4 Advice to Choose a Emergency medical trolley

Aug. 25, 2025

Crash Cart Management in Emergency Situations

Crash Carts

The crash cart is the commonly used term to describe a self-contained, mobile unit that contains virtually all of the materials, drugs, and devices necessary to perform a code. The configuration of crash carts may vary, but most will be a waist high or chest high wheeled cart with many drawers. Many hospitals will also keep a defibrillator and heart monitor on top of the crash cart since these devices are also needed in most codes. Since the contents and organization of crash carts may vary, it is a good idea for you to make yourself aware of the crash cart that you are most likely going to encounter during a code.

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What is in a crash cart?

The size, shape, and contents of a crash cart may be different between hospitals and between different departments within the same hospital. For example, an adult crash cart is set up differently than a pediatric crash cart or crash cart on the medical service may be different than the one on a surgical service.

Medications

Medications are usually kept in the top drawer of most crash carts. These need to be accessed and delivered as quickly as possible in emergent situations. Therefore, they need to be available to providers very easily. The medications are usually provided in a way that makes them easy to measure and dispense quickly.

The common set of first drawer medications might be:

Alcohol swabs
Amiodarone 150 mg/3ml vial
Atropine 1mg/10 ml syringe
Sodium bicarbonate 50mEq/50 ml syringe
Calcium chloride 1gm/10 ml syringe
Sodium chloride 0.9% 10 ml vial Inj. 20 ml vial
Dextrose 50% 0.5 mg/ml 50 ml syringe
Dopamine 400 mg/250 ml IV bag
Epinephrine 1 mg/10 ml (1:10,000) syringe
Sterile water
Lidocaine 100 mg 5ml syringes
Lidocaine 2 gm/250 ml IV bag
Povidone-Iodine swabstick
Vasopressin 20 units/ml 1 ml vial

If the crash cart also contains pediatric medications these may be contained in the second drawer. Often these would include:

Atropine 0.5 mg/ 5 ml syringe
Sodium bicarbonate 10 mEq/10 ml syringe
Saline flush syringes
Sodium chloride 0.9% 10 ml flush syringe

The second drawer of the crash cart might also contain saline solution of various sizes like 100 mL or 1 L bags. A crash cart in the surgery department may include Ringer’s lactate solution.

Intubation

Many crash carts will also include most of the materials necessary to perform intubation. These may be contained in the third or fourth drawers depending on the setup of the particular crash cart.

The adult intubation drawer will contain:

Endotracheal tubes of various sizes
Nasopharyngeal and perhaps oropharyngeal airways
Laryngoscope handle and blades of different sizes
A flashlight with extra batteries
A syringe of sufficient size to inflate the cuff on it endotracheal tube
Stylets
Bite block
Tongue depressors
Newer setups may also include the materials needed to start quantitative waveform capnography like a nasal filter line

Pediatric intubation materials may be in a separate cart or if they are included in the adult crash cart they may occupy their own drawer. The pediatric intubation supply drawer may contain the following:

2.5 mm uncuffed endotracheal tube
3.0 mm – 5.5 mm microcuff endotracheal tubes
Pediatric Stylet (8 Fr)
Neonatal Stylet (6 Fr)
Nasopharyngeal and perhaps oropharyngeal airways,
Laryngoscope blades
Disposable Miller blades
Disposable Macintosh blades
Armboards of various sizes
Vacutainers for blood collection
Spinal needles
Suction catheters of various sizes
Bone marrow needles of various sizes
Feeding tubes
Umbilical vessel catheter
Disinfectants (swab sticks)
Pediatric IV kits

Intravenous lines

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It is usually the case that the equipment necessarily to start an IV is in a separate drawer from materials needed to maintain an IV, such as the fluids in the tubing. The IV drawer(s) usually contain the following:

IV Start Kit
Angiocatheters 14 Ga and/or 16 Ga
Disinfectants (Chloraprep, Betadine, povidone-iodine)
Luer lock syringes of various sizes
Tourniquet tubing
Insyte autoguards of various sizes
Vacutainers
- Blue top
- Purple top
- Green top
- Red top
- Spinal needles of various sizes
- Regular needles of various sizes
- 3-Way stopcock
- Tape
- Armboards
- ABG syringes and sampling kits
- Catheter tips
- Tubing
- IV solutions may also be kept in this drawer

Procedure drawer

The bottom drawer on crash carts is usually devoted to keeping prepackaged kits available for various urgent and emergent procedures (or it is where the IV solutions are kept). In any case, the following kits may be found in the procedure drawer:

4 Things to Know When Choosing Portable Suction for Crash Carts

As a nurse, you know what to expect to find in a crash cart. From the defibrillator to the IV supplies to the resuscitation medications, everything in the cart has its specific place and purpose. The consumable supplies are restocked after they are used, and the durable medical equipment is properly cleaned so that it is ready to use for the next code.

However, as time goes on, even durable medical equipment will begin to show its age and will need to be replaced with newer and better technology. Your portable suction machine is one example of this. Let’s examine what things you should consider when choosing a new portable suction for your crash cart.

Codes can occur anywhere

Do most codes occur at an existing patient’s bedside? Yes. Do they only occur there? Absolutely not.

The suction machine on your crash cart gives you the ability to clear a person’s airway at any location within the hospital. So when a visitor in the cafeteria goes unconscious or newborn turns blue while en route to the newborn nursery, your portable suction machine can be quickly brought to that location. In the medical world, we know that every second counts. Make sure that your new suction machine is lightweight and easy to transport.

In-wall suction isn’t foolproof.

Sometimes, we tend to overlook the suction machine on the crash cart because we are used to having in-wall suction in our patients’ rooms. But have you ever needed suction in an emergency, only to find that the in-wall suction was not properly set up? Or, even with things set up as they should be, have you ever noticed that the vacuum pressure was too low or non-existent? Unfortunately, in-wall suction isn’t foolproof, either as a result of user-error or system failure.

In these circumstances, a portable suction machine can act as a back-up. As part of the daily crash cart checks, your portable suction machines should be assessed to make certain they are properly charged and have the necessary supplies. That way, with the flip of a switch, your suction machine is ready to go.

Your suction may need to travel with the patient.

What if your patient needs to be transported to the ICU after the code, or the unconscious visitor from the cafeteria needs to be brought to the ER? Some portable suction machines are designed to easily hang from the side of the hospital bed or stretcher. When purchasing a machine with this ability, you can keep your patients safe knowing that suction will be available if needed during transport.

Portable suction machines should be easy to use.

Often, nurses and other health care providers may feel intimidated when it comes to using a portable suction machine and worry that it will take them too long to “figure it out.” However, the machines of today are becoming increasingly intuitive. Look for a machine with clearly marked switches and gauges. You want a machine that feels quick and easy to operate.

You may not use your portable suction machine during every code, but when you do, you want to have a machine that you can rely on to keep your patients safe. Spend some time thinking about the ways that you will use portable suction on your crash cart, and be sure your new units meet those needs.

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