list was reviewed on October 28, 2026 define it this way.

What do the codes in hospitals mean?

The CISSS des Laurentides lists eleven in its March 2024 sheet: white, blue, brown, grey, yellow, silver, black, orange, pink, red and green. Red signals a fire, green an evacuation and orange disaster victims. The list and the definitions vary from one facility to another.

Who triggers a code orange?

The department writes that activation follows a strict, pre-established protocol and involves pre-authorized people. Each facility defines its own measures. At the CIUSSS de l'Ouest-de-l'Île-de-Montréal, the person in charge of the emergency department validates the call announcing the arrival of disaster victims.

What do staff do during a code orange?

Staff return to their workstation and wait for instructions from their manager or the head of their area. They suspend non-essential activities. The CIUSSS de la Capitale-Nationale also asks staff to stay alert and available.

What is the difference between a code orange and a code red?

Code orange covers the arrival of casualties or disaster victims from outside. Code red signals a fire, at the CISSS des Laurentides as at the CIUSSS de l'Ouest-de-l'Île-de-Montréal. Our article on code red in the hospital covers that case.

Are there different kinds of code orange?

At the CHUM, code orange-brûlé (burn) means the mass reception of victims of severe burns. At the CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, code orange has two phases depending on the number of seriously injured people. The department says a facility can also set alert levels.