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Hospital Crash Cart Arrangement and Checklist

/ By Ian LoperJuly 4, 2022

Hospital crash carts and healthcare storage solutions are vital components of the health industry. They contain medications and tools needed in an emergency and enable medical teams to respond to codes quickly, which can save more lives.

Such critical care contents follow standard crash cart trolley arrangements to speed up average response times and allow for better patient care.

What is a Crash Cart?

A medical cart is a rolling cabinet or mobile unit used by urgent care centers to address emergencies swiftly. This type of healthcare storage solution is supplied with readily available equipment and medications needed in codes or basic life-saving techniques like resuscitation.

Simply put, a medical cart combines an equipment center, a dispensing unit, and a medical rolling cart. It transports the necessary supplies and medication to the emergency scene—enabling staff to use them immediately for cardiac support.

The contents slightly vary depending on the ward or department where the cart is located. Even so, there are standard must-haves that we will talk about in this checklist.

How to Arrange a Crash Cart

A code cart may differ between hospitals and between departments within the same healthcare facility in terms of size, construction, and contents. For instance, a pediatric crash cart is arranged differently from an adult one, or an emergency department crash cart is arranged differently from a surgical service trolley. 

The most important consideration is the arrangement of an emergency cart. It should simplify work for medical staff and allow them to handle all emergencies calmly and conveniently.

Below, we’ll discuss how medical carts are generally arranged.

Top of the Crash Cart

Tools needed to prepare the patient-saving procedures should be at the top of the cart. These include gloves, monitors, life support equipment, defibrillators with lead and paddles, and a sharps disposal container.

The oxygen tank, regulators, cardiac arrest backboard, and handheld suction equipment should all be stored on the crash cart's sides and back.

1st Drawer of the Crash Cart

The first tray is for heart-related equipment, like ECG gel and electrodes.

These are essential paraphernalia of the ECG, which measures the heart's electrical activity and monitors heart conditions. It can also help check if a pacemaker is working properly.

2nd Drawer of the Crash Cart

The second drawer is for intubation or airway supplies. Often, it contains:

  • Endotracheal tubes
  • Syringes to inflate the cuff on the endotracheal tube
  • Nasopharyngeal and oropharyngeal airways
  • Laryngoscope handle and blades
  • Nasal filter lines
  • Magill forceps
  • Tongue depressor
  • Laryngeal masks
  • Bite block
  • Flashlight
  • Batteries
  • Stylets
  • Dyna plaster

3rd Drawer of the Crash Cart

The third cabinet is for intravenous or IV materials, including but not limited to the following:

  • IV start kit
  • IV solutions
  • 3-way stopcocks
  • IV sets with extensions
  • Catheters
  • Vacutainers
  • Disposable syringes and needles
  • Disinfectants
  • Tourniquet tubing
  • Pressure monitoring line
  • Burette set
  • PosiFlush
  • Disposable kidney tray

4th Drawer of the Crash Cart

Also known as the medication drawer, the fourth cabinet contains high-alert or emergency medications like the ones below.

Contents should be inspected regularly for expiration dates.

  • 50% Dextrose 50ml-1
  • Adenosine 3 mg/ml
  • Adrenaline 1mg/ml-1
  • Amiodarone 150 mg vial
  • Aspirin 81 mg tabs
  • Atropine 8 mg/20 ml vial
  • Benadryl 50mg
  • Dextrose 50% and 25% in pediatric wards
  • Diazepam 50 mg/10 ml
  • Dobutamine 250mg in 5ml or 20ml-2
  • Dopamine 40 mg/ ml
  • Epinephrine: EpiPen, Epinephrine 1:1,000
  • Lidocaine 100 mg
  • Lopressor 10 mg
  • Midazolam 50 mg/10 ml vial
  • Naloxone, Narcan 1 mg/ml
  • Vasopressin 20u/ml

5th Drawer of the Crash Cart

The fifth cabinet in an emergency trolley keeps all IV fluids, including:

  • 1,000 ml dextrose 5% in water solution, D5W
  • 1,000 ml normal saline solution, NS
  • 1,000 ml lactate solution, Lactate’s Ringer or LR
  • 500 ml of D5W and NS
  • 100 ml of NS-2

Some carts are built with a sixth or separate drawer that houses other high-alert necessities:

  • Pediatric tape
  • 15 adult gauzes
  • 18 pediatric gauzes
  • Intraosseous needles, bone marrow needles
  • Medication additive labels

Hospital Crash Cart Checklist

This cart checklist outlines supplies and equipment suitable for any medical facility:

  • Defibrillators
  • Suction devices and bag valve masks
  • Drugs for peripheral and central venous access
  • Calcium chloride 1g/10 ml
  • Sodium chloride 0.9%: 10 ml injection vial, 20 ml vial
  • Sterile water
  • At least one sedative
  • Intubation kits
  • Anesthesia

Pediatric care carts need to have:

  • Weighing scale
  • Measuring tools
  • Blood pressure cuffs
  • Warming devices
  • Pulse oximeter
  • Femur splints
  • Needles

Top Tray

  • Gloves
  • Sharps disposal container
  • Defibrillator with leads and paddles
  • Other life support equipment

Side Compartment

  • Cardiac backboard
  • Oxygen tank
  • Handheld suction

Drawer 1 (Procedure)

  • ECG Gel
  • Five electrodes
  • Sutures
  • Lumbar puncture kit
  • Suction supplies
  • Spare spinal needles
  • Spinal needle tips

Drawer 2 (Oropharyngeal Airway)

  • Nasogastric tubes, feeding tubes
  • One endotracheal stylet, one for children and one for adults
  • One uncuffed endotracheal tube, all sizes, 2.5 to 9
  • Two micro cuff endotracheal tubes, all sizes, 3 to 7
  • one disposable oropharyngeal airways, all sizes, 00,0,1,2,3,4
  • Maglis forceps
  • Wooden tongue depressor
  • Two laryngeal masks: No.3 and No.4
  • Two 10 cc syringes
  • 10 pieces of Dyna plaster
  • Battery

Drawer 3 (Venipuncture Supplies)

  • Two IV sets with extensions
  • Three Disposable syringes, all sizes: 1 ml, 2.5 ml, 5 ml, 10 ml, 20 ml, and 50 ml
  • One Pressure monitoring line with a disk, 1 without a disk
  • Two 3-way stopcocks
  • Five disposable needles with 18 gauze with and without filters
  • Five disposable needles with 23 gauze
  • Lock syringes
  • Tourniquet
  • Additional 2.5 ml and 5 ml syringes
  • 10 ready-to-use saline flush syringes, PosiFlush
  • Five IV dressing kits
  • 30 spirit swabs
  • 10 cotton swabs
  • Sterile gauzes
  • Suction catheters
  • Umbilical vessel catheter
  • Multi-lumen catheter
  • Disposable kidney tray
  • 1-in Micropore plaster
  • Burette set

Drawer 4 (Emergency Medication)

  • 50% Dextrose 50ml-1
  • Adenosine 3 mg/ml
  • Adrenaline 1mg/ml-1
  • Amiodarone 150 mg vial
  • Aspirin 81 mg tabs
  • Atropine 8 mg/20 ml vial
  • Benadryl 50mg
  • Dextrose 50%, 25% in pediatric wards
  • Diazepam 50 mg/10 ml
  • Dobutamine 250mg in 5ml or 20ml-2
  • Dopamine 40 mg/ml
  • Epinephrine: EpiPen, Epinephrine 1:1,000
  • Lidocaine 100 mg
  • Lopressor 10 mg
  • Midazolam 50 mg/10 ml vial
  • Naloxone, Narcan 1 mg/ml
  • Vasopressin 20u/ml

Drawer5 (Intravenous Fluids)

  • 1,000 ml dextrose 5% in water solution, D5W
  • 1,000 ml normal saline solution, NS
  • 1,000 ml lactate solution, Lactate’s Ringer or LR
  • 500 ml of D5W and NS
  • 100 ml of NS-2

Drawer 6 (Pediatric Intubation Supply)

  • Pediatric tape
  • 15 adult gauzes
  • 18 pediatric gauzes
  • Intraosseous needles or bone marrow needles
  • Medication additive labels

High-Quality Crash Carts for Intensive Care Situations

Hospital crash carts should follow standard sterile instrument storage arrangements to ensure fast and efficient responses to codes and emergencies. All supplies and emergency equipment should be properly labeled, too.

Most importantly, the cart itself should pass industry standards to meet specific workflow needs and minimize constant replacements and repairs.

For medical cart constructions that add value to your facility's processes, choose Distribution Systems International. We guarantee you engineered designs of healthcare storage solutions that abide by our consultation agreement.

You can reach our team by filling out our online form or contacting us at 800-393-6090 at Distribution Systems International today!

Crash Cart Trolley Arrangements FAQs 

How is a crash cart arranged?

Although the contents and size of a medical cart vary in each facility, each follows a per-compartment arrangement, clustering prep, cardiac, airway, intravenous, and medication supplies.

It should be placed in a low-traffic area to allow hospital staff to easily execute life-saving procedures on patients.

What is in drawer 3 of a crash cart?

The third drawers in crash carts contain all IV-related medical supplies like lines, needles, stopcocks, and dressings.

What equipment should be on the emergency trolley?

Defibrillators, suction devices, medications, intravenous fluids, intubation kits, anesthesia, and sedatives should always be in a hospital cart.

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