The medical crash cart is a vital part of the medical industry. The crash cart allows medical professionals to respond quickly to codes and is more than simply a medication cart because it contains everything that might be needed in terms of medication and equipment in an emergency.
What is a medical crash cart?
A medical crash cart is a portable cart used for emergency medical situations. It is stocked with easily accessible equipment and medication suitable for dealing with codes, or lifesaving procedures, such as resuscitation.
A crash cart is a combination of a medical rolling cart, a dispensing unit, and an equipment center. It can carry the medication and equipment to the site and allows staff to retrieve and use what they need quickly.
What is a medical crash cart used for?
The crash cart is mobile and can be wheeled to the location where it is required. It can also be moved around a room or ward to allow medical staff to use it.
By using a medical crash cart, medical staff can respond to emergencies quickly and efficiently. They can access equipment such as defibrillators and vital medication within moments, potentially saving someone’s life.
Medical crash carts are not found everywhere in a hospital and normally have specific locations which allow them access to many areas of the hospital. The most common places to put them are in an operating room, an emergency treatment area, or a site nearby any area which might require immediate medication or lifesaving devices.
Why are medical crash carts important?
There are many reasons that medical crash carts are vital. The increased speed they provide is one of the enormous benefits to the staff assigned to attending medical codes. These professionals are trained to respond as quickly as possible, and the crash cart can enhance their ability to do so.
These carts are intended to be used for urgent care and have been developed to meet all the needs of such a situation.
How is the cart organized?
Medical crash carts are not all organized in the same manner. The organization may vary depending on factors such as the facility in which the cart is used or the treatment area it is required.
However, there is a general standard for medical crash cart organization that often follows a similar pattern across different facilities.
The crash cart generally has a defibrillator on the top so that it can be accessed quickly, as well as oxygen supplies. Medications and equipment are stored in the drawers, always labeled, which make up the body of the cart below.
It is important to note that these descriptions are not an enforced standard. Make sure to familiarize your staff with the details of any crash cart they need to work with, as it might not be the same as one; they have previously used.
On top of the cart
The defibrillator on the top of the crash cart should be ready to use as soon as it is needed and checked daily to make sure it is in good working order. The pads should be multipurpose to allow it to be used in various situations. There should also be separate infant pads and paddles ready to use.
Oxygen supplies and valves should be easily accessible. These supplies and valves should include a few choices of face mask size, including an infant facemask.
The oxygen tank should be securely fastened to the side of the cart. The pressure or the level of oxygen in the tank should be checked regularly, dated, and initialed by the staff member who checked it.
A CPR backboard and a resuscitation tape for pediatric care should also be stored on the outside of the cart.
All medications should be stored and clearly labeled so staff can quickly tell the medications apart. Medications are generally kept in the top drawer, or the top two drawers, of the crash cart. If you have pediatric medications as well as adult medications, you might store pediatric medications in the second drawer.
Medications can be set out in rows within the drawer, with each row containing medications for different purposes. For example, medications used when treating cardiac arrest are typically kept closer to the front for faster access.
The medications should be set out so they can be measured quickly and dispensed as soon as possible.
Intubation can be one of the tasks a crash cart is used for. The materials for this might be kept lower down in one of the crash cart drawers, depending on how the rest of the drawers are organized.
Because of how the equipment looks, pediatric and adult intubation equipment should be separated. Whether this separation is done by placing the equipment in different carts or drawers, the equipment should be clearly labeled to prevent any confusion.
The materials needed to start an IV line should have their own drawer in the crash cart. This drawer should include all necessary items, with various sizes of needles, syringes, and other variable equipment so any patient can be treated. You may choose to have the IV solutions kept in the drawer as well for easy access.
The equipment needed for medical procedures is generally kept in the bottom drawer, often the fifth drawer, of the crash cart set. This equipment is designed to be used for the emergency procedures that are often required during a code.
The equipment should be prepared in kits, with each kit specified for a particular procedure. Sterile gloves and sutures should also be included in this drawer to be retrieved at the same time as the procedure kit.
Although the crash cart will be easy to transport, it should be kept near a treatment room, an emergency treatment area, or any other space in which it might be required.
For a location-specific crash cart, you might choose to make alterations or add certain features for particular tasks. For example, an ACLS Crash Cart treats patients with life-threatening cardiovascular conditions, such as stroke victims, so the American Heart Association (AHA) has specific guidelines on the crash cart’s contents. They release their guidelines for Emergency Cardiac Care and CPR every five years.
Types of crash carts
Although crash carts are often similar, some have specific purposes. These purposes vary based on the necessary equipment or medication as well as the organization of the cart.
For example, a crash cart in an age-specific facility might need particular medications or equipment. For example, pediatric medicine and geriatric medicine often have vastly different needs, and the cart’s contents can reflect this.
The part of the facility in which the cart is being used may also mean a different type of crash cart. A standard crash cart can differ from a crash cart kept in an operating room. You may also choose to add extra equipment, such as a computer system for digital health records.
Adaptable crash carts
Sometimes, you may need one crash cart that has multiple uses. If you know you might use one crash cart for both adult and pediatric care, for example, you will need to stock the cart with materials for both. Different equipment and medication may need to be stored in separate drawers and labeled clearly for each situation.
However, it is important to ensure the use of the crash cart is thoroughly understood by all who use it. Training those who use the cart properly can help to prevent errors and reduce the time taken for medication retrieval.
Several safety areas should be addressed when you use a crash cart. For example, there should be a restriction allowing only qualified individuals to access the crash cart.
Further safety checks should address whether everything in the cart is working as intended. The equipment should be checked frequently to ensure it is functioning correctly. These checks should also be documented in an official record.
Another important safety point is the equipment on the cart. A document of what is inside should be attached securely to the cart, without any danger of it moving around or falling off.
Inventory and maintenance
It is extremely important to ensure that an up-to-date inventory is maintained for your crash cart. Knowing which medications and equipment are on the cart maintains safety and prevents wasting time.
Another issue is that medication and equipment might be subject to expiration dates. Keep a schedule of when to check for expiration dates and note when they are on a separate document to be sure to refill the cart when necessary.
Make sure to have a specific schedule for inventories on each crash cart at your facility, with a log of who performed the checks. There should also be a record of what was replaced and when. Keeping a record can avoid potential medication mistakes, as well as dangerous situations such as empty oxygen tanks being left unfilled.
It can be preferable to use a closed or sealed tray setup for your crash cart. Using such a tray forces everyone who opens it to break the seal and make a note of what they removed. As a result, there should be less risk of unaccounted-for medications and equipment.
All medical staff will receive the appropriate training for their positions. However, it is also important to ensure they are trained to use the crash carts in your facility.
While there are often similarities in the way crash carts are organized, such as having medications in the top drawer, variations often occur. One of the most important aspects of a crash cart is the speed with which it can be used, and staff should know where everything is before a code takes place.
Staff should also be trained in any safety and security procedures for the carts, such as recording the use of the cart or noting when a security seal has been broken.
Dealing with issues
During your training, including any drills you might run, make sure to take detailed notes on any issues that staff experience. These issues could be problems with locating equipment or medication or the speed with which parts of the cart can be accessed.
Also, if there are any issues experienced with the crash cart during its everyday use, staff should know the protocols for reporting the problem.
Recording problems can ensure that even small issues are dealt with promptly. Because it is required in a fast-paced, urgent environment, a crash cart should be as easy to use as possible. Every second lost could mean a patient’s life may not be saved.
Should you customize your crash cart?
The fact that crash carts lend themselves to customization can be extremely useful.
When customizing your crash medical cart, make sure you discuss the design with a professional who has experience in this area. The cart should be easy to understand and to use, allowing it to assist with any code for which it is required.
Sometimes, customizing your crash cart means meeting the special medical needs of your facility. For example, in a facility where narcotics are administered, you may need special medications, or in a neonatal unit, you may need to stock Narcan Nasal Spray to reverse the effects of opioid overuse.
It is also worth noting the regulations required for your medical practice may vary depending on which state you operate in. Make sure to check whether there are any additional rules to follow in the way you set up or maintain your crash cart.
How can technology help improve a crash cart?
Although the crash cart will be mobilized in the event of a code, it is still a part of the patient’s wider care. Having computer technology available on the cart can allow those using it to access electronic records.
Easy access to patient files, or additional information on the procedure or treatment at hand, can significantly speed up the activities of the medical staff. This access can also help prevent errors.
Nurses and other care professionals may be able to input patient data using the crash cart, which can help to improve accuracy and patient communication. By choosing a mobile computer option, you can retain the all-important speed and maneuverability of the crash cart, while still enjoying the benefits of a medical computer cart.