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1. Crash cart
DR. GOURAV KUMAR
Assistant professor
Department of Radiation and Imaging Technology
NIMS University, Jaipur Rajasthan

2. Introduction
o A crash cart is a specialized medical equipment trolley or cart that is stocked with various emergency
medical supplies and equipment.
o It is designed to be readily accessible and mobile, allowing healthcare professionals to quickly respond to
medical emergencies, especially those involving cardiac arrest or other life-threatening situations.
o Crash carts are typically equipped with items such as defibrillators, medications, airway management tools,
intravenous (IV) supplies, and other critical emergency supplies.

3. o These carts are strategically placed in healthcare settings such as hospitals, clinics, and emergency rooms to
ensure rapid response and immediate availability of essential tools during emergencies.
o The contents of a crash cart may vary based on the specific needs and protocols of the healthcare facility, but
they are generally standardized to include equipment and medications necessary for initial resuscitation
efforts.
o The goal is to have all the essential tools in one place to increase the chances of successfully managing a
medical emergency.
o “ first crash cart used in 1962 in Bethany medical center in Kansas city.”

4. Purpose of crash cart
o A crash cart, also known as a code cart or emergency cart, is a specialized medical cart stocked with
essential equipment and medications designed for use in emergency situations, particularly in healthcare
settings like hospitals and clinics.
o The purpose of a crash cart is to provide immediate and organized access to life-saving interventions and
supplies when a patient experiences a medical emergency, such as cardiac arrest or respiratory failure. The
contents of a crash cart may vary, but they typically include:
o Cardiac Life Support Equipment: This may include a defibrillator for delivering electric shocks to restore
normal heart rhythm, as well as tools for airway management and ventilation.

5. o Medications: Essential drugs for emergency situations, such as epinephrine, atropine, vasopressors, anti-
arrhythmics, and other medications used to treat cardiac arrest or other critical conditions.
o Airway Management Tools: Items such as endotracheal tubes, laryngoscopes, and suction devices to assist
with maintaining a patient's airway.
o Monitoring Devices: Devices to monitor vital signs such as electrocardiogram (ECG) monitors, pulse
oximeters, and blood pressure cuffs.
o Intravenous (IV) Supplies: Fluids, IV catheters, and other supplies for establishing intravenous access
quickly.
o Emergency Resuscitation Equipment: Items like bag-valve masks (BVMs) for manual ventilation, chest
tubes, and chest decompression needles.

6. o Diagnostic Tools: Tools such as blood glucose meters, thermometers, and diagnostic tests that can aid in
quickly assessing a patient's condition.
o Miscellaneous Supplies: Additional items like gloves, gauze, syringes, and emergency documentation
materials.

7. Content of crash cart
o Defibrillator/AED (Automated External Defibrillator): Used to deliver an electric shock to the
heart in the case of cardiac arrest.
o Cardiac Medications:
o Epinephrine: A medication used to treat cardiac arrest and severe allergic reactions.
o Atropine: Used to treat bradycardia (slow heart rate) and certain types of organophosphate
poisoning.
o Amiodarone: An antiarrhythmic medication used to treat certain types of irregular heartbeats.
o Airway Management Supplies:
o Endotracheal tubes: Used for securing the airway in case of respiratory distress.
o Bag-valve-mask (BVM): Provides manual ventilation for patients who are not breathing
adequately.

8. o Intubation Supplies:
o Laryngoscope: Used to visualize the vocal cords during intubation.
o Endotracheal tubes: Different sizes for various age groups.
o Medication Administration Supplies:
o Syringes and needles: For administering medications.
o Intravenous (IV) access supplies: Catheters, fluids, and tubing for intravenous administration.
o Monitoring Equipment:
o EKG monitor: Displays the patient's cardiac rhythm.
o Blood pressure cuff: Measures blood pressure.
o Pulse oximeter: Monitors oxygen saturation levels.

9. o Emergency Medications:
o Nitroglycerin: Used to treat chest pain (angina).
o Aspirin: Administered in case of suspected heart attack.
o Dextrose: Used for treating hypoglycemia.
o Resuscitation Equipment:
o CPR masks and barriers.
o Suction devices: To clear airways.
o Chest tubes and drainage systems: For treating certain types of trauma.
o Miscellaneous Supplies:
o Gloves, gauze, and dressings.
o Scissors, tape, and other basic medical supplies.

10. Equipment of crash cart
o Cardiac equipment:
o Automated External Defibrillator (AED)
o Manual defibrillator (with paddles)
o Cardiac monitor
o Electrocardiogram (ECG) cables and electrodes
o Airway management:
o Endotracheal tubes of various sizes
o Laryngoscope with blades of different sizes
o Bag-valve-mask (BVM) resuscitator
o Oropharyngeal and nasopharyngeal airways

11. o Medications:
o Epinephrine
o Atropine
o Lidocaine
o Adenosine
o Amiodarone
o Vasopressors (e.g., dopamine, norepinephrine)
o Antiarrhythmics and other emergency medications
o Intravenous (IV) supplies:
o IV catheters of various sizes IV administration sets
o Normal saline and other intravenous fluids Syringes and needles

12. o Monitoring equipment:
o Blood pressure cuff
o Pulse oximeter
o Capnography equipment
o Thermometer
o Resuscitation equipment:
o CPR masks or shields
o Tourniquets
o Chest tubes and drainage systems
o Thoracostomy trays

13. o Miscellaneous supplies:
o Sterile gloves
o Gauze, bandages, and dressings
o Adhesive tape
o Scissors and forceps
o Emergency airway cart
o Emergency drug reference materials
o Documentation materials:
o Patient charts or documentation forms
o Pens, markers, and paper

14. Arrangement for a crash cart
o Top of the Cart:
o Emergency protocols and documentation.
o Defibrillator with pads or paddles.
o A suction device.
o Top Drawer: Airway Management:
o Endotracheal tubes of various sizes.
o Laryngoscope with extra blades.
o Stylet for endotracheal tube insertion.
o Bag-valve-mask (BVM) device.

15. o Second Drawer: Medications:
o Cardiac medications (e.g., epinephrine, atropine).
o Antidotes (e.g., naloxone, flumazenil).
o Emergency drugs for various situations.
o Intravenous (IV) access supplies.
o Third Drawer: Intravenous (IV) Supplies:
o IV catheters of various sizes.
o Fluids (normal saline, dextrose).
o IV administration sets.
o Syringes and needles.

16. o Fourth Drawer: Equipment and Supplies:
o Blood pressure cuff and stethoscope.
o Pulse oximeter.
o Glucometer.
o Thermometer.
o Gauze, bandages, and dressings.
o Fifth Drawer: Miscellaneous:
o Emergency airway equipment (e.g., supraglottic airway devices).
o Chest tubes and insertion kits.
o Trauma shears and scissors.
o Tape and securement devices.

17. o Bottom Shelf:
o Additional equipment such as a crash cart manual, gloves, and additional supplies.
o A sharps container for safe disposal of needles and sharps

18. Maintenance of crash cart
o Regular Inspection:
o Conduct regular inspections of the crash cart to ensure that all items are present, in good condition, and
within their expiration dates.
o Check the functionality of equipment such as the defibrillator, suction device, and other electronic
components.
o Check Expiry Dates:
o Regularly check the expiration dates of medications and supplies. Replace any expired items promptly.

19. o Documentation:
o Keep an inventory list of all items in the crash cart. This list should include the name, quantity, and
expiration date of each item.
o Document any maintenance or inspections performed on the crash cart.
o Restocking:
o Restock the crash cart immediately after it has been used or when any item is close to its expiration date.
o Ensure that there is an adequate supply of commonly used medications, emergency drugs, IV fluids,
airway management devices, and other essential items.

20. o Battery Maintenance:
o If the crash cart contains electronic devices such as a defibrillator or monitor, regularly check and replace
batteries as needed.
o Ensure that all devices are charged and ready for use in case of an emergency.
o Organization:
o Keep the contents of the crash cart well-organized to facilitate quick access during emergencies.
o Label all compartments clearly to help healthcare providers locate items easily.
o Training and Drills:
o Conduct regular training sessions and drills with healthcare staff to ensure they are familiar with the crash
cart's contents and know how to use each item.
o Simulate emergency scenarios to practice the efficient and effective use of the crash cart during high-stress
situations.

21. o Compliance:
o Ensure that the crash cart complies with local and national regulations and standards.
o Regularly review and update the crash cart based on changes in emergency protocols or guidelines.
o Temperature and Environment:
o Store the crash cart in a location with appropriate temperature and humidity levels to prevent damage to
medications and equipment.
o Emergency Information:
o Keep emergency contact information and protocols readily available on or near the crash cart.

22. Reference
 Ruth Ann Ehrlich. 2020 Sterilisation in textbook of Patient Care in Radiology Seventh Edition,
Elsevier New Delhi, P: 172– 178.
 Doyle, G. R., McCutcheon, J. A. (2015). Clinical procedures for safer patient care. BCcampus.
https://opentextbc.ca/clinicalskills