Crash Cart Policy and Checklist in Hospital
Crash Cart Policy and Checklist in Hospital
Crash Cart Policy and Checklist in Hospital
Crash cart is a lifesaving trolley which contains essential medicines, instruments and equipment that
can be used to save life of a patient (or a person), in case of medical emergency such as heart attack.
In hospital there is always a risk of a patient undergoing cardiac arrest and hence it is important to
have crash cart trolleys stationed at appropriate places for the code blue team to use it on the
patient, whenever required. (Code blue team is a dedicated trained team of doctors and nurses, who
can perform basic and advanced life support function on patient who has undergone a cardiac
arrest).
In-order to ensure that crash cart is usable whenever required some policies and practices needs to
be put into place. It is also important that crash cart contains all things that may be required during a
medical emergency. The checklist below can be used for this purpose.
Checklist of items in crash cart (Source: UC DAVIS Health System, Centre for professional Practices of
Nursing)
Top Basket
Bottom Basket
Large Gloves
Defibrillator Pads
Sharp container
Povidone-Iodine Swabstick
Alcohol Swabs
Blank Labels
Black Locks
Twill Tape
Lubafax
Bite Block
Tongue Depressor
Adult Stylet 14 Fr
35 cc Syringe (LL)
Laryngoscope Blade
Laryngoscope Handle
Laryngoscope Blades
Batteries, size AA
Spinal Needle
IV Start Kit
Vacutainers
Cannula
3-Way Stopcock
Adult Armboard
Betadine solution 4 oz
Buretrol Add-on-Set
Clear Cuff
Multi-lumen
Yankauer Suction
Sterile Field
10 cc or 12 cc Syringe
10 cc or 12 cc Syringe
Crico Pack
Maintaining crash cart: It is important that the items listed in the checklist above is available in crash
cart all the time. For this purpose, hospital should have a policy of not using crash cart medicines or
other items for routine patient care purpose. Also, whenever the crash cart has been used for
handling emergency, the used items should be replenished immediately after that. Hospital should
designate a person to ensure that the crash cart contains all required items and is replenished
whenever used. Periodically the medicines should also be checked for its expiry date and replaced if
required.
Some hospitals seal the crash cart with a plastic wrap, to prevent its use in routine cases. This is
however not recommended, as it can just increase the time to access its materials in case of
emergency. A small paper tape on edges of drawer can be put which doesn’t restrict its opening, but
tears off, letting others know that the crash cart was opened.
A copy of checklist should be kept on the crash cart for monitoring purpose
Number and locations of crash cart: There is no standard recommendation on how many crash cart
to be maintained in a hospital or where to station the cart. The general principle is that crash cart
should be easily available to all patient care areas and it should not take more that 30-45 seconds to
bring crash cart near the patient's bed, where it has to be used. Hence, depending upon the layout
of the hospital, number of crash cart should be procured. If the wards are big, one crash cart should
be kept in every ward. In floor wise arrangement, one or two crash cart can be kept on each floor
depending upon how big the floor is. One dedicated crash cart should be kept in areas like
emergency, blood donation room, imaging department, day care and OPD areas.
In case it is difficult to cover all areas by crash cart, a crash bag can be kept with the code blue team,
which contains some basic essential items out of the list, which they can start using on patient by the
time crash cart is brought in.
Staff training: While code blue team is the main user of crash cart, all healthcare staff should know
about it and should be able to perform at-least basic life support activities. Policies and procedure of
maintaining crash cart should be known to all.