A crash cart, often called a code cart, is a specialized, mobile storage unit that is fundamental to emergency medical response within a healthcare facility. Its singular purpose is to centralize and provide immediate access to the necessary equipment, medications, and supplies required to manage a life-threatening event, such as a cardiac or respiratory arrest. The cart’s readiness is paramount because, during a medical emergency, seconds directly influence patient outcomes. Ensuring that every item is present and functional is a continuous process that safeguards against dangerous delays in care.
Assigned Roles and Responsibilities
The responsibility for maintaining a cart’s readiness is deliberately shared across multiple professional roles to ensure comprehensive oversight and accountability. The most frequent check is typically performed by a designated Registered Nurse (RN) or a specialized unit technician on the patient care unit. This individual is responsible for a shift-to-shift handoff, visually verifying the cart’s location and the integrity of the security seal.
A secondary layer of verification involves detailed inventory management, often shared between nursing staff and the Hospital Pharmacy. Nursing personnel check for stock integrity and rotation, but Pharmacy staff are responsible for the final verification of controlled substances and replacing used medication trays. This partnership minimizes medication errors and ensures compliance with pharmaceutical handling regulations.
A tertiary role belongs to the Biomedical Engineering or maintenance department, focusing on the medical devices housed on the cart. These technical specialists are responsible for scheduled maintenance and testing of equipment like the defibrillator/monitor and suction apparatus. Preventative maintenance checks ensure that complex electronics are functioning correctly, charged, and calibrated to deliver therapies accurately.
Establishing the Checking Schedule
The timeline for checking the cart is structured into distinct intervals to ensure continuous readiness. The most frequent check is the daily or shift-change verification, involving a quick visual appraisal and documentation that the cart remains in its designated, accessible location. This check primarily confirms the integrity of the tamper-evident security seal, indicating the contents have not been accessed since the last inspection.
A more comprehensive full inventory check is immediately required following any use of the cart during a medical emergency. This post-use check involves a complete restock and requires a full accounting of all utilized supplies and medications before a new security seal is applied. This rapid turnaround is necessary to ensure the cart is available for the next potential event without delay.
Scheduled deep inventory checks occur less frequently, typically weekly or monthly, depending on the facility’s policy. These checks are exhaustive and involve opening the cart to perform detailed expiration date verification on all supplies and medications. Organizing these checks consistently helps standardize the process and prevent expired items from remaining in stock.
Essential Elements of the Cart Check
A comprehensive physical check of the cart must confirm the viability of its medications, the functionality of its devices, and the completeness of its inventory. Verifying medication integrity is a primary concern, as expired drugs represent a common failure point that can compromise patient care. Staff must physically check the expiration dates on all emergency drugs, such as epinephrine and atropine, and ensure correct concentrations are present.
The equipment housed on the cart must be tested to confirm operational readiness, with the defibrillator/monitor receiving focused attention. This includes checking that the device is correctly plugged into a power source, confirming the battery charge level, and ensuring an adequate paper supply for rhythm printing. If the cart includes oxygen, the pressure gauge on the tank must be checked to ensure it holds a minimum safe level, typically above 1000 pounds per square inch (PSI).
Beyond medications and devices, the check must verify the presence of all necessary supplies for airway and vascular access. This includes confirming that airway management tools are present and undamaged. Furthermore, the following items must be accounted for and sealed within the designated drawers:
- All sizes of the bag valve mask and laryngoscope blades.
- Intravenous supplies.
- Procedural kits.
- The backboard for chest compressions.
Documentation and Quality Control
The physical act of checking the cart must be formally recorded to establish a clear chain of accountability. This process necessitates the use of a standardized physical or electronic checklist detailing every item to be verified. The person performing the check must sign and date the record, noting the time and the unique identification number of the new security seal placed on the cart.
This documentation serves as the foundation for quality control, creating a verifiable record of the cart’s status at any given moment. Should any item be found missing, expired, or non-functional, a deficiency report is immediately filed, and the issue is resolved, often within a 24-hour window. The administrative protocol defines a clear chain of command for reporting these deficiencies, which typically involves notifying the charge nurse and the appropriate pharmacy or biomedical staff.
Accurate documentation is a requirement for quality assurance programs and for meeting external regulatory standards set by bodies like The Joint Commission. Routine audits of these checklists and deficiency reports allow the facility to identify trends, reinforce training, and ensure the process for maintaining life-saving equipment is consistently reliable.