Hospital Crash Cart Setup Checklist

Even in a medical setting seconds matter in an emergency.

Properly organized crash cart contents can tip the balance between life and death.

With that in mind this article has been created for the purpose of offering recommendations for crash cart setup and providing a comprehensive crash cart checklist of medical equipment, medications, and supplies.

Specifically, this article will explore:

• The Importance of a Properly Set Up Crash Cart
• Understanding Crash Cart Usage and Workflow
• Crash Cart Setup Checklist
• Emergency Crash Cart Customization and Considerations
• Crash Cart Setup Checklist FAQs

The Importance of a Properly Set Up Crash Cart

The importance of properly organizing crash cart contents cannot be overstated. Hospital crash carts are generally set up according to widely accepted best practices so they:

• Can speed up response time and help increase positive outcomes.
• Standardize emergency procedures.
• Facilitate efficient workflow during emergencies.
• Ensure regulatory compliance.

Understanding Crash Cart Usage and Workflow

Organized and stocked hospital crash carts can increase efficiency during an emergency event.

Crash cart contents that are consistently organized the same way give emergency staff the opportunity to memorize the location of items. Accessing equipment and supplies can become almost a reflex action which, by extension, can be lifesaving. Healthcare staff are not distracted or delayed by the need to search for equipment or medications. Their focus can remain on the patient.

In addition to the efficiency of locating items in the crash cart, communication, and coordination among emergency personnel benefits from a well-organized cart. Communication can be focused on what needs to be done rather than on where an item is located. Workflows can become seamless.

Crash Cart Setup Checklist

Hospital crash carts are self-contained, mobile units stocked with emergency equipment and medications. Most often these critical carts are red so they are easily identifiable although, some hospitals may choose to coordinate with the emergency signal “code blue” and use blue crash carts.

Regardless of the color of the hospital crash cart, there are basic equipment, medication, and supply must haves for emergency crash carts.

Although formal standardization does not exist for hospital crash cart setup, the following is a top-level view of the most widely used setup.

Location and Accessibility

Hospital crash carts should be strategically placed in central, low-traffic, and easily accessible locations throughout a healthcare facility. Local regulations, codes, and standards may govern the placement of emergency crash carts. Because crash carts are always considered “in use”, The Joint Commission allows these carts to be stored in hallways.

Access to crash carts should not be obstructed by other equipment or clutter.

Clear and conspicuous signage should be in place to show the location of crash carts.

Common locations include:

• Nursing Stations
• Emergency Rooms
• Intensive Care Units
• Cardiac Units
• Operating Rooms
• Labor and Delivery Rooms
• Code Blue Zones
• Defined Evacuation Routes

Basic Equipment

Federal, state, or voluntary standards can help identify required medical equipment, medications, and supplies, as can the location of the cart. Although actual crash cart contents can vary across medical facilities or across departments within a single facility, there are essentials suitable for any crash cart.

Here is a very top-level hospital crash cart content checklist:

• 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

In addition to these crash cart must-haves, pediatric crash carts should include:

• Weighing scale
• Measuring tools
• Pediatric sized blood pressure cuffs
• Warming devices
• Pulse oximeter
• Femur splints
• Needles

Medications

Emergency medications are a critical staple for hospital crash carts. These medications carry expiration dates and should be inspected frequently to ensure that expired vials are removed, and the medication restocked.

Crash cart medication lists can vary by facility. For example, Emergency Care Centers may have different medications in their crash cart than a standard clinic.

The following table is a recommended crash cart medication list. Always follow your facilities policies and procedures for administering and mixing medications

Supplies

Like medications, supplies stored in a hospital crash cart can vary across departments within a medical facility or across facilities. Regardless of what supplies are stored in the crash cart, stock must be replenished immediately following the conclusion of the emergency.

The following crash cart checklist of supplies and organization by drawer is intended to serve as a guide.

Drawer One – Heart Related Supplies

• ECG Gel
• ECG Electrodes (adult and pediatric)
• Lumbar puncture kit
• Spare spinal needles and spinal needle tips
• Suction supplies
• Multiple sizes and types of sutures

Drawer Two – Oropharyngeal Airway Supplies

• 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

Drawer Three – Intravenous Supplies

• 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 

Drawer Four – Emergency Medications

See the Recommended Medications Table Above

Drawer Five – 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 or LR
• 500 ml of D5W and NS
• 100 ml of NS-2 

Drawer Six – Pediatric Intubation Supplies or High-Alert Essentials

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

Patient Documentation

During an emergency event, interventions performed, medications administered, and the patient response to treatment are all documented. While vital signs and other data recorded by medical devices may be logged directly into the patient’s electronic health record (EHR), other information may still be recorded by hand.

Utility hooks on the side of the crash cart offer a location for clipboards of relevant forms. However, it is becoming more common for healthcare staff to enter all patient related information through mobile computer workstations rather than on paper.

Check Cart Readiness Regularly

The schedule for checking and performing maintenance on hospital crash carts can be contingent on facility policies and protocols, or compliance regulations.

Crash carts should be visually checked daily to ensure:

• they are properly stocked,
• properly locked,
• in their designated location, and
  

At least monthly check:

• Expiration dates on medications – usually on the first day of the month for consistency. Replace medications as needed.
• Defibrillation pads for the expiration date and replace as needed.
• Battery charge on the monitor and/or AED. This check should be documented.

It is best practice to restock supplies and medications immediately following an emergency.

Another best practice is to designate one person to organize and manage hospital crash carts according to established policy or compliance standards. This designated person may also carry the authority to enforce restocking policy.

Testing medical devices and maintenance on those devices or the cart itself should be done regularly. “Regularly” may be defined by compliance regulations or organization policy.

Crash Cart Customization and Considerations

Tailoring the Cart

Crash carts can be customized with accessories for the specific needs of the facility or department.

Although a hierarchy of the accessory’s importance is driven by the location of the crash cart and the medical staff using the cart, drawer trays and dividers may be universally considered the most important accessory.

Drawer trays and dividers offer a means of organizing and labeling supplies to prevent cross contamination of medications and or mixing of similar items. Organized drawers help critical workflow efficiency during an emergency and restocking efficiency later.

Other common emergency crash cart accessories include:

• 3-Sided Guard Rails for the top work surface
• Oxygen Canister Mounts
• Utility Hooks
• Cardiac Boards and Brackets
• Push Handles
• Overhead Shelves
• IV Pole Attachment

Crash cart manufacturers commonly offer various heights and drawer depths for a customized configuration. Ask about accessory packages too. For example:

CME Corp experts can work with you and the manufacturer to configure a custom hospital crash cart.

Regular Training

It is important to 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.

In addition to on-site training through mock emergencies, there are a variety of augmented reality crash cart training apps available in the market.

Documented training may be required to remain compliant with local, state, and federal healthcare regulatory bodies.

Healthcare facilities looking to become accredited by The Joint Commission (TJC) or to maintain their TJC accreditation are required to offer emergency medical training under MM standards.

CME Corp Your Source for Crash Carts and Life Saving Medical Equipment

It is a fact, seconds count during an emergency. Purposefully organized and properly configured crash carts stocked with lifesaving medical equipment and supplies could tip the balance to a positive outcome in an emergency.

CME Corp is the only medical equipment distributor in the United States solely focused on medical equipment. Over the last forty years we have built relationships with the leading medical equipment manufacturers in the industry. Our expert account managers can help you work with these manufacturers to purchase emergency crash carts and other lifesaving equipment specific to the healthcare services you offer and the patient populations you serve, all within an allocated budget.

Our Direct-to-Site services ensure your crash carts are delivered fully assembled with the selected accessories and emergency medical equipment, and damage and defect free. We will deliver the cart and medical equipment to the floor or department waiting on the purchase when it is convenient for the staff.

After delivery, check in with our Biomedical Services team to set up a preventative maintenance schedule to help keep your equipment working at optimal levels, extend the service life, and keep you in compliance with regulatory standards.

Click the CHAT button to start a conversation about your emergency crash cart and medical equipment needs.

Crash Cart Setup Checklist FAQs

What are the essential features to consider for a crash cart?

There are four essential features important to a crash cart: Defibrillator support rotary, oxygen tank holder, throw-away seal closure system, CPR Cardiac board, and adjustable height IV pole.

Are there any regulations or medical standards surrounding crash carts?

The Joint Commission requires crash carts be secured to prevent tampering or theft of medications; however, security measures must be designed for immediate access to the cart. Break away tags are recommended.

How often should the contents of a crash cart be inspected?

The inspection of crash carts contents varies according to the policies and procedures of the facility and/or state regulations. The best practice is to restock and visually appraise crash carts immediately after each use and to conduct a documented inspection of expiration dates, batteries, and function at least monthly.

How often should crash carts be sanitized?

Crash carts should be sanitized after each use and on a regular basis in accordance with facility procedures and policies.

How can healthcare providers ensure that their crash cart setup complies with industry standards and regulations?

Regulations and standards for crash cart setup are defined by the needs of the facility and the policies and procedures of that facility. Currently there are no universal industry standards.

About CME: With two corporate offices and 35+ service centers, CME Corp is the nation’s only equipment focused medical equipment distributer. We are the premier source for more than 2 million healthcare equipment products, from more than 2,000 manufacturers.

Our Turnkey logistics and biomedical services allow us to help healthcare facilities nationwide reduce the cost of the equipment they purchase, make their equipment selection, and schedule delivery, installation, and maintenance without impacting patient care. From medical equipment purchases to renovations and new facility construction CME Corp is your partner for seamless capital medical equipment purchases, delivered on time and in budget.