What is Crash Cart?

A crash cart or code cart (crash trolley in UK medical jargon) is a set of

trays/drawers/shelves on wheels used in hospitals for transportation and
dispensing of emergency medication/equipment at site of medical/surgical
emergency for life support protocols (ACLS/ALS) to potentially save
someone's life.
The contents of a crash cart vary from hospital to hospital, but typically
contain the tools and drugs needed to treat a person in or near cardiac
arrest. These include but are not limited to:

Monitor/defibrillators, suction devices, and bag valve masks (BVMs) of

different sizes

Advanced cardiac life support (ACLS) drugs such

as epinephrine, atropine,amiodarone, lidocaine, sodium
bicarbonate, dopamine, and vasopressin

First line drugs for treatment of common problems such

as: adenosine, dextrose,diazepam or midazolam, epinephrine for IM
use, naloxone, nitroglycerin, and others

Drugs for rapid sequence intubation: succinylcholine or

another paralytic, and asedative such as etomidate or
midazolam; endotracheal tubes and other intubatingequipment

Drugs for peripheral and central venous access

Pediatric equipment (common pediatric drugs, intubation equipment,
etc.)
Other drugs and equipment as chosen by the facility

Who need a crash cart?

Any facility that treats patients who have the potential to have a sudden
deterioration in their condition should have a crash cart available. State

Regulatory agencies require certain facilities to have a crash cart, but they
are recommended for many more. This would include hospitals, outpatient
surgery centers, urgent care centers, and all centers where conscious
sedation is performed. Nursing homes who provide treatment for patients in
cardiac arrest until EMS arrives would also have a need for a crash cart.
Physician offices who perform certain diagnostic testing such as Cardiac
stress testing or stress Echocardiogram also must have a crash cart
available.
What is in a crash cart? There is a basic list that all crash carts
contain. All carts contain:

Basic airway equipment including bag valve masks, oral and nasal
airways, oxygen masks and nasal cannulas, Magill forceps

Intravenous access equipment (or Intraosseous) including angiocaths,

IV tubing and IV fluid. If the facility elects to utilize intraosseous access
for emergency medications, then a drill and needles must be included.

Medications utilized in the treatment of cardiac arrest including

Epinephrine and Amiodarone.

Medications utilized to treat cardiac dysrhythmias including Adenosine,

Cardiazem, a Beta Blocker (usually Lopressor), and Atropine.

Monitor equipment with a defibrillator or an AED

Medications to treat allergic reactions such as Epi Pens, Solumedrol

and Benadryl

Aspirin 81mg PO

Nitroglycerin spray or 0.4mg tablets

Additionally, carts being utilized for specialized areas may add or

subtract from the basic list. Depending upon the specialty of the
facility, the following may be added:

Endotracheal intubation equipment if anesthesia personnel are present

in the facility

King Airways in facilities without anesthesia personnel or as a bail out

airway for the patient with a difficult airway

Narcan to reverse the effects of narcotics in facilities where narcotics

or sedation is used

Additional antiarrhtyhmics particularly in physician offices who do

cardiac stress testing