Crash carts are integral to patient care and are built to accompany doctors to treat emergency, life-threatening situations in hospital settings. Not all crash carts are designed the same or offer equal functionality, so it's important to do your research before making a decision about which type of crash cart is best for your facility.

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About Crash Carts

Crash carts hold the equipment and medications needed to treat patients in the first 30 minutes of a medical emergency. State agencies legally require code carts in certain health care locations and recommend them in many more areas to improve life-saving patient care.

What Matters in a Crash Cart

Having a crash cart well-suited to your practice can make a huge impact on the quality of care patients receive. We've compiled a list of four things you should look for in your crash cart.

1.Mobility

Crash carts are meant to travel, so a lightweight yet durable cart will make the process smoother and more efficient. Carts are often made from a combination of aluminum, stainless steel, and plastic for a lasting product that is weight-conscious.

Keeping carts streamlined cuts down on bulk, allows for easier steering, and ensures they fit neatly into patient bays.

Carts should be easy to move, but only when you want them to. Easily accessible wheel locks are important for keeping a cart stable when it's not in transit.

2.Organized Storage System

The layout and organization of a crash cart make a big difference to its functionality and accessibility, especially with so many people who use and maintain the cart. A smart organizational system makes monthly maintenance easier by allowing staff to quickly check expiration dates and refresh supplies.

When you add to that that a cart is expected to house expensive specialty equipment alongside more frequently used products, like sodium chloride, a proper layout becomes even more important.

The optimal layout of a cart will depend on its role in the healthcare field, making custom carts a popular option among emergency care professionals. Adult crash carts often have different arrangements than pediatric crash carts, and specialty practices require still different instruments and layouts. Where anesthesia is practiced, intubation equipment is important to have on board.

Some organizational features are relatively constant throughout crash cart design. The heart monitor and defibrillator are kept on top of the cart for easy access during common cardiac codes, while IV fluids are often hung on the back of the cart or stored in a drawer.

Drawer space and division capabilities are a major part of cart organization. Drawer labels are not for informational purposes only but are necessary for keeping emergency medications organized by allowing for easy identification and restocking.

Exterior storage for oxygen tanks and portable suction machines is a common storage solution, but these life-saving instruments can also be stored inside the cart in many newer models.

3.Charging Capability

Crash carts will not work without power. In some hospitals, carts are out of commission for large parts of the day while they recharge. To minimize the number of carts needed in your facility, ensure the power source is reliable and easily charged.

Flexible Mobile Cart Power Technology is a trusted solution to power mobile computing devices. It provides a 6 to 10-hour power source that can be charged in the cart or swapped with a charged battery. It also comes with a 5-year warranty.

4.Security and Accessibility

Medical carts must be kept on hand for emergencies yet secured to comply with FDA medical device safety regulations. Some carts come with computerized locking mechanisms to secure cart drawers against theft or dosing errors.

Because professionals use crash carts in teams, the functions of the cart should allow for simultaneous use to save precious time in an emergency.

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Final Thoughts

Crash carts provide the life-saving tools needed in an emergency medical situation. Their utility can be maximized by ensuring you get the right crash cart for your medical facility.

Crash Carts

The crash cart is the commonly used term to describe a self-contained, mobile unit that contains virtually all of the materials, drugs, and devices necessary to perform a code. The configuration of crash carts may vary, but most will be a waist high or chest high wheeled cart with many drawers. Many hospitals will also keep a defibrillator and heart monitor on top of the crash cart since these devices are also needed in most codes. Since the contents and organization of crash carts may vary, it is a good idea for you to make yourself aware of the crash cart that you are most likely going to encounter during a code.

What is in a crash cart?

The size, shape, and contents of a crash cart may be different between hospitals and between different departments within the same hospital. For example, an adult crash cart is set up differently than a pediatric crash cart or crash cart on the medical service may be different than the one on a surgical service.

Medications

Medications are usually kept in the top drawer of most crash carts. These need to be accessed and delivered as quickly as possible in emergent situations. Therefore, they need to be available to providers very easily. The medications are usually provided in a way that makes them easy to measure and dispense quickly.

The common set of first drawer medications might be:

• Alcohol swabs
• Amiodarone 150 mg/3ml vial
• Atropine 1mg/10 ml syringe
• Sodium bicarbonate 50mEq/50 ml syringe
• Calcium chloride 1gm/10 ml syringe
• Sodium chloride 0.9% 10 ml vial Inj. 20 ml vial
• Dextrose 50% 0.5 mg/ml 50 ml syringe
• Dopamine 400 mg/250 ml IV bag
• Epinephrine 1 mg/10 ml (1:10,000) syringe
• Sterile water
• Lidocaine 100 mg 5ml syringes
• Lidocaine 2 gm/250 ml IV bag
• Povidone-Iodine swabstick
• Vasopressin 20 units/ml 1 ml vial

If the crash cart also contains pediatric medications these may be contained in the second drawer. Often these would include:

• Atropine 0.5 mg/ 5 ml syringe
• Sodium bicarbonate 10 mEq/10 ml syringe
• Saline flush syringes
• Sodium chloride 0.9% 10 ml flush syringe

The second drawer of the crash cart might also contain saline solution of various sizes like 100 mL or 1 L bags. A crash cart in the surgery department may include Ringer's lactate solution.

Intubation

Many crash carts will also include most of the materials necessary to perform intubation. These may be contained in the third or fourth drawers depending on the setup of the particular crash cart.

The adult intubation drawer will contain:

• Endotracheal tubes of various sizes
• Nasopharyngeal and perhaps oropharyngeal airways
• Laryngoscope handle and blades of different sizes
• A flashlight with extra batteries
• A syringe of sufficient size to inflate the cuff on it endotracheal tube
• Stylets
• Bite block
• Tongue depressors
• Newer setups may also include the materials needed to start quantitative waveform capnography like a nasal filter line

Pediatric intubation materials may be in a separate cart or if they are included in the adult crash cart they may occupy their own drawer. The pediatric intubation supply drawer may contain the following:

• 2.5 mm uncuffed endotracheal tube
• 3.0 mm ' 5.5 mm microcuff endotracheal tubes
• Pediatric Stylet (8 Fr)
• Neonatal Stylet (6 Fr)
• Nasopharyngeal and perhaps oropharyngeal airways,
• Laryngoscope blades
• Disposable Miller blades
• Disposable Macintosh blades
• Armboards of various sizes
• Vacutainers for blood collection
• Spinal needles
• Suction catheters of various sizes
• Bone marrow needles of various sizes
• Feeding tubes
• Umbilical vessel catheter
• Disinfectants (swab sticks)
• Pediatric IV kits

Intravenous lines

It is usually the case that the equipment necessarily to start an IV is in a separate drawer from materials needed to maintain an IV, such as the fluids in the tubing. The IV drawer(s) usually contain the following:

• IV Start Kit
• Angiocatheters 14 Ga and/or 16 Ga
• Disinfectants (Chloraprep, Betadine, povidone-iodine)
• Luer lock syringes of various sizes
• Tourniquet tubing
• Insyte autoguards of various sizes
• Vacutainers
  • Blue top
  • Purple top
  • Green top
  • Red top
  • Spinal needles of various sizes
  • Regular needles of various sizes
  • 3-Way stopcock
  • Tape
  • Armboards
  • ABG syringes and sampling kits
  • Catheter tips
  • Tubing
  • IV solutions may also be kept in this drawer

Procedure drawer

The bottom drawer on crash carts is usually devoted to keeping prepackaged kits available for various urgent and emergent procedures (or it is where the IV solutions are kept). In any case, the following kits may be found in the procedure drawer:

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