During a code, knowing where your supplies are located on your crash cart is just as important as having everything necessary. Navigating your way through a hectic code is much easier when you have an organized system for your crash cart. Here are some tips.
Literally and figuratively, the “big things” are often the equipment you may utilize first, and you want to be able to keep them handy.
- You can make quick decisions on how to proceed with the code when you are able to assess your patient’s cardiac rhythm and respiratory status. If you determine that your patient is in a lethal cardiac rhythm, you’ll be ready to go. Make certain to have pediatric pads available as well.
Additionally, consider placing a basket on the outside of the crash cart to store other first-line items, such as gloves, extra electrodes, and various sized adult and pediatric bag-valve masks.
Crash carts will vary from hospital to hospital depending on individual facility requirements and patient population. However, the best practice is to keep supplies that are frequently used together in the same drawer, and separate your drawers based on function. Make sure each drawer is clearly labeled on the outside.
General guidelines for how to stock a typical 6- drawer adult crash cart:
- This will include your emergency medications such as epinephrine and sodium bicarbonate, normal saline and sterile water vials, and medication labels.
- Store your angiocaths, butterflies, tape, and collection tubes here.
- This will house your dextrose solutions, sodium chloride, and extension tubing.
- Stock ET tubes, laryngoscopes, blades, airway adjuncts, and supraglottic airways here.
- Stocking pediatric-appropriate medication, IV and airway supplies in a separate drawer will make it easier to find in an emergency.
- Chest tube trays, central line kits and other extra supplies are often stored in the bottom drawers.
Maintaining an inventory of your supplies as well as inspecting them is a crucial element. You don’t want to be in an emergency and find that your cart is missing the appropriate size endotracheal tube or that the epinephrine is expired.
To avoid this, keep a list hanging on the outside of the cart that specifies every item that is stocked. Make sure IV fluids and medications have their expiration dates listed next to them as well. Have a system for double-checking inventory at least monthly to make sure that all items are present and that no expired items are left in the cart. Document this. Additionally, consider placing a lock on the crash cart to ensure its integrity in between checks.
Regularly inspect all your big items to make sure they are functioning as they should. Check your defibrillator daily, and verify the joules discharged on schedule specified by your hospital. Make sure your oxygen tank is sufficiently full. Ensure that your portable suction machine is properly charged. Document appropriately that these checks have been performed.
Following these suggestions will help ensure that your code cart will always be properly stocked and that everything is right where you expect it to be. And when that code comes, you will be thankful.
Editor's Note: This blog was originally published in November 2015. It has been re-published with additional up to date content.
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