100%(1)100% au considerat acest document util (1 vot)
2K vizualizări12 pagini
This document provides information about crash carts including their purpose, contents, and types. It begins by defining a crash cart as a movable trolley used in hospitals to store emergency equipment and medications. Typical contents are then listed and can include defibrillators, ACLS drugs, airway equipment, IV supplies, and more. Crash carts are organized based on age or developmental variations such as adult, pediatric, and neonatal. General information provided includes crash cart checks, equipment labeling, and storage. The document concludes by discussing homemade crash cart options at minimal cost.
This document provides information about crash carts including their purpose, contents, and types. It begins by defining a crash cart as a movable trolley used in hospitals to store emergency equipment and medications. Typical contents are then listed and can include defibrillators, ACLS drugs, airway equipment, IV supplies, and more. Crash carts are organized based on age or developmental variations such as adult, pediatric, and neonatal. General information provided includes crash cart checks, equipment labeling, and storage. The document concludes by discussing homemade crash cart options at minimal cost.
This document provides information about crash carts including their purpose, contents, and types. It begins by defining a crash cart as a movable trolley used in hospitals to store emergency equipment and medications. Typical contents are then listed and can include defibrillators, ACLS drugs, airway equipment, IV supplies, and more. Crash carts are organized based on age or developmental variations such as adult, pediatric, and neonatal. General information provided includes crash cart checks, equipment labeling, and storage. The document concludes by discussing homemade crash cart options at minimal cost.
SAJITH KUMAR. RN,RM, MSc N ; Asst.Professor, International Life Support Instructor VENUGOPALAN. P. P. MB;BS; DA, DNB, MNAMS ;Chief, Emergency Medicine, eputy irector, MIMS Academy, irector, Masters Program in Emergency Medicine !"#$ $SA
INTRODUCTION A crash cart is the trolley for storing lifesa%ing e&uipment and drugs in a hospital emergency room, intensi%e care unit, clinics and other areas. 'he cart is characteri(ed )y )eing easily mo%a)le and readily accessi)le into all sides of the cart for &uic*ly %ie+ing and remo%ing e&uipment and drugs during a crisis situation. 'he first cardiac crash cart +as created at ,ethany Medical Center in -ansas City, -ansas. 'he first crash cart +as fa)ricated )y one of the doctor.s fathers. It contained an Am)u )ag, defi)rillator paddles, a )ed )oard and endotracheal tu)es. A crash cart or code cart /crash trolley in $- medical 0argon1 is a set of trays2dra+ers2shel%es on +heels used in hospital emergency rooms for transportation and dispensing of emergency medication2e&uipment at site of medical2surgical emergency for life support protocols li*e Ad%anced Cardiac Life Support2Ad%ance Life Support /ACLS2ALS1, Pediatric Ad%anced life Support 3PALS4 to potentially sa%e someone.s life. 5 PURPOSES: 5. 'o enhance the Code ,lue team6s response to patients +ith emergency medical situations )y pro%iding immediate access to supplies and medications. 7. An emergency cart or crash cart is a cart that facilitates coordination of emergency e&uipment. 8. A specific crash cart type facilitates staff familiarity +ith e&uipment 9. It is help to ensure a properly stoc*ed emergency cart +ill )e readily a%aila)le :. It also ensures a properly functioning defi)rillator +ill )e readily a%aila)le. ;. It helps to sa%e the %alua)le time at the time of emergency. 7 CONTENTS 'he contents of a crash cart %ary from hospital to hospital, )ut typically contain the tools and drugs needed to treat a person in or near cardiac arrest. 'hese include )ut are not limited to< Monitor2defi)rillators and suction de%ices Ad%anced Cardiac Life Support /ACLS1 drugs such as Epinephrine, Atropine, Amiodarone, Lidocaine, Sodium )icar)onate, opamine, and =asopressin >irst line drugs for treatment of common pro)lems such as< Adenosine, e?trose, ia(epam or Mida(olam, Epinephrine, Nalo?one, Nitroglycerin, and others rugs for rapid se&uence intu)ation< Succinylcholine or other paralytic agents li*e Pancoronoum , a sedati%e drugs such as Etomidate or Mida(olam; endotracheal tu)es and other intu)ating e&uipment =ascular access de%ices ! Intra =enous/I=1 Cannulae, rip sets 3Micro and Macro4, I= fluids 3Normal Saline/NS1, Lactated @inger/@L1, Aydro?y ethyl starch Bther drugs and e&uipment as chosen )y the facility. TYPES OF CRASH CART:- BASED ON AGE OR DEVELOPMENTAL VARIATIONS Adult Emergency Crash Cart Pediatric Emergency Crash Cart Ne+)orn Intensi%e Care Crash Cart GENERAL INFORMATION< 5. A Licensed Staff mem)er as designated )y the head of the department is responsi)le for chec*ing the crash cart, o?ygen cylinder le%els, defi)rillator, and documenting compliance on crash cart chec*list. 7. Each emergency cart is e&uipped +ith a loc* and *ept loc*ed unless in use. 8 8. If the loc* is not intact, the cart is to )e chec*ed and unit personnel +ill replace any missing supplies. 9. Crash cart is chec*ed e%ery shift and recorded. :. efi)rillator load chec*s +ill )e performed e%ery shift +ith the defi)rillator plugged in and unplugged. ;. All carts +ill )e opened and chec*ed for contents once monthly and follo+ing each use. Sterile items +ill )e chec*ed for pac*age integrity and e?piration date. Items +ith e?piration dates e?piring +ithin the month +ill )e replaced. 'he medication dra+er +ill not )e opened if it is sealed and intact. C. Laryngoscopes +ill )e chec*ed prior to placement on the cart and monthly. D. B?ygen cylinders are replaced +hen the tan* has emptied. E. ra+ers of crash carts are to )e clearly la)eled to identify contents. 5F.Special procedure trays are *ept on the )ottom shelf. 9 EQUIPMENT (!!"#$%&': F()"# *$+ S$, *$+ ra+ers are organi(ed and arranged from top to )ottom in different order in different institutions )ut it contain medications, I= solutions and tu)ing, miscellaneous.
'he medicines mainly used in crash cart is Adenosine, Amiodarone, Atropine,e?trose, o)utamine, opamine, Epinephrine, Etomidate, >luma(enil, Lidocaine, Magnesium, Nalo?one, Norepinephrine, Procainamide, Sodium )icar)onate, =asopressin, =erapamil etc. are the some medicines +e can commonly see in crash cart Along +ith this +e can see other e&uipments to esta)lish and maintain air+ay, )reathing and circulations li*e am)u )ag, nasal cannulae, oral air+ays, intu)ation trays /laryngoscope, straight and cur%ed )lade, 5Fcc : syringe, lu)ricant1,tongue )lades, adhesi%e tape, e?am glo%es, suction catheters, endotracheal tu)es, tracheostomy tu)es, I= cannulae, disposa)le syringes, o?ygen cylinder, defi)rillatorGetc. Arrangement of medicines and e&uipment in crash cart is different from different institutions )ased on their policy. ifferent types of arrangements are follo+ing< 51. )ased on the air+ay, )reathing, circulation and 7.1 )ased on the need and necessity of medicines and e&uipment.
51 ,ASE BN AI@#AH, ,@EA'AIN" AN CI@C$LA'IBN<I ra+er 5I Medications- Adenosine, Amiodarone, Epinephrin, Magnesium Sulfate, AtropinGetc ra+er 7 I ,reathing and Air+ayI Am)u )ag B7 Nasal cannulae, Bral air+ays, Intu)ation tray, suction catheters, Endotracheal tu)es, 'racheostomy tu)es, Inner cannulae,G.etc ra+er 8 ! Circulation< I= supplies,8I#ay, ,lood set, A," *its, heparini(ed aspirators, Needles, Alcohol s+a)s, SyringesG.etc ra+er 9ICirculation< I= solutions and tu)ingI @L, NS, :#, I= 'u)ing, Macro J Micro drip, E?tension tu)ing, ,lood pump tu)ing, Arm )oards< long J shortGetc ra+er :I Cardiac, Chest ProceduresI EC" electrodes, @estraints, Sterile glo%es, Mas*s +ith face shields or mas*s and eye protection, Scalpels +ith )lades, ressings, drain sponge, ,etadine solution, Sutures, sil* +ith needle, Cardiac needle, Sterile to+els,8 I lumen Central =enous Pressure catheter *it, Chest tu)esG.etc ; 7.1 ,ASE BN 'AE NEE AN NECESSI'H B> MEICINES AN EK$IPMEN'S<I 5. Medicines< It is again classified )ased on the priorityIfirst, Second and 'hird priority medicines. 7. E&uipments ILi*e @yle6s tu)e, Macro set J micro set ,lood set, I.= splint, Micro pore, "lo%es, -idney tray, EC" electrodes J 0elly, 'ourni&uets J spirit s+a) 8. I= fluidsI Li*e NS EL :FF ml, NS EL 5FF ml, Isolyte P, =ol%en :FF ml 9. Bpen tray on the topIisposa)le syringes, E?tension no.5Fcm, 7FFcm, I= cannulae, Needles, Intra osseous needle, efi)rillator :. ,ottom of crash cartIPlastic apron, Intu)ation tray, Intu)ation pillo+, IC set, Percutaneous tracheostomy set Commonly on the top of the Crash Cart +e can place efi)rillator, In%entory Chec*list2 Code ,lue sheets. Bn the side of the Crash Cart +e can find an B?ygen Cylinder and al so +e can find a Cardiac ,oard. In pediatric settings +e are using different types of crash cart )y using ,roselo+ CartI A colorIcoded pediatric Code ,lue cart3Color coding is )ased on the Broselow Pediatric Emergency] 'ape containing age specific supplies and medications for pediatric patients. 'he ,roselo+ Cart is designed to pro%ide appropriately si(ed e&uipment for a pediatric patient. Each dra+er is colorIcoded and contains supplies )ased on the age and +eight of the patient. 'he top dra+er contains medications for all ages.
C -.-,(%+( /,$%#($c c%(#
BROSELO0 PEDIATRIC EMERGENCY TAPE
No+ a day6s different types of crash *its are also a%aila)le i t contain different emergency drugs, o?ygen system, Am)u disposa)le resuscitator and manual suction unit. 'his types of crash *its help us to deli%er ACLS measures outside the hospital settings also.
Y)1 c%" 2%3 $# %! 4)1( )+"5 ifferent crash carts e?plained a)o%e is commercially a%aila)le and it is costly also. If you are ready, you can also ma*e an emergency crash cart as your o+n. ,uy a plastic dou)le ec*er )as*et +ith a lid and fe+ pearl pet 0ars. 'a*e pearl pet 0ars, put the medicines and la)el it /stic* the la)el on the sides and top of the 0ar lid for identification1 and *eep it on the top of the dou)le ec*er )as*et. -eep the needed e&uipment and supplies in the )ottom of the )as*et. Co%er the )as*et +ith lid. No+ your emergency crash cart is ready. Hou can prepare and use this crash cart in any settings +ith minimal cost. D MEDICINES USED IN CRASH CARTS E DRUG NAME ADULT DOSE PEDIATRIC DOSE INDICATION FREQUENCY EPINEPA@INE 5mg I= or 7I: mg I= %ia E'' F.F5mg2*g I= or IB or F.5mg2*g %ia E'' Any pulseless arrhythms E%ery 8I: min =ASBP@ESSIN 9F units I= Not indicated =>, Pulseless=' Single dose,may )e follo+ed at 5F min )y epinephrine AMIBA@BNE >or => or pulseless ='< 8FFmg I= push >or => or pulseless ='< :mg2*g I= push =>, pulseless =',=' +ith a pulse,S=' May use 7 nd dose of 5:Fmg for recurrent =>2='.In children may )e repeated in :mg2*g doses to a total of 5:mg2*g LIBCAINE 5I5.: mg2*g I= push Same =>, pulseless =',=' +ith a pulse 7 nd J su)se&uent doses of F.C:mg2*g e%ery : min to a total dose of 8 mg2*g MA"NESI$M 5I7g I= slo+ push 7:I:Fmg2*g I= slo+ push 'orsde de pointes, *no+n hypomagnesemia Single dose P@BCAINAMIE 5C mg2*g I= slo+ )olus at ma?imum rate of :Fmg2min 5: mg2*g I= load;8I; mg2*g o%er :min,not to e?ceed 5FFmg2*g =' +ith a pulse Continue infusion/9mg2min1 until K@S +ideningM:FL,dysrhythmia terminated, onset of hypotension; or 5C mg2*g infused. A'@BPINE PerfusingPatients< F.:mg I% push:min, to ma?imum of 8mg. Pulseless patients< 5mg I= push & : min, to ma?imum of 8mg F.F7mg2*g;minimu m dose of F.5 mg ,radycardia, asystole. May )e repeated once upto ma?imum dose of 8mg AENBSINE ; mg rapid I= push through pro?imal peripheral line; central line dose is oneIhalf F.5mg2*g rapid I= push;ma?imum dose,;mg S=' If needed,7 nd dose of 57 mg/pediatric,do)le initial dose up to 57 mg1;8 rd dose of 57I5D mg ILI'IANEM F.7:mg2*g to a ma?imum dose of 7Fmg I= push o%er 7min Same S=' 7 nd dose of F.8:mg2*g,ma?imum dose of 7:mg, at 5:min;after con%ersion, start dilitia(em drip at :I5: mg2A ESMBLBL :FFMcg2*g )olus o%er 5 min 5FFI:FF Mcg2*g )olus o%er 5min S=' May gi%e another )olus if desired effect is not achie%ed; start drip :FMcg2*g2min A'ENBLBL :mg I= o%er :min Not indicated S=',MI @epeat in 5F min, then gi%e :Fmg oral load ME'BP@BLBL : mg I= push Not indicated S=',MI @epeat t+ice at :min inter%als, then gi%e :F mg oral load 5F CONCLUSION< Crash cart is a specially designed trolley, used for transporting and dispensing medicines and e&uipments at the emergency site for participating in life sa%ing measures. Crash carts are located in areas of patient care in case of a lifeI threatening occurrence. Physicians, nurses, pharmacists, and respiratory therapists must )ecome familiar +ith the contents of this cart. It contains necessary e&uipments to handle an emergency situation. A crash cart is ena)ling healthcare pro%iders to manage medical emergencies easily and confidently. BIBILIOGRAPHY:I
5. Clinical Practice Policy and Procedure; emergency carts2defi)rillators uni%ersity of ne+ Me?ico health sciences center 7. Minimum Crash Cart Supplies and rugs /)ased on 7FFC ACLS protocols1; American Aeart Association. 8. Code )lue cart management and replacement; Sarasota memorial hospital policy 9. Crash cart +++.+i*ipedia.com :. $C a%is Aealth System standard crash cart; +++.ucdmc.ucda%is.edu ;. Stone C.-,Aumphries @.L,Lange/7FFD1.CURRENT DIAGNOSIS AND TREATENT !EERGENC" EDICINE.; 'A Edition.'he Mc "ra+Ihill companies. C. Sole,-lein,Moseley/7FFE1. INTRODUCTION TO CRITICA# CARE NURSING.: 'A edition. Saunders else%ier pu)lication A1#6)(7! %88$&$%#$)" -. D/%(#2"# )8 E2(9"c4 M,$c$" 55 $International Academic Training Center %G&U USA Regional Training center %American 'eart association] MALABAR INSTITUTES OF MEDICAL SCIENCES, G)*$",6%/1(%2, K):6$3), I",$% +++.2$2!$",$%.c)2,+++.2$2!%c%,24.)(9 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIII 57