Department
of Pharmacy Policies & Procedures
Number: 5:27
Effective Date: October,
1987
Revisions: 4/93; 7/99;
4/02; 4/08; 10/09
Approval: July, 1999
Subject: EMERGENCY CARTS
A. POLICY
The Department of Pharmacy
and Central Sterile Supply (CSS) jointly maintain standardized emergency carts
throughout the hospital and the Ambulatory Care Center. All carts with the
exception of H5 and F5 care units are standardized and are sealed with an
integrity seal. Contents of the standardized cart will be determined on
approval of the Patient Care Issues Committee.
B. TYPES OF STANDARD CARTS
1. Adult Cart
§ The Adult Emergency Cart is usually a
seven drawer cart. It is tan and red and contains items for treatment of adult
patients.
2. Pediatric Cart
§ The Pediatric Emergency Cart is a nine
drawer, multi-color coded cart. It
contains items that are specific for the length of each child, with the
exception of common medications in two drawers.
C. EXCHANGE PROCEDURE
1. Anytime the Emergency cart is entered,
the integrity seal must be broken. A broken seal signals the need to exchange
the cart. If the Pharmacy green seal is broken, a yellow seal will be placed on
the drawer prior to the cart being transported. The yellow lock is located in
the pharmacy drawer, but is replenished by CSS.
2. Immediately after the cart is used,
the staff on the unit must put a patient label on a Charge Ticket located on
top of the cart. Remove all disposable used
items and papers before locking the drawers, then return the used cart to CSS
and exchanges it for a checked, sealed cart.
3. At the time of exchange, a crash cart
receipt slip is signed by both the representative from the unit and a CSS
technical staff employee. One copy stays
with the cart and one stays in CSS.
D. REPLENISHING THE
EMERGENCY CART
1. CSS
inspects the used cart for all non-drug supplies used.
a. Missing items are replaced and charged
on the Patient Charge Ticket.
b. All items are checked for
deterioration, expiration dating and usability. Un-useable items are replaced.
c. Items that will expire within three
months are replaced unless no items with longer dating are available.
d. All equipment on the cart is checked
to assure that it is in working order.
e. All items replaced are logged on the
Crash Cart Check Sheet.
f. A Cart Inspection Card is placed on
the top of the cart stating when the cart was checked and by whom.
2. The cart is then transported to the
hospital pharmacy. The previous inspection card is left on the cart with an
"X" on it as well as the new inspection card.
a. The pharmacy staff will inspect all
drugs on the cart. A copy of the cart check sheet is used for this purpose.
b. Missing drugs are replaced and charged
on the patient charge ticket.
c. Drugs that are deteriorated or within
three months of the expiration dating will be replaced.
d. When the above has been completed, a
pharmacist signs and dates the inspection card. If a pharmacy student or
technician checks the cart, a pharmacist must certify the check at this point.
e. In addition, the pharmacist lists the
drug with the earliest expiration date on the inspection card.
f. The pharmacist seals the cart with a
green seal.
g. The old inspection card and the cart
check sheets are filed.
3. The sealed cart is
returned to the CSS for final processing.
a. The cart is given an expiration date
that corresponds to the earliest expiration date for either a drug or supply
item.
b. The inspection card is affixed to the
top of the cart.
E. CART INSPECTIONS
1. All standardized crash carts will be
checked monthly for dating and integrity by pharmacy during quality assurance
rounds.