Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
ERNA Crash Cart
General
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Crash Cart in place and accessible
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Crash Cart is locked/sealed
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Drawers labelled- Airway, Respiratory, medications and Circulation
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All items in date (No expired items)
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All items in correct placement
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Crash Cart and paddles clean
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All documents complete per crash cart index inside the folder-not kept on top of cart
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Current record of outside contents checked for each shift with initials, date & Lock Number
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Current record of internal contents checked monthly with signature and date
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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
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For daily and monthly check – Contents all present or If missing explanationaction noted in deficiency form. (Datix number to be mentioned for the reference)
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Deficiency for outside content to be recorded on daily basis and inside content to be mentioned on monthly basis
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Defibrillator and suction machine plug in to emergency power
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Oxygen gauge (at minimum of 1000 PSI) or above mid green
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Oxygen tubing attached to flow meter
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Resuscitation bag connected to face mask
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Medication list clear copy (With receiving staff name, date and signature recorded)
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Pharmacy check record within last month, expiry dates & that drug box is intact
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All Laryngoscope blades fit/match handle
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All Laryngoscope batteries/bulbs checked by connection
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Spare bulbs and batteries available in cart (if applicable)
Performance
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Defibrillator user test I cable and paddles test done on daily basis
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Policies (CPP: Crash Cart, Code Blue, DPP: Code blue preparedness and response, IPP: pharmacy crash cart)
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Updated Read and signs for policy present In crash cart
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Adult or Pediatric Algorithms/medication layouts available (Inside the folder)
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Code Blue forms x 5 (blanks)
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Crash Cart checklists x 5 (blanks)
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Crash cart Deficiency Form x 5 (blanks)
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Defibrillator operator's check list x 5 (blanks)
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Defibrillator Test strip Form x 5 (blanks)
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Record of ECG test strips (Last week in the crash cart folder)
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Specimen signatures available containing staff name, initials/signature and Emp. Number (updated if applicable)
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Records of completed crash cart checklists (2 weeks)
Office
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Record of staff BCLS/ACLS/PALS expiry list
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Daily allocation for checking and cleaning - shift and weekly
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Record of defibrillator training, crash cart training, code blue form training and which will be maintained by the Head Nurse/Designee
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Emergency numbers & instructions on station phones
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All staff have completed crash cart competency