A crash cart, also known as a code cart, is a specialized, mobile storage unit containing the medications, supplies, and equipment needed for immediate response to a cardiac or respiratory emergency. This unit is designed to be rapidly transported and deployed to a patient experiencing a life-threatening event such as a cardiac arrest. The immediate availability and functionality of its contents are directly linked to patient safety and the success of resuscitation efforts. Rigorous maintenance protocols ensure the cart is ready at a moment’s notice.
Establishing Standard Check Frequencies
The frequency of crash cart checks is determined by a multi-layered system of procedural checks mandated by facility policy and regulatory standards. The most frequent inspection is the visual check, which occurs at least once every 24 hours, typically at the beginning of each day. This daily check confirms the cart is in its designated, accessible location, is properly secured, and that all external equipment, like the defibrillator and oxygen tank, is present.
A supplementary check takes place at every shift change, particularly during nursing handovers, to ensure accountability between clinical teams. This shift-based review focuses primarily on verifying the integrity of the tamper-proof seal or lock number. If a seal is found to be broken or the cart has been opened, a full inventory must be completed immediately.
The most thorough inspection is the in-depth monthly check, which centers on the contents of the cart drawers. This is the minimum required frequency for verifying expiration dates on all medications and supplies. Finally, an immediate post-use check is mandatory; after every emergency response, the cart must be completely restocked, verified, and resealed before being returned to service.
Essential Elements of a Cart Inspection
The inspection process is highly detailed and divided into several distinct categories. A primary focus is on the security and integrity of the cart, which involves verifying the unique numerical identifier on the plastic breakaway seal or tag. The intact seal confirms that the medication drawers have not been compromised since the last full check. This is required for preventing drug diversion and ensuring contents are present.
The most time-intensive part of the inspection is medication verification, typically conducted monthly due to the volume of drugs and varied expiration dates. The inspector must systematically check the expiration dates of all emergency medications, such as epinephrine 1:10,000, atropine, and adenosine, especially those contained within a pre-sealed drug tray. Any medication expiring within the next 30 days must be promptly removed and replaced to prevent the use of ineffective agents during a resuscitation.
Beyond medications, the inspection requires a thorough assessment of all onboard equipment functionality. This includes checking the battery charge of the defibrillator or automated external defibrillator (AED) and performing a simple test run on the device according to the manufacturer’s instructions. Other equipment, such as the portable suction device and the laryngoscope handles used for intubation, must also be powered on to confirm they are operational. The final step involves a detailed inventory of the drawers containing non-drug supplies, confirming the presence and condition of airway supplies, intravenous (IV) start kits, and sterile consumables.
Documentation and Corrective Actions
Every crash cart check requires accurate and verifiable documentation to meet regulatory standards set by bodies like The Joint Commission and the Centers for Medicare & Medicaid Services (CMS). A detailed checklist or log sheet, whether paper-based or electronic, must be completed and signed by the staff member performing the inspection. This record serves as proof that the cart was ready for use, which is a necessary component of facility compliance and patient safety efforts.
If any deficiency is found during an inspection, such as an expired medication, a low defibrillator battery, or a missing supply item, immediate corrective action must be taken. The item must be replaced or repaired before the cart can be returned to its designated location. Following a full restock or replacement, a second staff member, often a pharmacist or nursing supervisor, is required to sign off on the log to confirm the resolution and re-seal the cart. This dual verification process ensures that the crash cart is fully prepared for an emergency response.