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THE CRASH

CART
DEFINITION :
It is a means of storing and
transporting vital equipment
and drugs which may be
required during a code blue
(cardiac emergency) to the
location of the emergency .

The crash cart should be kept in


an easily accessible position
which is central to the patient
care areas .
FUNCTION
The function of a crash cart is to provide a mobile
station within the hospital that contains everything
needed to treat a life-threatening situation. The
advantage of mobility is that it allows the treatment to
come to the patient when needed.
ARRANGEMENT OF CRASH CART:
Organizing a crash cart requires understanding of how a life-
threatening emergency progresses.
The arrangement of the equipment in the crash carts should be
standardized throughout the institution .

The top of the crash cart


electrocardiograph,
Defibrillator
capnograph,
pulse oximeter,
Ambu bags of various sizes,
blood pressure unit.
Keep examination gloves on top of the cart or nearby. All patients
arriving as emergencies should be handled with gloves.
DEFIBRILLATOR

ELECTROCARDIOGRAPH
CARNOGRAPH PULSE OXIMETER

AMBU BAG
DEFIBRILLATOR
This is an electrical device with two paddles that
are placed on your chest. It discharges electricity
through your heart when a lethal rhythm is
present.
The goal is to shock the heart back to normal.
lethal rhythms include ventricular fibrillation
(rapid, unsynchronized, uncoordinated heartbeat)
and Ventricular tachycardia (rapid heartbeat that
prevents the heart from pumping properly). It can
also be used in less dangerous rhythms to return
the heart to a normal rhythm.
OXYGEN SATURATION MONITOR
Without O2 brain death occurs within 6 minutes
O2 saturation is measured using pulse oximeter.
Pulse oximeter monitors the arterial hemoglobin
oxygen saturation (oxygen level) of the patients
blood with a sensor slipped over the finger or toe.
In emergency condition O2 is required for severe
physiological stress.
Shock
Traumatic injury
Acute myocardial infection
Cardiac arrest
FIRST DRAWER
The top drawer
intubation supplies, including ;
endotracheal tubes (at least one of each
size),
laryngoscope handles,
blades of various sizes,
and umbilical tape or something else for
tying endotracheal tubes in place.
ENDOTRACHEAL TUBE

LARYNGOSCOPE HANDLES
SECOND DRAWER
The second drawer
could contain emergency drugs.
Amiodarone 150 mg/3ml vial
Aminophylline,
Atipamezole.
Atropine 1mg/10 ml syringe
Calcium Chloride 1mg/10 ml syringe
Calcium Gluconate
Dexamethasone
Dextrose 50% 0.5 mg/ml 50 ml syringe
Diphenhydramine
Dopamine 400 mg/250 ml IV bag
Epinephrine 1 mg/10 ml (1:10,000) syringe
Lidocaine 100 mg 5ml syringes
Lidocaine 2 mg/250 ml IV bag
Naloxone
Sodium Bicarbonate 50mEq/50 ml syringe
Sodium Chloride 0.9% 10 ml vial
Sterile Water Inj. 20 ml vial
Vasopressin 20 units/ml 1 ml vial
SECOND DRAWER
The drawer could also include a small supply of
preassembled needles and syringes as well as a chart of
drug doses per body weight
Alcohol Swabs
Blank Labels
Pharmacy Pre-printed Labels,
Povidone-Iodine Swabstick
THIRD DRAWER
The third drawer
intravenous catheters of various sizes and the
supplies for placing them (e.g., T-ports, tape,
surgical scrub, needles, syringes, scalpel
blades).
FOURTH DRAWER
The fourth drawer
intravenous fluids and administration sets.
One or two bags of each type of intravenous
fluid stocked by the hospital could be kept in
the crash cart; suggestions include;
sodium chloride 0.9%,
Normosol-R (Abbott Laboratories),
lactated Ringer solution,
and hetastarch.
FIFTH DRAWER
The fifth drawer
miscellaneous items to help treat cardiac arrest.
Suggested supplies include;
suction catheters,
internal and/or pediatric defibrillator paddles,
conducting gel,
intravenous pressure administration bags,
chest tubes,
sterile thoracocentesis packs,
a butterfly catheter,
a three-way stopcock,
and a 60-mL syringe.
I N T ER N A L AN D E XT ER N AL DE F I B R I L L ATOR PA DDL ES

CO N DU CT I N G GE L
S U CT I O N CAT HET ER
BUTTERFLY CATHETER
THREE-WAY STOPCOCK

I V P R ES S U R E BAG
MAINTENANCE
Crash carts should be checked daily and monthly
against checklists to ensure that they are fully
stocked at all times.
When an item from the cart is used, it should be
replaced immediately after the emergency.
A daily check would include ensuring that the cart
has all the necessary supplies in the proper place and
that all its electronic equipment is fully charged.
A monthly check would include checking drug
expiration dates as well as sterilization dates for
endotracheal tubes if they are reused.
CONCLUSION
A crash cart can be very helpful in saving
lives, but staff members must be properly
trained to successfully use a crash cart. It is
very important for a crash cart to contain the
appropriate equipment and supplies and to be
centrally located. Being prepared and
organized can make a significant difference in
an emergency.