A crash cart, also known as a code cart or resuscitation cart, is a mobile unit containing the medications, supplies, and equipment needed to respond immediately to a cardiopulmonary arrest or other life-threatening medical emergency. This cart is strategically placed throughout a healthcare facility, ready to be rushed to the bedside during an event like a “Code Blue.” The contents are designed to facilitate advanced cardiac life support (ACLS) protocols. The success of a resuscitation attempt is directly linked to the readiness of this equipment, making its maintenance essential for patient safety.
Assigning Accountability for the Primary Check
The responsibility for checking the crash cart typically falls to the registered nursing staff assigned to the unit where the cart is located. Unit-specific policies often designate the charge nurse or a specific nurse on the shift as the individual accountable for this task. This assignment ensures that one professional verifies the cart’s readiness at the start of their shift. In specialized units or larger healthcare systems, a dedicated emergency response technician or biomedical engineering team member may be assigned this maintenance role.
Defining accountability eliminates ambiguity regarding who checks the cart, ensuring the process is not overlooked during transitions of care. This accountability is logged in a formal record, linking the cart’s integrity to a specific staff member. This system is a regulatory requirement designed to ensure the cart is prepared for immediate deployment. The designated checker must be trained on the location of all contents and the functional testing of the electronic equipment.
Mandatory Check Frequency and Timing
Maintaining a functional crash cart requires a rigorous schedule of checks. Standard protocol mandates a full visual and functional check at least once every 24 hours, often performed at a set time each day. This daily check is required by many accrediting bodies to ensure continuous readiness.
Verification of the cart’s sealed status also occurs at every shift change, acting as a handoff verification between nursing staff. The most immediate check is the mandatory inspection, restocking, and resealing that must occur immediately following every use. If a cart is opened or used for even a single item, it is considered compromised. It must be replaced with a fully ready cart, or fully restocked and resealed before it can be considered available again.
Core Components of the Inspection
The primary inspection requires a systematic, multi-point verification to ensure everything is present, functional, and current. The first step involves checking the tamper-evident security seal, often a numbered, plastic breakaway lock, to ensure it is intact and that the cart has not been accessed since the last documented check. Once opened, the checker must cross-reference all contents against a detailed inventory sheet, verifying the presence and correct quantity of every item in each labeled drawer.
A major focus is the inspection of expiration dates on all medications, such as epinephrine and atropine, sterile supplies, and defibrillator pads. This prevents the use of ineffective agents during a cardiac arrest.
Beyond supplies, the equipment requires functional testing. The defibrillator/monitor must be plugged in and fully charged; some protocols require a documented “fire” test with a test load to confirm readiness. The oxygen tank must be checked to ensure the pressure gauge indicates a sufficient gas level, typically above 500 pounds per square inch (psi). The mounted suction apparatus should also be briefly activated to confirm effective vacuum pressure.
Documentation and Sealing Protocols
The final stage of the crash cart check involves completing a comprehensive, facility-specific log sheet or checklist that memorializes the inspection process. This document serves as the legal and regulatory record of the cart’s readiness and must detail the status of all verified components. The checker records their printed name, signature, the date, and the time the inspection was completed.
This log sheet is typically affixed to the cart or stored in a designated binder for easy access by regulatory surveyors. Once the check is complete and the cart is confirmed ready, a new tamper-evident security seal must be applied to secure the cart. The unique number of this new seal is then recorded on the checklist. This creates an auditable trail that links the cart’s readiness to the specific personnel and time of the check, ensuring continuous, traceable accountability.