Crash Cart Medications

and Management
By: Mercy Macli-ing
KSMC CRASH CART
 OBJECTIVES:
• To identify what the crash cart consist of.
• To know the different types of medications
present inside the crash cart.
• To know the maintenance of crash cart.
 What is a CRASH CART?

• -isa set of drawers on wheels and is used in hospital

emergency rooms for transportations and dispensing
of emergency medications or equipment's at site of
medical or surgical emergency for LIFE SUPPORT
PROTOCOLS (DPP-RAD-006-V4)
 PURPOSES of a CRASH CART:
• To provide immediate access to supplies and medications.
• To facilitate coordination of emergency equipment's.
• To ensure a properly stock crash cart will be readily available.
• To ensure a properly functioning defibrillator will be readily available.
• To save the valuable time at the time of emergency.
Contents of the Crash Cart Trolley
TOP : MEDICATIONS
 Crash Cart Medications:
Amniodarone: is an antiarrhythmic medication used to treat and prevent a number of types of cardiac
dysrhythmias.
For refractory pulseless VT/VF
• 5mg/kg rapid
• 300mg IV/IO, over 3 mins.(dilute in 20-30ml) *Monitor ECG and BP
• For per fusing tachycardia
• Loading 5mg/kg over 20-60 mins.
• Max 15mg/kg/day IV
• Should be diluted by D5W
 ATROPINE SULFATE
• is a prescription medicine used to treat the symptoms of low heart rate (bradycardia),
reduce salivation and bronchial secretions before surgery or as an antidote for
overdose of cholinergic drugs. Atropine may be used alone or with other medications.
• Anticholinergic
• PEA- 0.5-1mg IV push
• Repeat at 3-5 mins
• Total dose: .04mg/kg
• May be given endotracheal route
 Calcium Chloride
• 10% (10ml) Prefilled
• For symptomatic hypocalcemia, hyperkalemia and calcium channel
blocker overdose.
• Preferably administer via a central venous catheter because of the risk of
sclerosis or infiltration with a peripheral venous line
 Glucose

• D 50% (50 ml) IV vial

• indicated in the treatment of insulin hypoglycemia
 Check blood glucose concentration during and after arrest.
 Dobutamine and Dopamine
• 2-20mg/kg/min
• Adrenergic effect at higher doses
Dopamine: 200mg, 40mg/5ml
Dobutamine: 250mg/ml 20 ml vials (2)
 EPINEPHRINE
Adrenergic agent, choice for cardiac arrest, vasoconstrictor
Uses:
• In pulseless VF, VT, asystole and PEA
• Dose: 1mg IV or IO every 3-5 mins.. May be given via endotracheal
route.
• Stock: 1mg/10ml 1:10,000 (10ml Prefilled syringe)
 NOREPINEPHRINE
Vasopressor
To support BP after return to spontaneous circulation.
Prefer IV infusion of 4mg/250ml. Initial Dose is 2-12mcg/min (7.5-
45ml/hr) and titrate to a adequate BP.
Monitor urine output, adequate hydration is imperative.
 MAGNESIUM SULPHATE
Anti-dysrhythmic, V, electrolytes
Recommended for treatment of Torsades de Pointes( is a specific type of
abnormal heart rhythm that can lead to sudden cardiac arrest) V-TACH with
or without cardiac arrest.
Maybe effective for rate control in patients with atrial fibrillations with rapid
ventricular response
Give 1-2 g diluted in D5W over 5-60mins. Slower rates are preferable in the
stable patient.
 SODIUM BICARBONATE
Used in METABOLIC ACIDOSIS
Initial dose 1meq/kg IV push in compatible with Dopamine,
Norepinephrine and Amniodarone.
 PROCAINAMIDE
Medication of the antiarrhythmic class used for the treatment of cardiac
arrhythmias.
Given IV or PO with the onset of action in 10-30mins.
Loading dose: 10-17mg/kg and administered at a rate of 20-50mg/min.
 LIDOCAINE

 For treatment of Ventricular Ectopy, VT and VF

 What is Ventricular Ectopy? Ectopic heartbeats are small changes in an otherwise normal
heartbeat that lead to extra or skipped heartbeats. They often occur without a clear cause and
are most often harmless. The two most common types of ectopic heartbeats are: Premature
ventricular contractions (PVC)

 Initial Dose: 0.5-1.5mg/kg, repeat 0.5-0.75mg/kg every 5-10mins as necessary, up to a maximum

 Total dose of 3 mg/kg
 VASSOPRESSIN
 Non-adrenergic peripheral vasoconstriction or antidiuretic hormones
 Hormone that plays a key role in maintaining osmolality (the concentration of dissolved
particles, such as salts and glucose, in the serum) and therefore in maintaining the
volume of water in the extracellular fluid (the fluid space that surrounds cells).
 40 units IV push may replace 1st or 2nd dose of epinephrine to produce vasoconstriction to
increase blood flow to the brain during CPR for VF or Pulseless VT. Use epinephrine.
 To follow up in 3-5 mins. if there is no response to vasopressin.