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

o Blue top

o Purple top

o Green top

o Red top

o Spinal needles of various sizes

o Regular needles of various sizes

o 3-Way stopcock

o Tape

o Armboards

o ABG syringes and sampling kits

o Catheter tips

o Tubing

o 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:

 ECG electrodes

 Sterile gloves of various sizes

 Sutures of various sizes and materials

 Suction supplies

 Salem pump

 Cricothyroidotomy kit

 Adult and pediatric cut down pack

 Yankauer suction

 Drapes to create a sterile field

 Large bore needle and syringe (for tension pneumothorax)

 Suction Cath Kit 14 Fr & 18 Fr

 Lumbar puncture kit

Did you know that the probability of recovery after suffering a cardiac
arrest is reduced by 7-10% for every minute that passes? After
the sixth minute, the chance of survival is cut in half.. This is
demonstrated by a published study in the Revista Española de
Cardiología, which details the need to have the knowledge in medical
sectors to perform resuscitation maneuvers and, above all, to be
prepared with the necessary equipment and material so as not
to waste any second.
In life-threatening medical emergencies, our enemy is time. One
minute wasted is one less chance of survival. Therefore, we
recommend hospitals to have the crash cart with the necessary
medication to take action in cardiopulmonary resuscitation according
to the patients capacity in the center.

1. Defibrillator support rotary

Its movement allows an easy control of the position of the
defibrillator to give you access to the contents of the cart or to place it
close to the patient. 
2. Oxygen tank holder
At the base they will be able to place the oxygen
containers essential for resuscitating patients in intensive care units.
3. Throw-away seal closure system
Seals tocontrol the use of the urgent care cart and its content,
which indicates to the healthcare professional the need for review
and replacement of the same
4. CPR cardiac board with support
In the back of the red car is this basic element to perform the
external cardiac massage. It should be placed under the patient
and thus have a flat, hard and smooth surface to exert pressure.
5. IV pole height adjustable
Serum support to channel the patient after resuscitation.
6. Content of crash cart
In addition to include drugs like adrenalin, atropine, lidocaine,
dopamine… the following supplies are a must-have:


 Crash cart monitor

 Blood pressure monitor
 Syringes
 Gloves
 Catheters
 Physiological saline solution ampoules
 Ambu bag with mask
 Laryngoscope
 Oxygen mask
 Cannula
 Pair of scissors
 Flashlight
 Endotracheal tubes
 Reservoir bag
 Adhesives, bandages, gauze…
The Crash Cart also contains an ergonomic handle and 4 swivel
wheels (2 of them with brakes) that allow you to have full control
during the emergency.

It is recommended
that emergency carts have several drawers to store materials. With
our Novimed trolleys you don’t have to worry, since with the drawer
configuration you can create models with up to 10 drawers.
 In addition, its ABS
drawers with 110% total extraction, have a large storage capacity
that allows the order of the necessary instruments to access them
immediately. So they offer enough space according to the specific
needs of each center, doctor or nursing professional. In all our
medical carts there is always the option of incorporating different
accessories for easy installation (without the use of tools) according
to the customer’s preference.

General Medical Supplies Checklist

According to a 2016 study on the history and importance of emergency
crash carts have been used by medical facilities since at least the early
1960s (then known as the emergency trolley).
Although the concept of a crash cart was not yet widespread, much of the
equipment found in these early trolleys was similar to the supplies found
in a modern cart.
The following equipment is suitable for use on any crash cart in a medical
facility, from adult crash carts to pediatric care carts.
 Defibrillators for sudden cardiac arrest
 Suction devices and bag valve masks
 Drugs for peripheral and central venous access
 Fluids: Calcium chloride (1g/10 ml), Sodium chloride 0.9% (10 ml
injection vial, 20 ml vial), sterile water
 At least one sedative as well as intubating equipment and
anesthesia
 Pediatric equipment: patient warming devices, restraints, weight
scale, measuring tool, blood pressure cuffs, pulse oximeter, needles,
femur splints, etc.
 Other hospital-specific equipment
Top-Mounted Equipment
 Gloves
 Monitor and all related life support equipment
 Defibrillator with leads and paddles
 Sharps disposal container
Side-Mounted Equipment
 Oxygen tank
 Rigid plastic backboard
 Handheld suction mechanism
Drawer 1 Equipment – Procedure Drawer
The procedure drawer contains all the equipment necessary for special
medical emergencies.
 ECG Gel
 5 Electrodes for both children and adults
 Lumbar puncture kit
 Spare spinal needles and spinal needle tips
 Suction supplies
 Sutures of multiple sizes and types
Drawer 2 Equipment – Oropharyngeal
Airway Supplies
 Wooden tongue depressor
 Battery
 One endotracheal stylet for both children and adults
 One uncuffed endotracheal tube in each size ranging from 2.5 to 9
 Two microcuff endotracheal tubes in each size ranging from 3 to 7
 Nasogastric tubes (feeding tubes)
 Maglis forceps for both children and adults
 Disposable oropharyngeal airways: 00,0,1,2,3,4 – include one of
each
 2 10 cc syringes
 10 small pieces of Dyna plaster
 Two Laryngeal masks: No.3 and No.4
Drawer 3 Equipment – Venipuncture
Supplies
 3 Disposable syringes in each of the following sizes: 1 ml, 2.5 ml, 5
ml, 10 ml, 20 ml, and 50 ml
 Additional 2.5 ml and 5 ml syringes
 One pressure monitoring line with a disk and one without
 5 Disposable needles with 18 gauze with and without filters
 5 Disposable needles with 23 gauze
 Lock syringes
 Tourniquet
 5 IV dressing
 30 spirit swabs and 10 cotton swabs
 Suction catheters (e.g., Venflon 16G, 18G, 20G, 22G, 24G)
 2 packets of sterile gauze
 2 IV sets with extensions
 Disposable kidney tray
 Multi-lumen catheter
 Umbilical vessel catheter
 10 ready-to-use saline flush syringes (e.g., PosiFlush)
 Micropore plaster 1-inch
 2 3-way stopcocks
 Burette set
Drawer 4 Equipment – Medication
The role of the medication drawer on crash carts is the storing and
dispensing of emergency medication.
The exact selection of drawer medication varies by facility (e.g., urgent
care centers may have a different selection of substances in their hospital
pharmacies than standard clinics) and cart role.
Here is an example list of items with some of the most common
medications:
 Adenosine 3 mg/ml
 Amiodarone 150 mg vial
 Aspirin 81 mg tabs
 Atropine 8 mg/20 ml vial
 Benadryl 50mg
 Dextrose 50% (25% in pediatric medication drawers)
 Diazepam 50 mg/10 ml
 Dopamine 40 mg/ ml
 Epinephrine (e.g., EpiPen, Epinephrine 1:1,000)
 Lidocaine 100 mg
 Lopressor 10 mg
 Midazolam 50 mg/10 ml vial
 Naloxone (e.g., Narcan 1 mg/ml)
 Vasopressin 20u/ ml
Drawer 5 Equipment – IV 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, LR)
 500 ml of D5W and NS
 100 ml of NS-2
Drawer 6 Equipment – Pediatric Intubation
Supply Drawer
 Pediatric emergency tape
 Adult (15 gauze) and pediatric (18 gauze) versions of intraosseous
needles (bone marrow needles)
 Medication additive labels
Helpful Arrangement Tips for Medical
Crash Carts
Although the configuration of crash carts may vary depending on the
facility, here are some tips to follow for improving your cart’s organization
and access.
 Use well-designed, purpose-built mobile carts. Studies have
shown that a properly-designed crash cart improves the quality of
medication management.
 Clearly distinguish pediatric materials from adult materials.
 Designate one person to organize and manage the medical crash
carts and enforce a policy for medical staff on replenishing stock.
 Place each adult crash cart and pediatric crash cart in separate,
easily accessible areas.
 Crash cart storage should be accessible from a low-traffic area. Do
not move the cart from this position unless it is in use.
 Educate your emergency care team and other hospital staff on your
life support protocols and how to locate and use the equipment in your
crash carts.