Cardiopulmonary

Resuscitation (CPR)

2025
G u i d a n ce W h i te pa p e r
Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Table of Contents List of

Whitepaper Abbreviations
List of Abbreviations 03

Acknowledgment 05

Authorship and Contributions 11

Development of the Whitepaper 12

Anticipated Impact 15

Executive Summary 16

Introduction 19

Goal 20

Objectives 20

Proposed Content of the Whitepaper 21

The required resuscitative services in healthcare facilities: 22 ACLS Advanced Cardiovascular Life Support
• Standardization of Training Programs
AED Automated External Defibrillator
• Training for Specific Groups
• Increasing Accessibility and Utilizing Technology in Training Process AHA American Heart Association
• Regular Assessments of training programs and its impact
• Acceptance of life support certificates ALS Advanced Life Support
Code Blue Teams and RRT: 24 ATLS Advanced Trauma Life Support
• Rapid Response Systems (RRS)& Code blue Teams
• Scoring system for clinical deterioration AVPU Alert, Voice, Pain, Unresponsive
• Responsibilities of the RRT
• Code Blue Team
BLS Basic Life Support

Crash Carts: 28 BP Blood Pressure

• Crash Cart Medication List:
CPR Cardiopulmonary Resuscitation
• Recommended emergency equipment for crash carts:
• Location and number of crush cart EDA Egyptian Drug Authority
Findings/Analysis 36
EgSC Egyptian Society of Cardiology
Recommendations 38
EHA Egypt Healthcare Authority
Implementation 39
EHC Egyptian Health Council
Conclusion 42

References 46
ER Emergency Room

Appendices 47 ERC European Resuscitation Council

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

EWS Early Warning Score

GAHAR General Authority for Healthcare Accreditation and Regulation

HR Heart Rate

ICU Intensive Care Unit

IO Intraosseous

IV Intravenous

MOHP Ministry of Health and Population

NICU Neonatal Intensive Care Unit

NRP Neonatal Resuscitation Program

OR Operating Room Acknowledgment

PALS Pediatric Advanced Life Support

PoE Point of Entry

RR Respiratory Rate

RRS Rapid Response System

RRT Rapid Response Team The development of this Cardiopulmonary for their participation in pilot visits and
Resuscitation (CPR) Guidance White Paper stakeholder consultations. Their insights and
SpO2 Peripheral Capillary Oxygen Saturation
was made possible through a multidisciplinary field assessments provided essential real-world
WHO World Health Organization team of experts, organizations, and healthcare perspectives that enriched this white paper.
professionals dedicated to advancing patient
safety and emergency response in Egypt. Lastly, we appreciate the commitment of all
those involved in shaping a future where
We extend our sincere gratitude to the General every healthcare facility in Egypt is equipped
Authority for Healthcare Accreditation and to provide timely, effective, and life-saving
Regulation (GAHAR) for their leadership in CPR interventions. Your commitment to
chairing the committee and guiding this initiative strengthening emergency response capabilities
which was also co- chaired by Egyptian Health will undoubtedly impact patient safety and
Council. We also acknowledge the invaluable healthcare quality nationwide.
contributions of the Egyptian Drug Authority
(EDA), the Egyptian Society of cardiology,
and the World Health Organization (WHO)
Egypt Country Office, whose expertise and
collaboration played a pivotal role in shaping the
recommendations outlined in this document.

We also thank the Ministry of Health and

Population (MOHP), the Egyptian Healthcare
Authority (EHA), and healthcare institutions
across Cairo, Alexandria, and Port Said

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

White Paper Development Committee

(in Alphabetical order)

Prof. Dr. Ehab Kamal Dr. Heba Hossam Mohamed Dr. Mohamed Elfaiomy
Bakry
Associate Professor of Tropical Medicine, Patient Safety Officer, WHO Egypt. Prof. Dr. Riham Elasady
National Research Center; Director General
of the General Administration of Strategic Director of Strategic Planning, GAHAR.
Management; General Supervisor of the Higher Clinical Governance and Patient Safety
Committees for Health Profession Examinations Consultant, WHO Egypt.
and Continuing Professional Development,
Egyptian Health Council; Former Assistant to Dr Mona Maroof
the Minister of Health and Population.
Dr. Hla Abdelmoaty Ahmed Technical Officer, WHO Egypt
Quality & Patient Safety Surveyor; International Prof. Dr. Tarek Elkholy
Affairs Representative, Egyptian Health Council.
Professor of Cardiology, Cairo University;
Dr. Eman Ahmed Salah Zakaria President of CPR Working Group, Egyptian
Elnawasany Dr. Rania Medhat Abdullah Society of Cardiology.

Manager of Pharmaceutical Development Prof. Dr. Magdy Abdulhamid General Manager of GAHAR Technical Office,
GAHAR.
Administration - General Administration
of Drug Utilization and Pharmacy Practice - professor of cardiology, Cairo University,
Central Administration of Pharmaceutical Care Chairman of Scientific committee for clinical Dr. Zakaria Abdulhamid
- Egyptian Drug Authority. guideline for cardiology, EHC
Technical Officer, WHO Egypt

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

CPR Whitepaper Leadership Group

Committee Chairperson
Committee Chairman
Professor Dr. Ahmed
A. Taha
Chairman of the General Authanity for
Healthcare Accreditation and Regula-
tion (GAHAR)

Committee Co-chairman
Professor Dr. Mohamed Co-
Lotaif Authors
Executive President of Egyptian Health
Council (EHC)

Dr Ali Al-Ghamrawy • Ministry of health and population- special-

ized medical centers
Head of the Egyptian Drug Authority
Dr Gasser Gad Elkareem • Egypt Healthcare Authority
• Suez Canal Authority – Port Said
Health systems coordinator WHO Egypt • Eleman Radiology Center – Port Said
Dr Nima Abid • Hope Oncology Center – Alexandria
• Alpha Oncology center- Cairo
WHO Representative-Egypt Prof. Dr. Nabil farag
President of Egyptian society of Cardiology
Dr Omar Abdulaziz Aboulata
Emergency Team Lead WHO Egypt

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Authorship
and Contributions

This whitepaper was developed by a

multidisciplinary committee chaired by the
Pilot Visits
General Authority for Healthcare Accreditation
and Regulation (GAHAR) and co-chaired by
Egyptian Health Council Pilot visits were conducted in collabora-
tion with:
The committee comprises representatives from
• Ministry of Health and Popula-
the following organizations:
tion (Specialized Medical Cent-
ers)
• Egyptian Drug Authority (EDA) • Egyptian Healthcare Authority
• Egyptian Society of Cardiology
• Suez Canal Authority primary
• World Health Organization, Egypt care center – Port Said
Country Office • ELIman Radiology Center – Port
Said
• Hope Oncology Center – Alexan-
dria
• Alpha Oncology Center-cairo

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Development of
the Whitepaper

The Cardiopulmonary Resuscitation (CPR) 2. Literature Review 3. Initial Draft

and Benchmarking Development
Guidance Whitepaper was developed through
a structured, multi-phase process that com- The committee conducted an extensive review of
international best practices, existing national
Based on the insights gained from the literature
review and stakeholder consultations,
bined evidence-based research, stakeholder policies, and clinical evidence to establish
a strong foundation for the whitepaper. This
the committee developed an initial draft
of the whitepaper. This draft outlined
engagement, and real-world assessments. included: standardized CPR training requirements,
recommendations for Code Blue and Rapid
• CPR guidelines from international author- Response Teams (RRTs), and guidelines for
ities, such as the American Heart Associa- the allocation and maintenance of crash
tion (AHA) and the European Resuscita- carts.
This approach ensured that the whitepaper is • Egyptian Drug Authority (EDA) tion Council (ERC).
both scientifically robust and practically ap- • Egyptian Society of Cardiology • National regulatory and accreditation The draft was then circulated among techni-
plicable across various healthcare settings in • World Health Organization, Egypt standards relevant to emergency re- cal experts and key stakeholders for prelimi-
Egypt. The development process followed these Country Office sponse and healthcare training in Egypt. nary review, allowing for refinements before
key phases: • Case studies and lessons learned from moving to the field validation phase.
other healthcare systems that have suc-
These stakeholders contributed their cessfully standardized CPR protocols.
expertise in medical regulations, emergency
response protocols, healthcare training, and
1. Formation of accreditation to ensure a comprehensive
This phase ensured that the recommenda-
tions in the whitepaper aligned with globally
the Expert Committee and context-specific approach to CPR recognized resuscitation standards while
enhancement. being adaptable to Egypt’s healthcare land-
The development of this whitepaper was led scape.
by a multidisciplinary committee chaired
by the General Authority for Healthcare
Accreditation and Regulation (GAHAR) and
co- chaired by Egyptian health council, with
active participation from key stakeholders,
including:

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

4. Pilot Facility Assessments 5. Refinement

and Stakeholder Consultations and Finalization
To assess the applicability and feasibility of Following the pilot assessments and stakeholder
the proposed recommendations, pilot visits consultations, the committee:
were conducted at selected healthcare facilities.
These visits aimed to: • Analyzed the findings from pilot visits to
adjust recommendations accordingly.
• Evaluate the availability and accessibility
of emergency equipment, including crash
• Refined training requirements and emer-
gency response protocols to address the Anticipated
carts, defibrillators, and resuscitation tools. challenges identified during field testing.
• Gather feedback from frontline healthcare
professionals on training adequacy, re-
• Strengthened alignment with national ac-
creditation and healthcare policies to fa-
Impact
sponse team functionality, and practical cilitate smooth integration into existing
challenges in implementing standardized healthcare frameworks.
CPR protocols.
• Assess real-world gaps and operational The revised draft was then subjected to
barriers that could affect the adoption of further technical review by experts before
the proposed recommendations. moving to the finalization phase.

Pilot visits were conducted across various By implementing these standardized CPR Ultimately, this whitepaper envisions a future
healthcare sectors, including: regulatory whitepaper, Egypt’s healthcare where every healthcare facility in Egypt—
6. National Endorsement system can reduce preventable deaths whether in a well-equipped urban hospital or
•
•
Dar El-Shifa Hospital (MOHP)
El-Nasr Hospital and a Primary Healthcare
and Policy Integration associated with cardiac arrest, enhance the a resource-limited rural clinic—delivers timely,
quality of emergency care, and foster a safer, competent, and lifesaving CPR interventions,
Facility (EHA) more equitable healthcare environment for all contributing to the long-term goal of improved
• Suez Canal Authority - Primary Care Center Upon finalization, the whitepaper will be
citizens. The whitepaper’s recommendations patient survival rates and a higher standard of
• Hope Oncology Center (Alexandria) submitted for national endorsement by key
also align with Egypt’s broader healthcare emergency care across the nation.
• Eleman Radiology Center (Port Said) regulatory bodies, and national healthcare
quality improvement goals and its commitment
• Alpha Oncology Center (Cairo) providers.
to meeting international standards in patient
safety. Stakeholders, including healthcare
Additionally, focus group discussions were This endorsement will serve as the foundation regulators, educational institutions, and
held with hospital administrators, emergency for policy integration, ensuring that the healthcare providers, are expected to play a
physicians, nurses, and medical educators to whitepaper’s recommendations become part pivotal role in this transformation by endorsing
gain further insights into implementation chal- of Egypt’s national healthcare regulations. and adopting these guidelines within their
lenges. Their input was instrumental in refining respective domains.
the whitepaper to ensure its practicality across
different healthcare settings.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Executive
Summary
Scope:

The whitepaper focuses on the following

objectives:

Standardizing Training Ensuring Effective Crash

Cardiac arrest remains one of the most urgent The purpose of this whitepaper is to address Requirements: Cart Allocation and
and critical medical emergencies, requiring these critical challenges by establishing Maintenance:
immediate intervention through effective standardized CPR guidelines tailored to the Establishing clear training standards for
Cardiopulmonary Resuscitation (CPR) to specific needs of Egypt’s healthcare system. By healthcare professionals, with specific Setting guidelines for the placement,
improve survival rates. In Egypt, however, implementing these guidelines, the whitepaper prerequisites for BLS and ALS training across organization, and upkeep of crash carts based
disparities in healthcare infrastructure and aims to provide a foundation for consistent and various healthcare roles. This will ensure that all on facility type, patien flow, and emergency
training standards across regions—especially effective resuscitative care across all healthcare personnel involved in resuscitative care possess department layout. Regular inspection and
between urban centers and rural areas—pose settings, regardless of location. This includes the necessary skills to perform CPR effectively. restocking procedures will ensure crash carts are
significant challenges to delivering consistent setting minimum training requirements for readily available and equipped for emergencies.
and high-quality CPR. Urban hospitals generally Basic Life Support (BLS) and Advanced Life
benefit from better-equipped facilities and Support (ALS), defining the composition
trained personnel, while rural and underserved and responsibilities of Code Blue and Rapid Optimizing Code Blue and
regions often struggle with resource limitations Response Teams (RRT), and optimizing the
and inconsistent CPR preparedness. This accessibility and maintenance of crash carts Rapid Response Teams:
disparity places patients in these areas at in healthca facilities.
increased risk of poor outcomes during cardiac Providing detailed criteria for creating and
arrest events. maintaining effective Code Blue and RRT teams
tailored to facility size, patient volume, and
available expertise. Well-defined roles and
responsibilities within these teams are expected
to reduce response times and improve patient
outcomes during cardiac emergencies.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Intro-
duction
Strategic Recommendations and
Implementation Approach

Cardiopulmonary Resuscitation (CPR) is a criti-

To achieve these objectives, the whitepaper These recommendations emphasize the need cal emergency procedure designed to restore
provides a series of recommendations,
including the creation of national policies in
for:
blood circulation and breathing in individuals
collaboration with key healthcare stakeholders
such as the Ministry of Health and Population
National Standardization: experiencing cardiac arrest.
(MOHP), Egyptian Health Council, the Egyptian A unified framework for CPR practices, training,
Health Authority (EHA), the General Authority and resource allocation.
for Healthcare Accreditation and Regulation In Egypt, where healthcare infrastructure faces The purpose of this whitepaper is to bridge
(GAHAR), Egypt Drug Authority(EDA), and
professional organizations like the Egyptian
Structured Training unique challenges, standardized regulations these gaps by providing standardized CPR
for CPR are imperative. Urban centers in Egypt process guidance tailored to the needs of
Society of Cardiology. and Certification: boast well-equipped hospitals, while rural areas Egypt’s healthcare system.
A unified framework for CPR practices, training, often struggle with limited resources and access
and resource allocation. to medical facilities. This discrepancy creates By addressing key areas such as training
significant disparities in the quality of care requirements, code blue team composition,
Strategic Resource Allocation: that patients receive, particularly in emergency and crash cart availability, this whitepaper aims
Guidelines for the strategic placement and situations such as cardiac arrest. to enhance resuscitation practices across the
regular maintenance of crash carts and other country, ensuring that all patients receive the
essential emergency resources.and resource highest standard of care, regardless of their
allocation. location.
Additionally, the level of training among
healthcare professionals varies widely.
Data-Driven While some practitioners have received
comprehensive education in evidence-based
Quality Improvement: resuscitation techniques, others may lack
Systematic data collection on CPR outcomes adequate exposure and training. This variability
and team performance to continuously refine in preparedness can result in inconsistent
and enhance resuscitative care practices. responses to cardiac arrest events, potentially
emergency resources.and resource allocation. compromising patient outcomes.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Goal Proposed Content

of the Whitepaper
Establish Minimum Training
Requirements:
To optimize CPR practices across healthcare
facilities in Egypt. Define clear training prerequisites for healthcare
professionals involved in Cardiopulmonary
Resuscitation to ensure all practitioners have
the essential skills for high-quality resuscitation.

Objectives Primary Health- Point of Entry

Hospital Polyclinic Ambulatory Care Solo- Clinic
care (PoE)

Basic Life
Support √ √ √ √ √ √

Advanced Life at least one per Required in

Support shift for each code case the facility
Identify the Minimum Optimize Code Blue Teams: blue team scope include:
dialysis, invasive

Resuscitative Services Define specific training prerequisites for

procedures, or
sedation
healthcare professionals involved in CPR,
Required for Each Type of ensuring that all practitioners possess the
Healthcare Facility. necessary skills to perform high-quality
resuscitation. This includes setting standards
Establish Minimum Training for both basic and advanced life support training
across various healthcare settings.
Requirements:
Define specific training prerequisites for Ensure Proper CrashCart
healthcare professionals involved in CPR by
EHC, ensuring that all practitioners possess Allocation and Maintenance:
the necessary skills to perform high-quality Recommend guidelines for the allocation and
resuscitation. This includes setting standards maintenance of crash carts within healthcare
for both basic and advanced life support training facilities. The whitepaper will address the
across various healthcare settings. appropriate number of crash carts based on
facility scope, patient flow, and the layout of
emergency departments, as well as ensure
regular inspection and restocking to maintain
readiness during emergencies.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

This includes setting standards for both Basic 2. Training for Specific Groups
and Advanced Life Support training, tailored In compliance with legal requirements, all
medical doctors renewing their practice
to various healthcare settings, to maintain licenses, beginning with the Class of 2024, must
provide proof of meeting renewal criteria after
consistency and effectiveness in life-saving five years of practice, including obtaining an
Advanced Life Support (ACLS) certification.
practices. 4. Regular Assessments of
By 2030, all practicing doctors will need to training programs and
demonstrate fulfillment of these renewal
standards based on their specialty: their impact:
1. Standardization of • Certification and Accreditation of Trainers
by Egyptian Health council Ongoing assessments of training programs will
Training Programs: • certification validity period for BLS is two
• Advanced Cardiovascular Life Support
(ACLS): Required for Anesthesiologists, be conducted to ensure their effectiveness,
years, And can be renewed with a refresh- Surgeons, Emergency Physicians, ICU promote continuous improvement, and
Develop National Guidelines: er course, unless guidelines changed. Doctors, and Cardiologists. maintain alignment with healthcare standards.
maintaining high standards in critical • Neonatal Resuscitation Program (NRP): This approach supports the consistent quality
care competencies. Required for Neonatologists and Obstet- and relevance of training initiatives.
This phase (planned to be phase two after • Integrating CPR Training in Education
finalizing this white paper) will include the rics & Gynecology Surgeons.
(Medical& Nursing Schools and Institu-
development of Egyptian Cardiopulmonary tions):
• Pediatric Advanced Life Support (PALS): 5. Accreditation of life support
Guidelines, the guidelines will be developed Required for Pediatricians and Neona-
by EHC, covering both Basic and Advanced
• Basic Life Support (BLS) Training Require- tologists. certificates
ment: • Advanced Trauma Life Support (ATLS):
Life Support. This initiative aims to establish o BLS training has become a legal
standardized, high-quality care practices Required for Emergency Physicians and
requirement for medical students begin- • BLS and ACLS certificates to be accredited
tailored to national healthcare needs. Critical Care Doctors.
ning with the Class of 2024, and it must by Egyptian Health Council. Generally
be completed within their two-year need to be accredited either from:
internship.
o Supreme Council of University
o This mandate also applies to nursing 3. Increasing Accessibility Hospitals
students starting with the same class,
with successful completion required to and Utilizing Technology or
obtain a practice license. in Training Process o An Official Egyptian Authority.
o Additionally, medical graduates from
2020 to 2024 are required to complete To facilitate effective learning and quick or
BLS certification by the time they renew reference, trainees will have access to essential
their licenses, while ACLS certification is o AHA
Booklets and Algorithms in both hard copy
recommended but remains optional for and digital formats. This dual-format approach or
this group. ensures that critical information is easily
o Efforts are also in progress to expand accessible. o ERC
the BLS training requirement to include
graduates in dentistry, pharmacy, physi- or
otherapy, and veterinary medicine. o Training Center Certified from EHC.
• Advanced life support is mandated for
renewal of license for specialists and
consultants.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Suggested Rapid Re- Responsibilities

Code Blue Teams sponse Team (RRT) of the RRT:
and RRT Structure:

Members: The main responsibilities for

• ICU specialist/anesthesiologist/ RRT are:
internist, or Cardiologist.
• Ensure the availability of emergency
• primary physician.
equipment.
• assigned nurse.
Rapid Response Systems (RRS • head nurse.
• Direct and coordinate necessary activities
and treatment during emergencies.
& Code blue Teams Mobility:
• Communicate outcomes to relevant
healthcare teams, patients, and their
families, as appropriate.
The team should be capable of rapid
Background: deployment to the relevant department.
• Make decisions regarding intra- and inter-
hospital transfers, involving additional
clinicians when required.
Rapid response teams (RRT) are a
straightforward concept: When a patient shows Timeliness: • Document all care provided and treat-
ment outcomes.
signs of imminent clinical deterioration, a team
Team members must respond promptly,
is summoned to assess and treat the patient Scoring system for with response times recorded in the RRT
immediately to prevent an intensive care unit The primary assigned nurse
(ICU) transfer, cardiac arrest, or death. These clinical deterioration report.
teams have become a common patient safety
will have prepared the
intervention, largely due to their inclusion in Early Warning Score (EWS) systems are tools Expertise: following:
the Institute for Healthcare Improvement’s that use alterations in vital signs to rapidly
identify clinically deteriorating patients and RRT members should possess the necessary • Documentation of cause of prompted the
“100,000 Lives Campaign” in 2005.
escalate care accordingly. EWSs, also referred subject matter expertise and advanced RRT call
to as track and trigger systems, were developed assessment skills. They also mentor • Current HR, RR, BP, Temp, SPO2, AVPU
Patients who deteriorate acutely in hospitals
to identify clinically unwell hospitalized. bedside staff responding to the patient’s • Allergies.
often show warning signs, such as abnormal
patients who may require additional support deteriorating condition. • Present history.
vital signs, in the hours leading up to adverse
beyond standard care. An EWS consists of an • Last meal.
outcomes. Unlike cardiac arrest or “code blue”
teams, which respond after cardiopulmonary input and an output. The input includes the Coordination: • Events precipitated this occurrence.
identification of a deteriorating patient who • Interventions already attempted and
arrest, RRTs are designed to intervene earlier,
requires a higher level of care and the activation RRT activities must align with broader results.
usually in general medical or surgical wards.
of a response. The output is the response, which emergency response priorities and involve • Present medications and last dose.
These early warning signs are detected by a
may include increased monitoring, review by relevant stakeholders. • Recent diagnostic tests.
scoring system.
a rapid response team (RRT), or transfer to the • Patient medical file.
intensive care unit (ICU). These scores were • The RRT documentation record.
developed on the premise that severe clinical
deterioration in an inpatient setting is usually
preceded by abnormalities in vital signs.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

The patient-assigned nurse and the head

nurse must remain at the patient’s bedside. Code Blue Team • Resuscitation Triangle Roles:
o Compressor: Assesses the patient and
performs compressions.
The primary physician should support the ICU o AED Monitor/Defibrillator: Operates the
AED and alternates with the Compressor.
specialist with the patient’s history, diagnosis, Background: o Airway: Manages the airway and pro-
current medical condition, and plan of care.
Cardiac arrests in hospitals are common, and vides ventilation.
The team leader, he/she should respond within rapid response teams, such as “code blue • Leadership Roles:
5 minutes of the RRT call and should perform teams,” exist to reduce preventable in-hospi- o Team Leader: Assigns roles, makes
patient assessment and recommend the plan of tal deaths. treatment decisions, and provides feed-
care in coordination with the primary physician back.
o IV/IO Medications: Administers medica-
and assigned nurse. Characteristics: tions and ensures access is maintained.
• Effective Communication: Team members o Timer/Recorder: Records the timing of
1 Team per 200 beds
should anticipate each other’s needs, interventions, medication administration,
communicate continuously, and lever- and any interruptions in compressions.
age their strengths and weaknesses for
optimal performance.
The team will: Documentation: • Timeliness: Code blue teams must re- Team Dynamics:
spond swiftly, with time recorded in the
• Collaborate assessment findings and rec- • The head nurse documents the team’s ar- Team member roles may differ depending
code blue report.
ommendations for interventions. rival and departure times, the reason for the on the type of patient and department. For
• Expertise: According to guidelines, team
• Immediately implement treatment or diag- call, and the patient’s early warning signs. instance:
members must possess the skills to per-
nostic services as appropriate. • The primary physician documents interven- form CPR and other resuscitative inter-
• Assist with the implementation of physician tion orders. • Adult Code Blue: Includes an intensivist
ventions.
orders, and • The ICU specialist documents assessments, (team leader), anesthesiologist, two criti-
• Assist transport of patients when necessary. interventions, recommendations, and pa- cal care nurses, a nurse supervisor, and
tient outcomes. Structure: the patient’s primary and assigned nurses
• Documentation is filed in the patient’s medi- and cardiologist.
The core structure of the Advanced Cardio-
RRT immediate interventions: cal records under physician notes. vascular Life Support (ACLS) team revolves
• Pediatric Code Blue: Involves a pediatri-
cian, intensivist, anesthesiologist, two
The RRT may initiate the around the resuscitation triangle, but roles
critical care nurses, nurse supervisor, and
may vary based on resources and personnel
following: available. Regardless of the number of team
relevant primary and assigned nurses.
• Maternity Code Blue: Includes an inten-
members, key roles must be performed con-
• Special/frequent monitoring. sivist, anesthesiologist, gynecologist, two
sistently during resuscitation efforts.
• Lab work pertinent to the assessment find- critical care nurses, nurse supervisor, and
ings. relevant primary and assigned nurses.
The high-performing ACLS team typically
• Requesting radiological investigations. • Silent code blue (OR, ICU, NICU) as these
includes:
• Ordering medications or IVs. departments have already their own
• Management of airways, and oxygen ther- teams
apy.
• Transfer to critical care unit or operating
theatre.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Number:
One code blue per 200 beds with response
time that doesn’t exceed 2 minutes

Other health care facilities should deter-

mine number based on the time of re-
sponse that dosen’t exceed 2 minutes 1-Crash Cart Medication List.

Medication Indication Conditions

Sudden cardiac arrest due to asystole,

Adrenaline 1 mg / ml pulseless electrical activity, ventricu-
Crash ampoule lar fibrillation, or pulseless ventricular
tachycardia

Carts
• life-threatening arrhythmias:
Amiodarone 150 mg / • Supraventricular arrhythmias
3 ml ampoule • Ventricular arrhythmia

Sodium Bicarbonate • Prolonged Cardiac arrest.

8.4% • ​Acute severe Metabolic acidosis
Crash Cart Definition:
Lidocaine 2% Vial Ventricular arrhythmias
A movable collection of emergency equipment The crash cart is the commonly used term
and supplies meant to be readily available for to describe a self-contained, mobile unit
resuscitative effort. It includes medications containing virtually all the materials, drugs,
as well as the equipment for defibrillation, and devices necessary to perform a code. The • Hypotension or shock
Dopamine 200 mg / 5 • Inotropic support To be restricted to
intubation, intravenous medication, and contents and organization of crash carts may ml ampoule Crush cart in ER
passage of central lines. vary depending on the code to be executed. • Bradycardia

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Medication Indication Conditions Medication Indication Conditions

• Eclampsia/preeclampsia with • Septic shock or sepsis-induced

severe features, seizure prophylaxis hypoperfusion, fluid resuscitation
Magnesium Sulfate Sodium Chloride
and treatment • Diabetic ketoacidosis or
10% ampoule 0.9%
• Torsades de pointes hyperosmolar hyperglycemic state,
• Hypomagnesemia fluid management

• Hypocalcemia Midazolam 5 mg /ml • Status epilepticus

• Hyperkalemia, severe/emergent ampoule • Sedation for conscious patients
• Cardiac arrest or cardiotoxicity in prior to D.C shocks, SVT and VT.
Calcium Gluconate the presence of hypocalcemia or
10% injection hypermagnesemia
• Calcium channel blocker over-
dose
• Beta-blocker overdose

• Bradycardia
• Organophosphate or carbamate
Atropine sulfate 1 mg insecticide or nerve agent poison-
/ml ampoule ing
• Muscarine-containing mushroom
poisoning

Norepinephrine 4 mg • Cardiogenic shock

/ 4 ml ampoule • Post–cardiac arrest shock
• Septic shock and other vasodila-
tory shock states

Dextrose 25% OR • Hypoglycemia To be individualized

50% • Severe/emergent Hyperkalemia according to each
organization

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2-Recommended emergency
equipment for crash carts:

A. Top of the cart: 1. First Drawer: 3. 3rd Drawer of the Crash Cart: 5. 5th Drawer of the Crash Cart:

• Gloves Medications mentioned above. • IV start packs (IV start kit) • All IV fluids (Solutions mentioned in the list):
• Stethoscope • IV tubing • Dextrose 25% OR Dextrose 50%
• Blood pressure measurement device • IV sets with extensions • Sodium Chloride 0.9%
• Sharps disposal container • 3-way stopcocks
2. Second Drawer of the crash cart:
• Defibrillator with leads and paddles (with • Disposable syringes and needles (Three
pediatric paddle) Disposable syringes, all sizes: 1 ml, 2.5 ml,
• Gel • Airway (oral and nasal) all sizes 5 ml, 10 ml, 20 ml, and 50 ml)
• Other life support equipment • McGill forceps, large and small • Tourniquet tubing
• Ambu bag (adult and pediatric) • 3 Laryngoscope (Laryngoscope handle and • Pressure monitoring line
blades) and endotracheal tubes • Spinal needles
• Bag valve mask (adult and pediatric)
• Nasal cannula (adult and pediatric); Nasal
B. Side Compartment: filter lines
• Nonrebreather oxygen face masks (3 sizes)
• Cardiac backboard • Laryngeal masks 4. 4th Drawer:
• Oxygen tank • Tongue depressor
• Handheld suction • Bite block • NasoGastric tube holder
• Sharps container: sharps disposal 5.4 qt red • A flashlight with extra batteries • Lubricant
• A syringe of sufficient size to inflate the • OG/NG syringe
cuff on it • Scissors
• Endotracheal tube all sizes • Kelly clamp
• Stylets • Adhesive tape
• Dyna plaster • Waterproof tape
• Sutures of various sizes and materials
• Disinfectants (Betadine, povidone-iodine)

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Location and number Number of crash carts will

of crash cart: be determined by the facility
based on:
The number of crash carts in a hospital depends Maintain the cart in a location that is easily
• The Crash cart must reach the site
on the hospital’s size and patient population. accessible to the clinical areas.Make sure staff
within 60 seconds.
Smaller hospitals with fewer beds may only know where and how the cart and/or emergency
need a few crash carts, while larger hospitals equipment is stored
with more patients may need many. It’s also
important to note that crash carts should be Work on the following risk points:
A hospital’s crash cart should be located in
strategically placed throughout the hospital, the central treatment area and in areas where
so they can be quickly accessed during an patients are anesthetized. The station should
emergency. be near oxygen and suction sources to increase Safety Actions to Consider: Risk points can include:
cardiopulmonary resuscitation (CPR) success
Crash carts are typically located in high-traffic rates. Hospitals that have separate wards or • Medical emergencies have the tendency • Staff training and educational needs
areas throughout a medical facility, such treatment areas should consider maintaining to create an uneasiness and a sense of • Identify who responds, ensure that the
as hallways, emergency departments, and multiple crash carts to cover all areas. chaos during the event. staff person has appropriate education
operating rooms. They are brightly colored These feelings may be magnified if the and training.
(often red) and easily recognizable so that emergency equipment used to rescue the • Identify who checks the crash cart and
medical personnel can quickly locate them in patient is not readily. how frequently it is checked (e.g., daily,
an emergency. • available. once per shift, once during hours of op-
• The intent of a crash cart is to ensure that eration) (per policy or written plan)
the correct emergency equipment, medi- • Identify who checks emergency equip-
cations and ment (per policy or written plan).
supplies are readily available to manage
the emergency.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Resource and Equipment Opportunities for

Findings Gaps in Crash Cart Technological Integration
Accessibility
/Analysis • The integration of technology, such
as digital CPR algorithms, training
• The allocation and maintenance of crash
modules, and real-time monitoring tools,
carts are inconsistent, particularly in
is limited across facilities. Adopting
smaller or under-resourced hospitals.
technology-based resources could
While some facilities adhere to a
increase accessibility to standardized
systematic placement of crash carts with
information and improve the consistency
regular checks, others lack protocols for
of emergency response protocols.
cart location, restocking, and equipment
• Expanding access to training resources,
The current landscape of Cardiopulmonary checks. This lack of standardization can
such as digital learning materials, could
Resuscitation (CPR) practices in Egypt reveals lead to delays in emergency interventions
enable a more consistent training
significant disparities in training, resource and may compromise patient safety.
experience across facilities, reducing
allocation, and response protocols across
healthcare facilities. These disparities impact
Inconsistent Code Blue and • Guidelines for the organization and
contents of crash carts are not uniformly
disparities in CPR knowledge and skill
the quality and consistency of emergency Rapid Response Team (RRT) followed, leading to variations in
levels among healthcare providers.
responses, leading to variability in patient
outcomes during cardiac arrest events. Key
Structures available medications, equipment, and
supplies essential for resuscitative efforts.
findings from the analysis are detailed below.
• The structure and readiness of Code
Blue and Rapid Response Teams vary Lack of Comprehensive Data
Variability in Training significantly, especially in facilities with
and Outcome Monitoring
limited resources. In some settings,
Standards there is a lack of standardized protocols,
defined roles, and designated team • Many healthcare facilities do not
• Training standards for CPR differ widely members, which can lead to delays systematically track data on CPR
among healthcare providers, with and miscommunication during critical outcomes or team performance. Without
some facilities offering comprehensive, situations. reliable data collection and analysis,
evidence-based CPR training while • Rapid Response Systems (RRS), designed facilities face challenges in identifying
others lack formalized or up-to-date to identify and respond to early signs of areas for improvement or tracking the
training programs. This variability is most patient deterioration, are not uniformly effectiveness of implemented CPR
pronounced between urban and rural implemented. Many facilities lack trained guidelines. This lack of data limits
facilities, where resources and training RRT personnel who can assess and evidence-based decision-making,
opportunities differ substantially. address early warning signs, increasing impacting the quality of patient care.
• Basic Life Support (BLS) is legally the risk of preventable adverse outcomes. • Data on CPR events, patient outcomes,
mandated for certain groups, such and emergency response times could
as medical and nursing students, but provide valuable insights for continuous
Advanced Life Support (ALS) training improvement but are not yet widely
is generally limited to higher-level captured or analyzed within the Egyptian
specialists. There is also a lack of healthcare system.
systematic refresher courses, which may
result in skill degradation over time.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Code Blue Team

Recommendations Composition and
Rapid Response Team
Development
Standardize code blue teams and rapid response
teams by defining team member roles, training,
and communication protocols. Each team
Implementation
should consist of individuals with specified
competencies based on the resuscitation needs Methodology
of different hospital departments.
Based on the analysis, the following
recommendations are provided to enhance
Cardiopulmonary Resuscitation (CPR)
practices in Egypt’s healthcare sector. Each
Ongoing Training and
recommendation is intended to address gaps Competency Assessments
in training, team dynamics, and resource
allocation: Implement mandatory refresher courses and
skill assessments to ensure ongoing compliance To ensure successful adoption and integration of
with CPR standards. This should include periodic these recommendations, a structured, phased
evaluations of healthcare professionals’ skills approach will be followed. Each step is designed
in CPR, especially in high-turnover healthcare to build consensus, gather feedback, and
National Standardization of Resource Allocation and settings. establish a robust framework for consistent CPR
CPR Training Crash Cart Accessibility practices across healthcare facilities in Egypt.

Establish and enforce national CPR guidelines Develop guidelines for distributing crash
Routine Outcome
that align with international standards, ensuring carts based on facility type, patient load, and Monitoring and Data Focus Group Discussions
consistency across all healthcare settings. This emergency response needs. Ensure that each
Collection and Testing of the Document
would involve updating curriculum in medical cart is regularly audited for equipment and
and nursing schools and setting certification medication availability, with checks aligned Initial engagement involved arranging visits
requirements for both Basic Life Support (BLS) to best practices. Establish a feedback system to monitor CPR
and organizing focus group discussions
and Advanced Life Support (ALS) for healthcare outcomes, track team response times, and
with key healthcare providers, including the
providers across levels. gather data on emergency resource usage. This
Ministry of Health and Population (MOHP),
information should be analyzed to continuously
the Egyptian Health Authority (EHA), and
refine CPR practices and improve patient
selected private healthcare facilities. These
outcomes.
focus groups allowed for in-depth discussion
of the recommendations, providing a platform
for healthcare professionals to review, validate,
and offer feedback on the proposed CPR white
paper. The focus group sessions also helped
identifying practical challenges and specific
needs unique to each type of facility.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Focus group discussion Emergency Equipment High-Level Endorsement Nationwide Training

and pilot visits: Following Focus Group Programs:
• AEDs should be prioritized due to ease of
use and practicality. Feedback: A coordinated training initiative will be launched
• Crash carts are required only in facilities
to ensure healthcare providers are equipped
Selected facilities were offering dialysis, sedation, or invasive Upon completion of focus group discussions,
with the necessary skills in both Basic Life
procedures. revisions to the recommendations will be made
accredited or provisionally based on the feedback collected. A finalized
Support (BLS) and Advanced Life Support (ALS).
Training programs will be rolled out across
accredited facilities version of the document will then be presented
high-impact areas, with an emphasis on rural
Standardized Certifica- for high-level endorsement by regulatory
facilities and high-risk departments such as
authorities and stakeholders, including
Visits was done in 3 tion Criteria for Life Sup- the MOHP, EHA, and other key institutions.
ICUs, emergency departments, and anesthesia
units.
governorates: Cairo, port Training This endorsement is essential for ensuring
organizational commitment to implementing
Alexandria, and PortSaid • BLS and ACLS certificates to be accredited
the whitepaper and for facilitating widespread
Resource Allocation
acceptance within the healthcare sector.
• MOHP: Dar Elshifa hospital
by Egyptian Health Council. Generally
need to be accredited either from:
Framework:
• EHA: Elnasr hospital and 1 primary care
• Suez canal authority: 1 primary care Policy Development and Criteria will be established for the placement,
• Supreme Council of University
• Private: 2d oncology center, 1 radiology
center Hospitals Regulation: quantity, and maintenance of crash carts within
each facility. This includes implementing a strict
• An Official Egyptian Authority schedule for equipment checks, ensuring that
• AHA With high-level endorsement, regulatory bodies,
carts are equipped with age-appropriate and
• ERC such as the General Authority for Healthcare
specialty-specific supplies, and aligning with
Main recommendations • Training Center Certified from EHC Accreditation and Regulation (GAHAR), EHC and
the Egyptian Ministry of Health, will formalize
best practices for accessibility in emergencies.

according focus groups the whitepaper into binding policies. These

policies will clearly define training requirements, Data Collection and
Staff Training & Certification Code Blue Response team structures, and resource distribution
standards to ensure consistency in CPR practices Evaluation:
• All ambulatory care staff must be BLS-
Evaluation across all healthcare settings.
certified. An ongoing system for data collection will be
• Implement a standardized checklist introduced, capturing details of CPR events,
• ACLS certification and crash carts are only
required in facilities that provide:
to assess Code Blue responses. that Engagement and Feedback patient outcomes, and team performance.
Evaluate:
• Renal dialysis
Mechanisms: This data will inform continuous quality
improvement, identifying areas for training
• Sedation services • Response time. refinement and policy adjustments based on
Feedback channels will be established for
• Any invasive procedures • Emergency equipment readiness. actual clinical outcomes.
healthcare professionals to report challenges,
• Staff coordination.
successes, or suggestions related to the new
• BLS and AEDs are sufficient for other • Proper escalation and transfer
CPR practices. This will allow for real-time
ambulatory care settings. protocols.
adjustments and improvements to maintain
high standards of patient safety and emergency
response readiness.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Final Recommendations • Neonatal Resuscitation Program (NRP)

Conclusion of the whitepaper •
for neonatologists and obstetricians.
Pediatric Advanced Life Support
(PALS) for pediatricians and
Based on the findings and analysis conducted neonatologists.
throughout the development of this whitepaper, • Advanced Trauma Life Support (ATLS)
the following final recommendations have for emergency physicians and critical
been established to enhance Cardiopulmonary care doctors.
Resuscitation (CPR) practices across Egypt’s
healthcare system. These recommendations
The critical importance of Cardiopulmonary Resuscitation focus on standardized CPR training Mandatory Certification and
(CPR) as a life-saving intervention in emergency care can- requirements, structured Code Blue and Rapid Recertification
Response Teams (RRTs), and optimized crash
not be overstated. This whitepaper provides a roadmap for cart allocation and maintenance to ensure • Basic Life Support (BLS)
elevating CPR practices within Egypt’s healthcare system a comprehensive and effective approach to o Mandatory for all healthcare profes-
emergency resuscitation.
through the establishment of standardized training, optimized sionals, including physicians, nurses,
paramedics, and emergency responders
resource allocation, and robust team protocols. By address- in all healthcare facilities.
Standardized CPR Training
ing disparities in training and resources, Egypt can create a o Recommended to be Required for
Requirements medical and nursing students prior to
unified approach to CPR that ensures equitable, high-quality graduation.
care across the healthcare continuum. Key points covered in • National CPR Training Framework o Certification valid for two years with a
mandatory refresher course for renewal.
the whitepaper include: A nationally standardized CPR training o Advanced Life Support (ALS)
framework should be established to ensure • All ambulatory care staff must be BLS-
consistent competency levels among healthcare certified.
professionals. This framework must align with • ACLS certification and crash carts are only
international standards such as those of the required in facilities that provide:
American Heart Association (AHA) and the o Renal dialysis
European Resuscitation Council (ERC) while o Sedation services
being tailored to the Egyptian healthcare o Any invasive procedures
system’s needs and regulatory requirements. • BLS and AEDs are sufficient for other am-
bulatory care settings.
o Mandatory in hospitals to have one
• Recommended Specialized Life Support
staff ACLS certified at least per shift
Training
o Certification must be renewed every
two years.
• Advanced Cardiovascular Life Support
(ACLS) for critical care physicians,
emergency physicians, and
anesthesiologists.
• Eventually, according to EHC, all
specialists and consultants will be
ACLS-certified, as per the license
renewal requirements.

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

Recommended Specialized Rapid Response Crash Cart Allocation

Life Support Training Teams (RRTs) for Early and Maintenance
• Advanced Cardiovascular Life
Deterioration Detection
Support (ACLS) for critical care Strategic Placement of Crash
• Hospitals must implement Rapid
physicians, emergency physicians, and Carts
anesthesiologists. Code Blue and Rapid Re- Response Teams (RRT) to identify and
respond before a cardiac arrest occurs.
• Neonatal Resuscitation Program (NRP) for
neonatologists and obstetricians. sponse Teams (RRTs) • Each hospital must define Early Warning • Crash carts should be strategically dis-
tributed based on hospital size, patient
Score (EWS) criteria to activate RRTs
• Pediatric Advanced Life Support (PALS) volume, and risk levels.
when a patient shows signs of clinical
for pediatricians and neonatologists. Code Blue Team deterioration. • Crash cart accessibility standards should
• Advanced Trauma Life Support (ATLS) for
emergency physicians and critical care
Standardization • RRT Composition: ensure that carts are unobstructed,
properly labeled, and reachable within 60
o ICU specialist, internist, or
doctors. seconds in emergencies.
• Every hospital must establish a Code Blue cardiologist
o Primary physician responsible for the • In other healthcare facilities rather than
Team, responsible for immediate inter-
hospitals, crash carts are only required in
Integration of CPR Training vention during cardiac arrests. patient
facilities that provide:
• The team must include: o Assigned nurse and head nurse
in Medical and Nursing o A team leader (an intensivist, emer • RRTs should operate on a 24/7 availability o Renal dialysis
o Sedation services
Education gency physician, or anesthesiologist) basis and be able to respond within five
o Any invasive procedures
o A critical care nurse minutes of activation.
• BLS training must be integrated into o A defibrillator/AED operator • RRT team per 200 beds. In any other cases only AED is required
undergraduate medical and nursing o A documentation officer (responsible
curricula as a prerequisite for internship for recording time, interventions, and
and licensing. patient response) Training and Drills Routine Maintenance and
• Postgraduate programs for specialists o Additional personnel as needed based
• All healthcare staff must receive periodic
Readiness Checks
and consultants must include mandatory on hospital size and specialty (e.g.,
ALS certification pediatric specialists in pediatric hospi training on Code Blue protocols and RRT
• Crash carts must be checked at the start
tals). activation.
of every shift to ensure all supplies are
• Code Blue activation response time • Regular simulation drills should be
intact and medications are within expiry
Accreditation and Quality should not exceed two minutes in conducted to ensure staff readiness and
limits.
inpatient settings. coordination.
Assurance of CPR Training • 1 code blue team per 200 beds.
• A dedicated staff member should be
assigned to perform daily inspections and
• other health care facilities rathar the
weekly detailed audits.
• BLS and ACLS certificates to be accredited hospitals will determine the no based on
• Electronic tracking systems should be
by Egyptian Health Council. Generally response time (2 minutes max).
implemented to monitor crash cart
need to be accredited either from: inventory and restocking requirements.

• Supreme Council of University

Hospitals
• An Official Egyptian Authority
• AHA
• ERC
• Training Center Certified from EHC

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Cardiopulmonary Resuscitation (CPR) Guidance Whitepaper | 2025

References

• ACLS.net. Terms and Conditions [Internet]. Available • Government of Western Australia. Suggested Roles and Responsibilities for a Rapid
from: https://www.acls.net/terms Response Team [Internet]. Available
• ACLS.net. ACLS Crash Cart Requirements [Internet]. Available from: https://www.health.wa.gov.au/~/media/Files/Corporate/Policy-Frameworks/
from: https://www.acls.net/acls-crash-cart Clinical-Governance-Safety-and-Quality/Policy/Recognising-and-Responding-to-Acute-
• ACLS Medical Training. Crash Carts: Preparation and Maintenance [Internet]. Available Deterioration/Supporting/Suggested-Roles-and-Responsibilities-for-a-Rapid-Response-
from: https://www.aclsmedicaltraining.com/crash-carts/ Team.pdf
• DSI Direct. Hospital Crash Cart Arrangement and Checklist [Internet]. Available • ScienceDirect. Rapid Response Teams in Hospital Settings [Internet]. Available
from: https://www.dsidirect.com/hospital-crash-cart-arrangement-and-checklist/ from: https://www.sciencedirect.com/science/article/abs/pii/B9780323695848000384
• InnerSpace Healthcare. Organizing a Crash Cart [Internet]. Available • PubMed. Early Warning Score Systems for Patient Deterioration [Internet]. Available
from: https://innerspacehealthcare.com/news/organizing-a-crash-cart/ from: https://pubmed.ncbi.nlm.nih.gov/34995083/
• The Joint Commission. Quick Safety Issue 32: Crash Cart Readiness [Internet]. Available
from: https://www.jointcommission.org/-/media/tjc/documents/newsletters/quick_
safety_issue_32_20171pdf.pdf
• University of North Carolina Media. Crash Cart Contents [Internet]. Available
from: https://apps.media.unc.edu/crashcart/Resources/CrashCartContents.html
• Pharmacy Times. Health-System Pharmacists: What’s in Your Crash Cart? [Internet].
Available
from: https://www.pharmacytimes.com/view/health-system-pharmacists-whats-in-your-
crash-cart
• American Heart Association. 2020 AHA Guidelines for CPR and ECC [Internet]. Available
from: https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/
hghlghts_2020_ecc_guidelines_english.pdf
• Ministry of Health, Saudi Arabia. Protocol 011: Emergency Response Protocols [Internet].
Available Appendices
from: https://www.moh.gov.sa/Ministry/MediaCenter/Publications/Documents/
Protocol-011.pdf • Clinical deterioration early signs and
• Dubai Health Authority. Purchasing Emergency Medication Guidelines [Internet]. Available scoring system.
from: https://www.dha.gov.ae/ar/uploads/022022/Purchasing%20Emergency%20 • Content of emergency medication
Medication2022259893.pdf cabinet.
• National Center for Biotechnology Information (NCBI). Crash Cart Utilization in Emergency
Settings [Internet]. Available
from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847507/
• ACLS Online. Resuscitation Triangle Roles [Internet]. Available
from: https://www.aclsonline.us/blog/resuscitation-triangle-roles/

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