What Do You Need for a Crash Cart?

What Do You Need for a Crash Cart?

Any medical facility and its team of health care professionals must be ready at any given moment to deliver lifesaving assistance to patients who need it. Even if your medical facility is not designed to routinely treat emergencies, the chance of encountering a patient in distress is always there. One of the key things your medical facility can do to make sure your team is prepared is to stock and maintain an appropriate number of emergency crash carts.

As it turns out, there is no standard list of medications and equipment required for a well-stocked crash cart, though you may check to see if your state issues guidelines in this area. Depending on your facility’s area of focus and expertise, some accrediting bodies may also issue guidelines or requirements.

However, considering the range of potential emergencies your team may be called to address, there are some basic items that are sure to be valuable components of your crash cart. We’ve outlined several below:

What Do You Need for a Crash Cart?

• IV Equipment
• Airway Management and Intubation Supplies
• Vital Signs Monitor
• Defibrillator and Heart Monitor
• Wound Care Supplies
• Appropriate Emergency Medication

One of the biggest misconceptions about crash carts is that they are necessary only in hospital settings. The reality is that the likelihood of needing to deliver lifesaving assistance exists in any medical setting, so it pays to make sure your team is prepared. Emergencies can happen any time, including during routine medical appointments. And while calling 911 and alerting trained emergency professionals to the situation is a must, your facility must be prepared to administer treatment until emergency services arrive.

When one thinks of a patient “crashing,” chest pain and heart issues typically are first to come to mind, and heart attacks and other cardiac emergencies are certainly cause for keeping a crash cart close at hand. Other medical emergencies requiring swift medical attention may include complications related to sedation, complications related to diabetes, sudden and severe allergic reactions, asthma attacks and more. A well-stocked and -maintained crash cart can give your team the proper tools to save a life when called to do so.

What is a Crash Cart?

A crash cart is a simple, self-contained and portable collection of emergency medical supplies and equipment your team may need to offer lifesaving and stabilizing medical treatment to a patient in distress. In most cases, you’ll see this as a wheeled cart that features several different drawers to house materials, devices and medication. While the contents of a crash cart will differ depending on the type of medical facility served, a basic crash cart should contain everything necessary to treat and/or stabilize a patient within the first 30 or so minutes of a medical emergency.

For the most part, your crash cart needs to equip your team with ventilation equipment, medication for allergic reactions and anaphylaxis, and the equipment and medication needed within the first 15 to 20 minutes of cardiac arrest, including nitroglycerin. Your team also must have the ability to monitor a patient’s vital signs and defibrillate if necessary.

Why Do You Need a Crash Cart?

A crash cart is a vital tool in any medical facility’s arsenal when it comes to providing the lifesaving and critical care a patient may need. A well-stocked crash cart should enable your team to stabilize a patient in distress and keep them stable for up to 30 minutes as you wait for emergency services to arrive and take over patient treatment.

Even if your medical facility is designed for routine services only, it’s important to remember that medical emergencies can happen anywhere and everywhere. It’s imperative to make sure your team has what it needs to save the life of a patient.

Depending on the type of medical facility or emergency department you serve, your state regulatory agency also may mandate that your team have access to at least one crash cart. These types of mandates are common for outpatient surgery centers, hospitals, urgent care centers and any other health care facility that offers services under sedation. In addition, crash carts are often mandatory for nursing homes and physician offices that provide certain cardiac services.

What Do You Need for a Crash Cart?

Now let’s take a closer look at some of the basic supplies, equipment and medication your team should include in its crash cart.

This includes appropriate disinfectants, bags of saline solution at various sizes, tourniquet tubing, vacutainers, multiple sizes of conventional and spinal needles, syringes, tape, tubing, three-way stopcocks and catheter tips. It’s also wise to include blood draw equipment, including specimen tubes. Make sure your emergency cart also includes a sharps container to effectively dispose of equipment and materials once they’re used.

Many patients in distress need help managing their airways and/or breathing properly. To help them, you may need forceps, sized for both adults and children, tongue depressors and disposable airways. In addition, many crash carts will also include everything a medical team would need to intubate a patient. This can include multiple sizes of endotracheal tubes; nasopharyngeal or oropharyngeal airways; laryngoscope blades and handle; stylets; tongue depressors and syringe appropriate for inflating the endotracheal tube cuff. Some emergency crash carts may also include a portable ventilator . Depending on the type of practice you serve, your team can decide whether it needs intubation supplies for both adults and children.

Make sure your emergency cart also includes an oxygen tank and a variety of face masks in various sizes in order to administer oxygen if needed. In addition, you’ll want to include a CPR board to assist with chest compressions if the administration of CPR if required.

Vital Signs Monitor

Being able to monitor a patient’s vitals is one of the most important aspects of stabilizing a patient who is in medical distress. You’ll also need to make sure you have team members on your staff who are well trained in how to take vital signs and should make sure your kit includes the basics, like a stethoscope and blood pressure cuff.

Defibrillator and Heart Monitor

Both a defibrillator and heart monitor are often needed when a patient crashes, so you can think of these items as basic staples of a crash cart, no matter your type of medical practice. A heart monitor, in particular, can provide valuable additional information to that can collected by your vital signs monitor for gauging a patient’s overall state of health.

Getting a patient’s heart started quickly and being able to monitor its performance are vital for emergency resuscitation. It’s largely for this reason that a defibrillator is often stored on top of a medical crash cart so that it can be accessed quickly and easily in an emergency situation. Defibrillator pads should be of various sizes so they can serve multiple purposes, and, depending on your medical practice, your setup may include pads and paddles for both children and adults.

Wound Care Supplies

This can include everything from basic bandages, Band-Aids and butterfly closures to tape, gauze, alcohol prep pads, sutures and sterile medical gloves. If someone is injured while at your facility, your team will be able to quickly and effectively stabilize the wound.

Your team may need a wide range of medication designed to help minimize or halt certain reactions and medical conditions. For example, you should make sure your crash cart contains epinephrine in order to treat a severe allergic reaction or anaphylaxis that occurs within your medical facility and nitroglycerin to treat cardiac distress when appropriate. Medication typically is housed in the top drawer(s) of a crash cart so that it is easily accessible in an emergency and can be administered easily and effectively when every second matters.

Other commonly stocked emergency medication may include atropine, sodium bicarbonate, calcium chloride, sodium chloride, amiodarone, dextrose, dopamine, lidocaine and vasopressin. You should also plan for at least one sedative and anesthesia. Keep in mind that the nature of the patients you serve may also dictate the kinds of emergency medication that you should stock within your crash cart. Pediatric and geriatric emergency medication, for example, differ greatly. It’s also smart to stock basics like aspirin, Benadryl and Epi Pens as part of your medical crash cart.

How Many Crash Carts Should a Medical Facility Have?

The number of crash carts you should have may depend on several factors, including the size of your facility or hospital and the type of medical services you offer. It’s wise to first check on your state’s requirements—for example, medical offices that treat pediatric patients may have different requirements than a nursing home or outpatient surgery center. The sizes and dosages for a pediatric crash cart will be very different than those for adult crash cards.

The important thing is to make sure that your crash cart(s) can easily and quickly be moved to a wide variety of locations within your facility. For example, if you have multiple floors within your medical office, you may consider housing at least one crash cart per floor to prevent the need to transport it from floor to floor in an emergency situation.

How Often Should Crash Carts Be Checked?

This is a key point in guaranteeing the safety of your patients. In particular, when it comes to medication included in your crash cart, you must ensure that all medication is appropriate for administering to patients and well within their expiration dates. If your medical team includes an on-site pharmacist, she is likely the best candidate for cataloguing all medication and developing an appropriate schedule for updating them based on expiration date. Your team can also take advantage of several technology solutions that will alert you when expiration dates are approaching and/or even automatically order new medication for you.

Otherwise, all medical equipment should be tested on a regular basis to ensure that it functions correctly and can safely be used in an emergency. A sound recommendation is that all items within your crash cart be tested on at least a monthly basis. An exception to this may be your defibrillator, which some experts recommend be tested daily. Whatever your testing schedule, you should keep a careful log of each time the emergency cart is examined and the state of the inventory at that time.

Crash Carts Save Lives

Having a crash cart close at hand and well stocked with the right equipment and supplies can mean the difference between life and death for a patient in medical distress at your facility. If your medical facility or hospital currently has a crash cart, make sure you inventory its contents on a regular basis to ensure that everything is in full working order and all of your medication is within its expiration date. If you’re putting your crash cart together for the first time, take the time to confer with your medical team or hospital staff on what kinds of emergencies, beyond the basic, you may need to be prepared for. Your team—and patients—will thank you for positioning them to provide the best possible treatment during an emergency.