In 2007, a federal regulation mandating anesthesia carts be locked between patient cases whenever authorized personnel was not in the room was overturned. As a result, as long as these portable storage carts on wheels are kept in secure areas, they can remain unlocked, allowing quick and easy access to life-saving medications in the event of a crisis.
Not only was the locking of these carts slowing down anesthesiologists from speedily obtaining anesthesia drugs and reversal agents, but many personnel forgot to lock the carts anyways, leading to reprimands and more severe consequences from surprise inspections.
While this regulation now states, “All drugs and biologicals must be kept in a secure area, and locked when appropriate,” Schedules II, III, IV, and V drugs must always be locked, even in a staffed and secured area like an O.R.
Some hospitals and surgery centers have continued to require their staff to keep the anesthesia carts locked as well, to prevent theft and misuse of the anesthesia and reversal drugs.
Emergency surgery
Not all surgeries can wait for an anesthesiologist to arrive. Sometimes a doctor has to immediately access the anesthesia cart, such as when they must perform an emergency cesarean section delivery. The anesthesia carts often have all the tools and anesthesia drugs on top of the cart or in an unlocked drawer so medical professionals can quickly access them to save the lives of patients who can’t wait for an anesthesiologist.
Compromise
Anesthesia carts can include some locking drawers for Schedule II and above drugs. A compromise that has been made in many facilities is providing a tamper-proof seal for storage of anesthesia and reversal drugs. This way, each time the drawers holding these components are accessed, the seal is broken, and a chain of custody can be determined if unauthorized access has occurred.
Debate
While federal regulations have lightened, some states and medical facilities still require anesthesia carts to be locked, even in secured areas. This has remained a source of debate for many years, especially among anesthesiologists and doctors who work in emergencies every day.
Anesthesia cart features
Most anesthesia carts have a combination of automatic and manual locking drawers. This ensures tools and non-dangerous medications can be obtained quickly, while more dangerous or addictive medications can only be acquired by authorized personnel. The anesthesia cart is a portable storage cart on wheels so it can be maneuvered over any surface to anywhere in the room or unit for quick and easy access by the medical team.
Scott-Clark Medical manufactures anesthesia carts with expandable table tops so tools can be laid out in a single layer. The metal is also made to withstand disinfectant cleaners so the cart can be utilized for the long term.
Anesthesia carts can also be customized with peripheral options, including large supplies drawers, sharps containers, and trash bins. In emergencies, medical teams don’t have time to worry about finding places for disposal or locating supplies. Anesthesia carts are equipped to provide ease of access to medical teams for their emergency surgical needs.
Final thoughts
While laws and individual rules may vary, it’s always wise to use common sense when deciding whether to keep anesthesia carts locked in between patients. If the secured area can be monitored closely with cameras, or if a chain-of-custody can be established for the cart, then it is probably safest to keep anesthesia drugs, reversal drugs, and tools readily available for professionals to retrieve quickly. When lives depend on minutes or seconds, a locked anesthesia cart should not stand in the way.