E-Cart O verview

Prepared by: Michael Cruz, RN, MAN

O bjectives:
Provide brief overview of crash cart , its
contents and arrangements
Define the emergency trolley and Identify its
purpose
Classify the different drawers of the emergency
trolley
Identify emergency drugs and state their action
Recognize nurses responsibilities

The Em ergency Cart

A crash cart is the trolley for
storing lifesaving equipment and
drugs in a hospital emergency
room, intensive care unit, clinics
and other areas. The cart is
characterized by being easily
movable and readily accessible
into all sides of the cart for
quickly viewing and removing
equipment and drugs during a
crisis situation.

W hat are the Purposes:

To ensure availability of all drugs, equipment, and
supplies necessary to initiate advanced life-support
measures.
To have the emergency cart and Defibrillator
constantly ready for use in case of life threatening
condition such as cardiopulmonary arrest.
To provide a mobile station within the hospital that
contains everything needed to treat a life-threatening
situation and allows the treatment to come to the
patient when needed.

RN Responsibilities:
Responsible for checking the crash cart, oxygen cylinder
levels, defibrillator, and documenting compliance on crash
cart checklist.
Each emergency cart is equipped with a lock and kept locked
unless in use.
If the lock is not intact, the cart is to be checked and unit personnel will
replace any missing supplies.

Properly stocked age-appropriate emergency cart and a

properly functioning defibrillator will be readily available.
Replenishments and monitoring of supplies and reporting of
malfunction equipment e.g. Defibrillator

RN Responsibilities:
All carts will be opened and checked for contents and
following each use. Sterile items will be checked for package
integrity and expiration date. Items with expiration dates
expiring within the month will be replaced. The medication
drawer will not be opened if it is sealed and intact.
Laryngoscopes will be checked prior to placement on the
cart and monthly.
Oxygen cylinders are replaced when the tank has emptied.
Drawers of crash carts are to be clearly labeled to identify
contents.
Special procedure trays are kept on the bottom shelf.

Em ergency Cart

A rran g em en t of Em erg en cy
C art

Arrangem ent of Em ergency Cart

First Drawer

Second Drawer

First D raw er
Activated Charcoal

Dobutamine 250mg/20ml vial

Amiodarone 150mg/amp

Dopamine 200mg/vial

ATS

Epinephrine 1mg/ml amp

Aspirin 325mg/tab

Furosemide 20mg/2 ml amp

Atropine 1mg/ml amp

Hydrocortisone 250mg/vial

Benzodiazepine 10mg/2 ml amp

Hyoscine-N-Butyl bromide
20mg/vial

Dexamethasone
Digoxin 0.5mg/amp

Lidocaine 2% solution/vial 1g/50

ml

Diphenhydramine 50mg/amp

Mannitol 20% solution 500 ml/vial

Second D raw er
Mefenamic acid 500mg/tab

Paracetamol 300mg/amp

Methylprednisolone 4mg/tab

Potassium chloride 40mEq/vial

Metoclopramide 10mg/amp

Pyridoxine 1g/amp

MgSO4 1g/amp

Sodium bicarbonate
50mEq/amp

Nitroglycerine patch
Isosorbide di-nitrate 5
mg/tab/amp

Tramadol 50 mg/cap
Terbutaline 0.5 mg/amp

Noradrenaline 2mg/amp

Tetanus toxoid 0.5 ml/vial

ORS preparation

Verapamil 5mg/2ml

Epinephrine
Classification
Bronchodilator

Vasopressor
Cardiac
Stimulant

Effects

Indications

Increases
Cardiac Arrest
myocardial
Hypersensitivit
contractility,
y reactions
heart rate, SBP
Anaphylaxis
and CO
Acute asthma
Relaxes
attacks
bronchial
smooth muscle Symptomatic
bradycardia
Severe
hypotension

Atropine Sulfate
Classification
Anticholinergic
Muscarinic
antagonist

Effects
Increases
conduction
through the
AV node and
increases the
HR

Indications
Inhibit
salivation and
excessive
secretions of
the respiratory
tract
Prevent other
cholinergic
effects during
surgery (e.g.,
cardiac
arrhythmias,
hypotension,
bradycardia)

Atropine Sulfate
Classification

Effects

Antidysrhythmi Slows
c
conduction at
AV node
Decreases
cardiac
workload and
myo-cardial
oxygen
consumption
through its
vasodilatory
effects

Indications
Used to help
keep the heart
beating
normally in
people with
lifethreatening
heart rhythm
disorders of
the ventricles
ventricular t
achycardia

or
ventricular fi
brillation
.

D iphenhydram ine
Classification
Antihistamine

Effects

Indications

Hypersensitivit Prescribed for

y reactions
severe allergic
conditions
Nighttime
such as runny
sleep aid
nose,
sneezing,
itchy, watery
eyes. It is also
used for
itching of
insect bites,
sunburns, bee
stings, poison
ivy, poison oak
and minor skin
irritation.

D exam ethasone
Classification
Corticosteroid
that prevents
the release of
substances in
the body that
cause
inflammation.

Effects

Indications
used to treat
conditions
such as
arthritis,
blood/hormone
/immune
system
disorders,
allergic
reactions,
certain skin
and eye
conditions,br
eathingprobl
ems, certain
bowel
disorders, and

Benzodiazepine
Classification
Anti-anxiety
Benzodiazepin
e

Effects

Indications

useful in the
Management
symptomatic
of anxiety
relief of acute
disorders
agitation,trem Adjunct
or, impending
therapy in
or
convulsive
acutedelirium
disorders
tremens and
Relief of
hallucination
anxiety and
tension in
those
undergoing
surgical
procedures

D igoxin
Classification
Cardiac
glycoside

Inotropic

Effects
Increases
myocardial
contractility

Decreases
heart rate
Antidysrhythmi
c
Enhances
cardiac output

Indications
Patients with
heart failure
Cardiogenic
shock

Atrial
dysrhythmias
such as atrial
fibrillation,
atrial flutter
and SVT

D opam ine
Classification

Effects

Sympathomim
etic

Contraindicate
d in
hypovolemia.
Effects of drug
varies with
dose:

Vasopressor

Inotropic

2-5
mcg/kg/minute
-renal
perfusion
5 10
mcg/kg/minincreased
cardiac output
10 20

Indications
Shock state

Symptomatic
bradycardia

D obutam ine
Classification
Inotrope

Effects
Increases
myocardial
contractility

Increases
myocardial
cardiac output

Increases
coronary blood
flow and
myocardial
oxygen
consumption

Indications
Heart failure
Cardiac
decompensati
on

Lidocaine
Classification

Effects

Alternative
Alternative to
Antidysrhythmi
other
c
antiarrhythmic
drugs (e.g.,
amiodarone,
procainamide,
sotalol)
Suppresses
the
automaticity of
ectopic foci

Indications
Cardiac arrest
from VF and
VT
Stable VT
Wide complex
tachycardias
of uncertain
type

Furosem ide
Classification
Loop diuretic

Effects
Prevents your
body from
absorbing too
much salt,
allowing the
salt to instead
be passed in
your urine.

Indications
Treats fluid
retention
(edema) in
people with
congestive
heart failure,
liver disease,
or a kidney
disorder such
as nephrotic
syndrome.

M annitol
Classification
Osmotic
Diuretic

Effects

Indications

Preventing or
treating excess
body water in
certain kidney
conditions,
reducing
swelling of the
brain, or
reducing
pressure in the
eye.

Acute oliguric
renal failure
Toxic overdose
Edema
Increased
intracranial
pressure (ICP)
Intraocular
pressure (IOP

M orphine Sulfate
Classification
Opiate
Analgesic

Effects
Decreases
pain impulse
transmission

Decreases
myocardial
oxygen
requirements
Relieves
pulmonary
congestion

Indications
Chest pain
with ACS
unresponsive
to nitrates
Cardiogenic
pulmonary
edema

N itroglycerin
Classification
Nitrates

Effects
Decreases
venous return,
preload and
myocardial
oxygen
demand

Improves
coronary
artery blood
flow and
oxygen
delivery

Indications
Angina
Hypertension
Heart failure in
AMI

N orepinephrine
Classification
Sympathomim
etic

Effects

Indications

Produces
Hypotensive
vasoconstrictio
states
n

Increases
myocardial
contractility

Dilates
coronary
arteries

Vasopressor

Sodium Bicarbonate
Classification

Alkalinizer

Electrolyte
replenisher

Effects
Increases the
plasma
bicarbonate
Increases
blood pH

Indications
Metabolic
acidosis
Alkalinize urine

H ydrocortisone
Classification
Antiinflammatory
glucocorticoid

Effects

Indications
Relieve the
itching,
redness,
dryness,
crusting,
scaling,
inflammation,
and discomfort
of various skin
conditions; the
inflammation
of ulcerative
colitis or
proctitis

Atropine Sulfate
Classification
Calcium
Channel
Blocker

Effects
Moderately
increases CO
and HR
Decreases
peripheral
vascular
resistance

Indications
Hypertension
(high blood
pressure) and
angina (chest
pain).

Phenobarbital
Classification
Sedative
hypnotic

Barbiturate

Effects
Anti
convulsant
Emergency
control of
acute seizure
disorders

Indications

Verapam il
Classification
Calcium
channel
blocker

Effects
It works by
relaxing the
muscles of
your heart and
blood vessels.

Indications
Treat
hypertension
(high blood
pressure),
angina (chest
pain), and
certain heart
rhythm
disorders.

Arrangem ent of Em ergency Cart

Third Drawer

Arrangem ent of Em ergency Cart

Endotracheal tubes of
different sizes
Nasopharyngeal airway
Oropharyngeal airway
Suction catheters
different sizes
Catheters (Straight cath,
2-way foley, 3-way foley,
Curved)

Syringes different sizes

Asepto syringe
3 way stopcock
Laryngoscope blades
Laryngoscope handle
Sterile Gloves (various
sizes)
Stylet
Electrodes

Arrangem ent of Em ergency Cart

Forth Drawer

Arrangem ent of Em ergency Cart

Syringes

Clean Gloves

IV Cannula

Surgical mask

IV tubing's

Water soluble gel

Urine Bag

Nasal Cannulas

Needles

Face Masks

Arrangem ent of Em ergency Cart

Fifth Drawer

Arrangem ent of Em ergency Cart

IV Supplies
IV solutions
Suction liner

Size D oes M atter

Suction Catheters

IV Cannulas

Catheters