ERNA Crash Cart

• Site conducted

• Conducted on

  Date

• Prepared by

• Location

General

• Crash Cart in place and accessible

  Met

  Not Met

  N/A

• Crash Cart is locked/sealed

  Met

  Not Met

  N/A

• Drawers labelled- Airway, Respiratory, medications and Circulation

  Met

  Not Met

  N/A

• All items in date (No expired items)

  Met

  Not Met

  N/A

• All items in correct placement

  Met

  Not Met

  N/A

• Crash Cart and paddles clean

  Met

  Not Met

  N/A

• All documents complete per crash cart index inside the folder-not kept on top of cart

  Met

  Not Met

  N/A

• Current record of outside contents checked for each shift with initials, date & Lock Number

  Met

  Not Met

  N/A

• Current record of internal contents checked monthly with signature and date

  Met

  Not Met

  N/A

• Per Shift for the Unlock content/Monthly for all the Crash Cart Items OR if the seal is broken, missing, tampered with or after resuscitation the crash cart are to be checked according to the Checklist

  Met

  Not Met

  N/A

• For daily and monthly check – Contents all present or If missing explanationaction noted in deficiency form. (Datix number to be mentioned for the reference)

  Met

  Not Met

  N/A

• Deficiency for outside content to be recorded on daily basis and inside content to be mentioned on monthly basis

  Met

  Not Met

  N/A

• Defibrillator and suction machine plug in to emergency power

  Met

  Not Met

  N/A

• Oxygen gauge (at minimum of 1000 PSI) or above mid green

  Met

  Not Met

  N/A

• Oxygen tubing attached to flow meter

  Met

  Not Met

  N/A

• Resuscitation bag connected to face mask

  Met

  Not Met

  N/A

• Medication list clear copy (With receiving staff name, date and signature recorded)

  Met

  Not Met

  N/A

• Pharmacy check record within last month, expiry dates & that drug box is intact

  Met

  Not Met

  N/A

• All Laryngoscope blades fit/match handle

  Met

  Not Met

  N/A

• All Laryngoscope batteries/bulbs checked by connection

  Met

  Not Met

  N/A

• Spare bulbs and batteries available in cart (if applicable)

  Met

  Not Met

  N/A

Performance

• Defibrillator user test I cable and paddles test done on daily basis

  Met

  Not Met

  N/A

• Policies (CPP: Crash Cart, Code Blue, DPP: Code blue preparedness and response, IPP: pharmacy crash cart)

  Met

  Not Met

  N/A

• Updated Read and signs for policy present In crash cart

  Met

  Not Met

  N/A

• Adult or Pediatric Algorithms/medication layouts available (Inside the folder)

  Met

  Not Met

  N/A

• Code Blue forms x 5 (blanks)

  Met

  Not Met

  N/A

• Crash Cart checklists x 5 (blanks)

  Met

  Not Met

  N/A

• Crash cart Deficiency Form x 5 (blanks)

  Met

  Not Met

  N/A

• Defibrillator operator's check list x 5 (blanks)

  Met

  Not Met

  N/A

• Defibrillator Test strip Form x 5 (blanks)

  Met

  Not Met

  N/A

• Record of ECG test strips (Last week in the crash cart folder)

  Met

  Not Met

  N/A

• Specimen signatures available containing staff name, initials/signature and Emp. Number (updated if applicable)

  Met

  Not Met

  N/A

• Records of completed crash cart checklists (2 weeks)

  Met

  Not Met

  N/A

Office

• Record of staff BCLS/ACLS/PALS expiry list

  Met

  Not Met

  N/A

• Daily allocation for checking and cleaning - shift and weekly

  Met

  Not Met

  N/A

• Record of defibrillator training, crash cart training, code blue form training and which will be maintained by the Head Nurse/Designee

  Met

  Not Met

  N/A

• Emergency numbers & instructions on station phones

  Met

  Not Met

  N/A

• All staff have completed crash cart competency

  Met

  Not Met

  N/A