An organized crash cart could be the deciding factor in a life or death situation. Although the specific layout of a crash cart may differ due to the availability of certain materials or location-specific techniques, the crash cart is a self-contained, mobile unit with emergency equipment for use in an emergency department.
Dedicating specific drawers or separate cart areas to store certain items is critical for the organization of crash carts. Proper arrangement allows your emergency care team and other hospital staff to memorize their location and reach for them inside the medical cart with drawers quickly if a patient experiences a sudden deterioration of their health.
General Medical Supplies Checklist
According to a 2016 study on the history and importance of emergency crash carts have been used by medical facilities since at least the early 1960s (then known as the emergency trolley).
Although the concept of a crash cart was not yet widespread, much of the equipment found in these early trolleys was similar to the supplies found in a modern cart.
The following equipment is suitable for use on any crash cart in a medical facility, from adult crash carts to pediatric care carts.
- Defibrillators for sudden cardiac arrest
- Suction devices and bag valve masks
- Drugs for peripheral and central venous access
- Fluids: Calcium chloride (1g/10 ml), Sodium chloride 0.9% (10 ml injection vial, 20 ml vial), sterile water
- At least one sedative as well as intubating equipment and anesthesia
- Pediatric equipment: patient warming devices, restraints, weight scale, measuring tool, blood pressure cuffs, pulse oximeter, needles, femur splints, etc.
- Other hospital-specific equipment
- Monitor and all related life support equipment
- Defibrillator with leads and paddles
- Sharps disposal container
- Oxygen tank
- Rigid plastic backboard
- Handheld suction mechanism
Drawer 1 Equipment – Procedure Drawer
The procedure drawer contains all the equipment necessary for special medical emergencies.
- ECG Gel
- 5 Electrodes for both children and adults
- Lumbar puncture kit
- Spare spinal needles and spinal needle tips
- Suction supplies
- Sutures of multiple sizes and types
Drawer 2 Equipment – Oropharyngeal Airway Supplies
- Wooden tongue depressor
- One endotracheal stylet for both children and adults
- One uncuffed endotracheal tube in each size ranging from 2.5 to 9
- Two microcuff endotracheal tubes in each size ranging from 3 to 7
- Nasogastric tubes (feeding tubes)
- Maglis forceps for both children and adults
- Disposable oropharyngeal airways: 00,0,1,2,3,4 – include one of each
- 2 10 cc syringes
- 10 small pieces of Dyna plaster
- Two Laryngeal masks: No.3 and No.4
Drawer 3 Equipment – Venipuncture Supplies
- 3 Disposable syringes in each of the following sizes: 1 ml, 2.5 ml, 5 ml, 10 ml, 20 ml, and 50 ml
- Additional 2.5 ml and 5 ml syringes
- One pressure monitoring line with a disk and one without
- 5 Disposable needles with 18 gauze with and without filters
- 5 Disposable needles with 23 gauze
- Lock syringes
- 5 IV dressing
- 30 spirit swabs and 10 cotton swabs
- Suction catheters (e.g., Venflon 16G, 18G, 20G, 22G, 24G)
- 2 packets of sterile gauze
- 2 IV sets with extensions
- Disposable kidney tray
- Multi-lumen catheter
- Umbilical vessel catheter
- 10 ready-to-use saline flush syringes (e.g., PosiFlush)
- Micropore plaster 1-inch
- 2 3-way stopcocks
- Burette set
Drawer 4 Equipment – Medication
The role of the medication drawer on crash carts is the storing and dispensing of emergency medication.
The exact selection of drawer medication varies by facility (e.g., urgent care centers may have a different selection of substances in their hospital pharmacies than standard clinics) and cart role.
Here is an example list of items with some of the most common medications:
- Adenosine 3 mg/ml
- Amiodarone 150 mg vial
- Aspirin 81 mg tabs
- Atropine 8 mg/20 ml vial
- Benadryl 50mg
- Dextrose 50% (25% in pediatric medication drawers)
- Diazepam 50 mg/10 ml
- Dopamine 40 mg/ ml
- Epinephrine (e.g., EpiPen, Epinephrine 1:1,000)
- Lidocaine 100 mg
- Lopressor 10 mg
- Midazolam 50 mg/10 ml vial
- Naloxone (e.g., Narcan 1 mg/ml)
- Vasopressin 20u/ ml
Drawer 5 Equipment – IV Fluids
- 1,000 ml dextrose 5% in water solution (D5W)
- 1,000 ml normal saline solution (NS)
- 1,000 ml lactate solution (Lactate’s Ringer, LR)
- 500 ml of D5W and NS
- 100 ml of NS-2
Drawer 6 Equipment – Pediatric Intubation Supply Drawer
- Pediatric emergency tape
- Adult (15 gauze) and pediatric (18 gauze) versions of intraosseous needles (bone marrow needles)
- Medication additive labels
Helpful Arrangement Tips for Medical Crash Carts
Although the configuration of crash carts may vary depending on the facility, here are some tips to follow for improving your cart’s organization and access.
- Use well-designed, purpose-built mobile carts. Studies have shown that a properly-designed crash cart improves the quality of medication management.
- Clearly distinguish pediatric materials from adult materials.
- Designate one person to organize and manage the medical crash carts and enforce a policy for medical staff on replenishing stock.
- Place each adult crash cart and pediatric crash cart in separate, easily accessible areas.
- Crash cart storage should be accessible from a low-traffic area. Do not move the cart from this position unless it is in use.
- Educate your emergency care team and other hospital staff on your life support protocols and how to locate and use the equipment in your crash carts.
Organize Your Crash Carts and Supplies With Scott-Clark Medical
Crash carts are vital in all intensive care situations, from bleeding to cardiac arrest. Medical carts store all the necessary equipment for immediate intervention and all common medications that your hospital staff needs.
Scott-Clark Medical offers a wide variety of standard medical carts and emergency crash carts. We can also provide custom carts like a rolling computer cart, and retrofit or refurbish your fleet of carts.
Investing in a quality crash cart, mobile workstation or anesthesia cart from Scott-Clark Medical provides you with the space you need for your medical supplies, improving the quality of care in your facility.
Organizing your supplies in one of our carts helps ensure your hospital staff and emergency care team can intervene quickly, resulting in a higher chance of survival.