To identify what is the crash cart consist of
To identify how to arrange crash cart contents
according to policy listed from CBAHI
To determine role of nurse during checking on the
Definition of the crash cart
History of the crash cart
Policy about crash cart
Arrangement of the crash cart
It is a means of storing and
transporting vital equipment
and drugs which may be
required during a code blue (
cardiac emergency ) to the
location of the emergency .
The crash cart should be kept in
an easily accessible position
which is central to the patient
care areas .
The first cardiac crash cart was created in 1962 at
Bethany Medical Center in Kansas City, Kansas,
home to the first Cardiac Care Unit in the country.The
first crash cart was fabricated by one of the doctor's
fathers. It contained an Ambu bag, defibrillator
paddles, a bed board and endotracheal tubes
The function of a crash cart is to
provide a mobile station within the
hospital that contains everything
needed to treat a life-threatening
situation. The advantage of mobility
is that it allows the treatment to
come to the patient when needed.
The arrangement of the equipment
in the crash carts should be
standardized throughout the
1. Crash cart must be checked by head nursestaff
nurse every shift and document in checklist.
2. Standarization must be maintained.
3. Defibrillator will be checked by biomed department
regularly or as necessary.
4. crash cart items must be checked monthly for expiry
5. Each unit will have crash cart placed in an easily
place acceaaible location.
Ultrasound Jelly for DC shock
Ambu bag Adult with mask
Ambu bag pedia with mask
ECG recording paper
, to know rhythm and or delivering shock
ETT ( various sizes)
Suction Catheter (all sizes)
Laryngoscope with Blades ( curved , straight)
ETT of various sizes ( adult , child and infant )
5 & 10 ml syringes
The endotracheal tube serves as an open passage through
upper airway. The purpose of endotracheal intubation is
to permits air to pass freely to and from the lungs in order
to ventilate the lungs .
1. EPINEPHRINE Adrenergic agent of choice for
cardiac arrest, vasopressor used in Pulsless
VT/VF, Asystole and PEA: 1 mg IV every 3-5 min.
Or more frequently. May be given endotracheal
Stocked 1 mg/10 ml 1:10,000. If using for
hypersensitivity reaction 0.1-0.25mg SQ, SIVP.
Agent used for symptomatic bradycardia,
PEA: 0.5-1 mg IV push
, repeat at 3-5 min.
Intervals to max. Total dose of .04 mg/kg
. May be given via endotracheal route. Stocked 1
Atrpoine is antidote for
0.318.1- 29.5 kg
Calcium Channel blocker
Inhibits the movement of calcium ions across the
membranes of cardiac and arterial muscle cells.
Treatment of SVT
I.V : initial dose , 5-10 mg over 2 min ; may repeat dose of 10 mg
30 min after first dose.
1 year and younger : initial dose 0.1 -0.2 mgkg over 2 min.
1-15 years : initial dose 0.1-0.3 mg kg over 2 min .Do not exceed 5
mg .Repeat above dose 30 min after initial dose if response is
not adequate. Repeat dose should not exceed 10 mg.
Monitor patient carefully ( BP , cardiac rhythm , and
Protect IV solution from light
Monitor patients with renal or hepatic impairment
carefully for possible drug accumulation and adverse
Type III antiarrhythmic. Acts directly on cardiac cell membrane.
Only for treatment of the following documented life-threatening
recurrent ventricular arrhythmias.
Recurrent ventricular fibrillation.
Unstable ventricular tachycardia.
150 mg loading dose over 10 min , followed by 360 mg over 6 hr
at rate of 1 mg/ min .
For maintenance infusion 540 mg at 0.5 mg / min over 18 hr.
Amiodarone should be diluted with D5W)
-Drug class and indications:
Conversion to sinus rhythm of paroxysmal
6 mg by rapid IV bolus ; for repeat dose , use 12 mg by IV
bolus within 1 – 2 min
Vasopressor: IV infusion: 500 mg Dobutamine in
250 ml IV solution. Usual dose 2-5mcg/kg/min.
May titrate to upper dose of 20mcg/kg/min.
Primarily stimulates B-1 receptors in the heart
and is used for inotropic support with mild
chronotropic effect. Adequate hydration of
patient imperative in blood pressure support.
When mixing more than 500mg. Dobutamine in
IV solution, equal volume must be removed (e.g.
1gm/40ml Dobutamine, remove 40ml from IV
Vasopressor, IV infusion: Usual dose in code situation
is 5-20mcg/kg/min. Renal perfusion dosing 2-
5mcg/kg/min, increase of cardiac output 5-
10mcg/kg/min and peripheral vasoconstriction 10-
20mcg/kg/min. As approaching 20mcg/kg/min assess
urine output. Extravasation treatment is with
phentolamine. Adequate hydration of patient
imperative in blood pressure support. Premix drip of
400 mg Dobutamine in 250 ml IV solution.