Imagine administering anesthesia medications only to have the patient vomit immediately after losing consciousness. Now imagine instinctively reaching for the suction equipment normally stored in an anesthesia cart only to find an empty space where the device should be.
A fictional scenario…. No. A preventable scenario… Yes!
Well organized, properly stocked, and smooth-rolling anesthesia carts are imperative for ensuring patient safety in an emergency and serve to undergird efficient surgical procedures.
While actual anesthesia cart setup is governed by the unique needs of the facility, anesthesia professionals, and of course regulatory agencies like the Joint Commission, this article aims to offer general and practical recommendations. We will share thoughts on:
- The Importance of Proper Anesthesia Cart Setup
- Essential Components and Features of an Anesthesia Cart
- Anesthesia Cart Accessories
- Best Practices for Anesthesia Cart Setup
- Anesthesia Cart Setup Checklist
- Anesthesia Cart Setup Checklist FAQs
The Importance of Proper Anesthesia Cart Setup
For healthcare facilities employing anesthesia during medical procedures establishing a standard anesthesia cart setup is wise.
Here are four benefits associated with thoughtfully organizing anesthesia cart contents.
Safety
Anesthesia carts organized with properly labeled medications, medical equipment in working order, and fully stocked consumable supplies mitigates the risk of medication errors, equipment malfunctions, and missing supplies that can adversely affect the safety of the patient and potentially, the outcome of the surgery or procedure.
Efficiency
Immediately accessible anesthesia essentials promote smooth workflows in the often-congested surgical environment. A properly stocked and organized anesthesia cart can help eliminate critical time wasted running to find or retrieve medications or equipment during surgery or an emergency.
Emergency Preparedness
In some ways preparing anesthesia cart contents with safety and efficiency in mind is also preparing the medical cart for an emergency. Cardiac arrest and anaphylaxis are examples of critical situations that require emergency medications and specialized medical equipment to be meticulously organized and immediately accessible.
Regulatory Compliance
In the current healthcare landscape compliance with mandated and voluntary regulations can result in healthcare facilities receiving the maximum in insurance reimbursements and commanding a better local reputation. Noncompliance can result in the closure of the facility.
These regulatory agencies offer guidelines, standards, and requirements for organizing, labeling, stocking, and expiration date management of the contents of anesthesia carts. Announced and unannounced inspections by these agencies are common.
Here are several of the more common U.S. agencies regulating the contents and organization of anesthesia carts.
- Food and Drug Administration (FDA)
- The Joint Commission
- The Centers for Medicare and Medicaid Services (CMS)
- State Health Departments
It is important for healthcare facilities offering services requiring anesthesia to be aware of and comply with guidelines and regulations relevant to anesthesia cart setup.
Essential Components and Features of Anesthesia Carts
Like a host of other medical carts, anesthesia carts are designed with efficiency in mind.
They typically
- are constructed of durable and easily cleanable aluminum and steel,
- have drawers or varying depths to house and organize a variety of medications and equipment required for the safe administration of anesthesia,
- are equipped with locking, caster wheels for ease of movement in congested environments,
- ergonomically designed for staff safety
Other essential features to look for include:
Foot Operated Brakes
Look for casters equipped with push brakes on at least one of the casters.
Secure Locking Mechanisms
Most regulatory agencies require anesthesia carts to be equipped with secure locking mechanisms to prevent potent anesthesia drugs from being diverted to an understocked cart without authorization or stolen. Locking systems range from simple break-away or key locks to sophisticated electronic keypads.
Anesthesia Machine Integration
Anesthesia carts can be designed as workstations with special compartments to accommodate anesthesia machines, vaporizers, and other associated equipment used to enable patient ventilation as well as generate and mix anesthetic gasses and vapors used to induce and maintain unconsciousness.
Equipment Storage
Specially engineered spaces for equipment used to administer and monitor anesthesia can help organize laryngoscopes, endotracheal tubes, syringes, IV catheters, airway devices, and monitoring devices for easy and immediate access.
Power Supply
Look for built in power outlets or battery compartments to power essential equipment such as infusion pumps, monitors, or extra lights.
Wireless Connectivity
Anesthesia carts with connectivity capability allow important medical data generated during a procedure or surgery to be directly recorded into a patient’s electronic medical record (EMR) from the connected medical devices. Electronic data transfer at the point of care minimizes, if not eliminates, recording errors and increases efficiency maintaining accurate patient records.
Anesthesia Cart Accessories
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In addition to standard structural components and essential features to look for in anesthesia carts, most manufacturers offer a wide variety of accessories to further tailor the cart for use in surgical environments.
Drawer Dividers and Organizers
Removable divider trays for drawers allow medication to be separated to prevent cross contamination and organized for accurate administration. Smaller instruments, tools, and supplies can also be organized and labeled for accessibility.
Many divider trays allow custom configuration of the compartments using spacers placed in slots arrayed in one-inch increments.
Sharps Container
Built in waste containers allow for compliant, safe disposal of used needles, scalpels, and other sharps used during surgical procedures.
Secondary Locking System for Drawers
Internal drawer compartments with a separate locking system add another layer of security against unauthorized use of medications.
IV Pole Attachment
Attaching an IV pole to an anesthesia cart helps keep IV lines from becoming tangled and prevents an accidental disconnection in often congested operating rooms.
Overhead shelf
Organize supplies within easy reach on the top of the cart.
Self Closing Drawers
Self-closing drawer slides ensure the security of the cart and the safety of staff moving near the cart by preventing drawers from being left open.
O2 Canister Mount
Readily accessible oxygen is always a best practice in a surgical environment.
Monitor Mounts
Securely mounting monitors or displays on an anesthesia cart offers nurse anesthetists optimal viewing of patient vital signs while they are under anesthesia.
Push Handle
Push handles extending approximately 3.6” from the cart help healthcare staff maneuver the cart quickly and without strain to their backs.
Custom Drawer Configuration
Drawers are commonly available in standard depths of 3”, 6”, 9”, and 12” and can be “mixed and matched” within the height of the cart to ensure optimal organization of equipment, tools, and supplies.
Many, if not most, anesthesia cart manufacturers offer the option to custom configure the height of the cart and the number and depth of drawers.
CME experts can work with you and the medical cart manufacturers to configure an anesthesia cart customized specifically for use in surgical environments.
Best Practices for Anesthesia Cart Setup
While actual statistics vary from facility to facility, it is a safe bet to say that anesthesia carts are used multiple times in a twenty-four-hour period. Carefully stocked and organized carts will need to be maintained to ensure they are always ready for use.
Here are some best practices to consider.
Standardization
Although mentioned earlier in the article, it bears repeating that establishing a standard content list and organization plan for anesthesia carts in your facility will offer staff the consistency of knowing that needles or suction devices, for example, will always be in the same location. Consistency promotes efficiency by streamlining workflow. Standardization also offers a quick visual check for inventory management practices.
Logical Organization
Use drawer trays and compartment dividers to arrange equipment, medications, and supplies in a systematic and logical manner. Drawer dividers help prevent items from becoming mixed together and offer easy identification of the drawer contents.
Proper Labeling
Clearly label compartments, drawers, and drawer divider sections with the contents. Where applicable include expiration dates on labels. Color coded labels can help quickly differentiate medication categories.
First In, First Out (FIFO)
Apply the principle of FIFO to ensure that items that may expire are used in the order they are received into the cart. Arrange newer supplies and medications behind older ones to ensure the older contents are used first. Practicing FIFO helps healthcare facilities save money by mitigating waste associated with expiration.
Emergency Equipment Placement
Emergency equipment such as defibrillators and airway devices should be placed in designated, easily accessible areas of the anesthesia cart. Consider color coding these areas of the cart for easy identification during a medical event.
Cart Security
Configure anesthesia carts with locking mechanisms to prevent supplies and medications from being used without authorization. Locking anesthesia carts is a regulatory standard across multiple agencies.
Schedule periodic reviews of the list of staff with access rights to anesthesia carts and update as necessary to ensure only truly authorized healthcare personnel can open the cart.
Regular Inventory Checks
Conduct regular inventory checks to ensure the anesthesia cart is properly stocked with essential medications, supplies, and equipment. Restock as needed and remove expired or damaged items right away.
Only keep essential items needed for the administration of anesthesia.
Periodically test equipment to ensure it is working properly. Replace any equipment that is damaged or underperforming.
Routine Maintenance
Schedule routine cleaning and disinfection to maintain the anesthesia cart and prevent the potential for contamination.
Staff Education and Training
Require comprehensive training and education for staff on the proper organization and stocking of the anesthesia cart according to facility standards.
Anesthesia Cart Setup Checklist
Anesthesia cart setup has not been standardized within the healthcare industry. There are, however, essential supplies and equipment required for the administration of anesthesia that are commonly organized and stored in specialized medical carts.
The following general checklist is intended as a guide for stocking and organizing anesthesia carts and workstations. Actual contents and organization of anesthesia carts may depend on the type of anesthesia being administered and the preferences of the anesthesiologist.
Anesthesia Cart Contents
Anesthesia carts are most commonly organized with each drawer containing like items with the more critical or most often used items in the top drawers.
There are innumerable combinations of drawers available for anesthesia carts. For the purposes of this guide a standard five drawer cart has been used.
❏ Medications
Drawer One usually contains “non-controlled” medications vials organized and labeled in drawer divider bins. This drawer and its contents are almost an unofficial standard in the industry.
Anesthesia cart medications fall into seven categories:
- Muscle Relaxants
- Saline Flush
- Antiemetics
- Antibiotics
- Volatile or IV agents
- Emergency
- Hypertension
Controlled drugs such as Propofol and Fentanyl must be sourced from the pharmacy and are not typically stored in an anesthesia cart.
❏ Needles and Syringes
Drawer two commonly organizes various needles and syringes by type and gauge. These sharps fall into several categories:
- Trocar
- Syringe
- Biopsy
- Nerve Block
- Microcapsule
- Spinal Anesthesia
- Fluoroscopy
❏ Airway Equipment and Supplies
Drawers three and four are often used for airway equipment and supplies. This equipment falls into three categories and includes masks and tubing supplies.
- Oropharyngeal airway (OPA)
- Nasopharyngeal airway (NPA)
- Endotracheal Airway (ETA)
In some cases, entire carts may be dedicated to storing and organizing airway equipment and consumable supplies.
❏ Defibrillators
Drawer five, often the deepest drawer, may hold AED equipment.
Contingent on design and configuration, some anesthesia carts may also have space for anesthesia machines, ventilators, and monitors.
Anesthesia Workstation Setup
Anesthesia workstations are mobile carts specifically designed to hold equipment used in the delivery of anesthesia. Anesthesia workstations are also known as anesthesia delivery systems.
The following equipment is commonly found on an anesthesia workstation:
- Anesthesia Machine
- Vaporizer
- Ventilator
- Breathing Systems
- Scavenging Systems
- Monitors
- Drug Delivery Systems
- Suction Equipment.
Well-organized anesthesia cart contents offer the benefit of efficiency, safety, and cost savings in the form of supply management. Cart organization and supplies may be standardized within a healthcare facility based on need and the preferences of the healthcare professionals using the cart but can vary across facilities. Although universal standardization does not exist for anesthesia carts, there are some regulatory requirements, such a locking mechanism, that must be followed.
CME Corp. Can Help You Buy The Best Anesthesia Carts
CME Corp. account managers are medical cart experts. We have long-standing relationships with many industry leading cart manufacturers and can help you choose and configure the anesthesia cart best suited for your needs and budget.
Our Direct-to-Site delivery services assure your anesthesia carts will be delivered when and where you need them.
Browse our comprehensive line of carts, including anesthesia carts or click CHAT and talk with one of our experts about the features and accessories you need in an anesthesia cart.
A Cart Setup Checklist FAQs
How much does an anesthesia cart weigh?
The weight of an anesthesia cart is dependent on how tall it is, the number of drawers, and whether it is constructed of aluminum, steel, or a combination. Weights can range from 97 lbs. to 150 lbs.
How often should anesthesia carts be replaced?
Anesthesia carts are constructed of durable materials and can easily stay in service for ten years or more with proper preventative maintenance.
How are anesthesia carts maintained?
Regularly scheduled cleaning, disinfection, and inspection of the carts will help ensure a long service life. Replace worn or cracked antimicrobial trays or damaged wheels when the issue is identified during an inspection.
What is an anesthesia tray?
Anesthesia trays contain the medications and equipment needed to administer anesthesia at the beginning of a surgery. Items on the tray will vary according to the type of anesthesia being administered.
About CME: CME Corp is the nation’s premier source for healthcare equipment, turnkey logistics, and biomedical services, representing 2 million+ products from more than 2,000 manufacturers. With two corporate offices and 35+ service centers, our mission is to help healthcare facilities nationwide reduce the cost of the equipment they purchase, make their equipment specification, delivery, installation, and maintenance processes more efficient, and help them seamlessly launch, renovate and expand on schedule.
