Section 6.310 Emergency Cart Checklist - Outpatient Surgery ...
Section 6.310 Emergency Cart Checklist - Outpatient Surgery ...
Section 6.310 Emergency Cart Checklist - Outpatient Surgery ...
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Crash <strong>Cart</strong> Drawer-by-Drawer Breakdown<br />
Courtesy, Dan Simonson, CRNA, MHPA, Spokane Eye <strong>Surgery</strong> Center<br />
June, 2011<br />
<strong>Section</strong> <strong>6.310</strong><br />
<strong>Emergency</strong> <strong>Cart</strong> <strong>Checklist</strong><br />
Date and Initial:<br />
Top: LifePack 7/Defib-Monitor or<br />
AED/ Aqueous Gel<br />
Blue Ambu Bag & Mask<br />
O2 Cylinder Pressure Over 600 PSI<br />
Tank #1 post op<br />
Tank #2 laser area<br />
Side: CPR Board<br />
Algorithm Large Cards<br />
Drawer 1: EKG Pads/Aqueous Gel<br />
Stethoscope/ BP Cuff<br />
Drawer 2: Masks(Green, Yellow,<br />
White)<br />
Microshield<br />
O 2 Mask with Tubing<br />
Drawer 3: Medications:<br />
Lock # -><br />
Syringes 1,3, & 5cc (4ea)<br />
Adenosine (Adenocard) 6mg/2mL (3ea)<br />
Albuterol Inhaler 8.5g<br />
Albuterol (Diluted for Nebulizer)<br />
Aminophylline 500 mg / 20 ml<br />
Amiodarone HCl (Cardarone) 150<br />
mg/3 ml (3ea)<br />
Atropine Sulfate 0.4 mg/ml<br />
Calcium Chloride 1.36 mEq/ml<br />
Diphenhydramine (Benadryl)<br />
50mg/1mL (3ea)<br />
Epi 1:10,000 Abboject (2ea)<br />
Ephedrine 50 mg/mL (3ea)<br />
Esmolol (Brevibloc) 100 mg/10ml<br />
(3ea)<br />
Flumazenil (Romazicon) 0.1 mg/ml<br />
Furosemide 10mg/mL<br />
Heparin 1000 u/ml<br />
Hydralazine HCl 20mg/mL<br />
Labetalol HCl (Normodyne) 5 mg/ml<br />
Magnesium sulfate 0.5 gm/1 ml<br />
Naloxone (Narcan) 0.4mg/mL<br />
Phenytoin (Dilantin) 100mg/2mL<br />
KCl 20 mEq/ml<br />
Procainamide HCl 100mg/ml<br />
Propanolol 1mg/ml<br />
Vasopressin 20 u/ml (3ea)<br />
Pediatric Diphenhydramine<br />
Reviewed:12/94,4/97,6/98,6/99,10/99,12/99,9/00,11/01,2/02,8/02,4/03,1/04,5/04,5/05, 4/06,2/11<br />
Located in the Crash <strong>Cart</strong> Binder<br />
Revised:12/95,4/97,6/98,10/99,12/99,2/02,10/02,1/04,5/04, 5/05,4/06,2/07, 4/08,2/11 Reference <strong>Section</strong> <strong>6.310</strong>
(Benadryl) 12.5 mg/5mL (liquid)<br />
Epi Pen Adult 0.3 mg<br />
Epi Pen Children’s 0.15 mg<br />
50% Dextrose 25g/50ml<br />
SodiumBicarb 4.2g 50 ml Abboject (1ea)<br />
Glucagon 1mg<br />
2%Lidocaine HCl abboject 20mg/mL<br />
Lidocaine 2 g 500mL bag<br />
Drawer4: Laryngoscope handle (2)<br />
Blades: Miller #1, #2<br />
Blades: Macintosh #3, #4<br />
Tongue Blades<br />
Malleable Stillette (1 Ped, 1 Adult)<br />
Magill Forceps<br />
Oral Airways: 100mm<br />
80mm<br />
60mm<br />
Nasal Airways: 28F, 30F<br />
32F, 36F<br />
Silk Tape<br />
Nu-Trake Set<br />
Spare Laryngoscope Bulbs<br />
Drawer 5: (Adult and Pediatric)<br />
Endotracheal Tube Sizes:<br />
4, 4.5mm<br />
5, 5.5mm<br />
6, 6.5mm<br />
7, 7.5mm<br />
8mm<br />
Trach Tube Sizes: 6, 7, 8, 9<br />
Drawer 6: Nasal Cannula (12ea)<br />
Oxygen Tubing (5ea)<br />
EKG tape<br />
Drawer 7: IV set-up:<br />
10cc Syringes (5 ea)<br />
5cc Syringes (4 ea)<br />
20 Gauge 1 ½ in Needles (10ea)<br />
Lifeshield Blunt Needles<br />
Macrodrip IV Sets (2ea)<br />
Microdrip IV Sets (2ea)<br />
18ga Catheters (2 ea)<br />
20ga Catheters (5 ea)<br />
22ga, 24ga Catheters (2 ea)<br />
Heparin Locks (3ea)<br />
500ml NaCl<br />
Tape (1 Plastic, 1 Paper)<br />
Tagaderm Dressings<br />
Tourniquet (Latex Free/ Regular)<br />
Filter Needles<br />
Normal Saline Syringes (5ea)<br />
Needleless Vial Adapter (3ea)<br />
Drawer 8:<br />
88/86<br />
Reviewed: 12/93,5/94,2/95,4/96,6/98,6/99,10/99,12/99,9/00,11/01,2/02,4/03,1/04,5/05,4/06,2/11<br />
Revised: 12/93,4/96,10/99,12/99,2/02,1/04,5/05,4/06, 2/07, 6/07, 4/08,2/11 Reference <strong>Section</strong> <strong>6.310</strong>
Suction Catheters #18 F (10ea)<br />
Suction tubing (4ea)<br />
Pediatric Paddles<br />
Airlife Nebulizer (2ea)<br />
Check Eye Wash Stations<br />
88/86<br />
Reviewed: 12/93,5/94,2/95,4/96,6/98,6/99,10/99,12/99,9/00,11/01,2/02,4/03,1/04,5/05,4/06,2/11<br />
Revised: 12/93,4/96,10/99,12/99,2/02,1/04,5/05,4/06, 2/07, 6/07, 4/08,2/11 Reference <strong>Section</strong> <strong>6.310</strong>
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