Technical Bulletin

Crash Carts &Accessories
Introduction ..........................................................................2
Organization, Control, Security and Accountability ........2
Site Specificity ......................................................................2
How to Improve Organization and Efficiency....................2
1. Crash Cart Drawer – Trays and Boxes ..........................3
2. Drawer Dividers ................................................................3
3. Foam Inserts ......................................................................3
4. Labels, Magnets, Clings and Label Overlays ................4
5. Drug/Supply Expiration I.D. Tags ...................................5
6. Security Seals and Bags....................................................5
7. Cart Attachments – Oxygen Tank Brackets,
Ambu Bag Holder, Cart IV Pole, ......................................
Monitor/DefibrilatorShelf, And Emergency Supplies ..
Dispenser ........................................................................6-7
8. Wheeled Supply Case and Mobile Storage System....7
Summary ................................................................................8
INTRODUCTION
As one peruses the literature on crash
carts one finds articles on design,
supply, restocking, hospitalwide
programs and exchange programs,
and the list goes on and on. One thing
that stands out in a literature review
of this area is that there are as many
different ways of approaching crash
carts as there are institutions and
facilities that have them.
As a result, customization and
flexibility are key factors in the supply
of crash carts and their corresponding
accessories.
This technical bulletin will focus on
the variety of crash cart accessories
that are available through HCL to
allow for complete site-specific design
and customization of a crash cart.
ORGANIZATION,
CONTROL, SECURITY &
ACCOUNTABILITY
Organization should be the primary
concern of those responsible for
creating a site-specific crash cart
system. An organized crash cart can
be reassuring in the throes of a code
situation when time is of the essence
and lives are at stake.
As a pharmacist assuming the
responsibility for the disposition of
all drugs in the institution, control,
security and accountability also
become factors.
Factors of control, security and
accountability that pharmacy should
integrate into a crash cart exchange
system are:
i. the drugs on the cart are those that
are needed
ii. assuring the crash cart is properly
stocked at all times
iii. that all drug products have good
dating
iv. the drugs on the cart are secure
and protected from pilferage
v. replenishment is completed quickly
after cart is used
vi. charges for drugs used are
captured
vii.personnel that have accessed the
cart are identified
SITE SPECIFICITY
Even though the ideal is to
standardize crash carts within the
institution so that no matter which
crash cart is used the medications and
supplies would always be in the same
location, this ideal is difficult at best
to achieve.
J ust as different institutions have
different and varying needs for the
composition of drug products on a
crash cart, differences can exist
throughout the various departments
within the same institution.
The crash cart on the pediatric unit
will differ from that which is on a
general med-surg unit versus that
which is in labor and delivery.
Again, there is a need for flexibility
and customization.
HOW TO IMPROVE
ORGANIZATION AND
EFFICIENCY
Improving crash cart organization and
efficiency can be achieved through the
use of a wide variety of accessories
that aid in customization and
flexibility.
The remainder of this technical
2
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com
bulletin will focus on various
categories of accessories that can be
utilized to improve organization and
efficiency.
They are:
1. Crash Cart Drawers - Trays and
Boxes
2. Drawer Dividers
3. Foam Inserts, Self Customizable,
and Custom Cut
4. Labels, Magnets, Clings and Label
Overlays
5. Drug/Supplies Expiration I.D. Tags
6. Security Seals and Bags
7. Cart Attachments, Holders, and
Brackets
1. CRASH CART
DRAWER — TRAYS
AND BOXES
• Crash cart boxes are available in full
and half drawer sizes with handles
that make for easy placement and
removal. They are used to organize
medications and supplies in the
drawer. Being modular they allow for
easy removal and easy access during
a “code” situation as well as during
the replenishing of stock. They
provide the pharmacy with the
flexibility necessary to develop a
workable system of replenishment
and exchange.
• These crash cart boxes are sized to
fit the majority of the crash carts
used in institutions today.
• See-thru lids can be added to the
box to contain and secure its
contents.
• Lids are available in both a clear
plastic or amber plastic.
• The amber plastic lid meets USP
specifications for light resistance
and is used in situations where light
sensitive drugs are stocked on the
crash cart.
• Lids and boxes have security holes
to accommodate security seals.
• The security seals prevent pilferage,
maintain control and serve as
indicators of use when seal is broken
flagging the pharmacy to replenish
products.
2. DRAWER DIVIDERS
• To further enhance crash cart
drawer organization, plastic drawer
dividers are available for shallow
and deep cart boxes. The dividers
are grooved so they can be
interlocked to provide a stable and
secure fit. They allow uniformity of
layout in the boxes.
• Divider sets can be measured and
cut to fit any crash cart box when
customizing box layout. Cutting
templates as well as a retractable
knife are available to facilitate the
customization process.
• Divider sets are available in a variety
of sizes; for shallow or deep crash
cart drawers; with scored
interlocking grooves or plastic strips
with bendable clips.
• They provide a simple and
economical means to organize
drawers, boxes or trays or other
work area.
3. FOAM INSERTS
• J ust as plastic drawer dividers
enhance crash cart organization a
more permanent customization
solution can be achieved by using
foam inserts. These inserts are
available in both full and half crash
cart box sizes.
• The foam inserts are thick foamed
blue polyurethane. They can be cut
to accommodate any size or shape
medication container. They are
attached to the drawer, box or tray
with a special two-sided tape.
Securing the foam insert in this
manner prevents movement and
provides stability. If the foam
becomes soiled it can easily be
removed and replaced.
3
• The foam inserts can be cut to
specification in the pharmacy. For
convenience a “Pinch & Pull” pre-
scored foam grid pad is available.
Customization can be achieved by
simply pulling out the removable,
pre-scored 1/2” cubes until the
desired area is exposed

• A even more convenient method for
utilization of foam inserts is custom
cut-foam. A layout with dimensions,
shapes and labeling is provided by
the pharmacy. A computer drawing
of the layout is made and approved
by the pharmacy. Upon final
approval, dies which are designed
for each shape and size, are pressed
into the foam to cleanly cut and form
the custom foam insert. Optional
labeling overlays are available so
that each foam cutout is labeled with
a description of the product
intended for the cutout space. This
method provides the ultimate in ease
and customization. The inserts come
to the pharmacy cleanly pre-cut to
meet site specific crash cart needs.
Stock designed dies are available in a
variety of shapes and sizes to
accommodate ampules, vials,
syringes and boxes. If special shapes
are needed, custom dies can be
designed for an additional charge.
4. LABELS, MAGNETS,
CLINGS, AND LABEL
OVERLAYS
• Labels are an important adjunct
in the layout and organization of a
crash cart. Labels aid the health
personnel that use the cart to find
items they need quickly and
efficiently in a time of great urgency.
Labels, Magnets, and Clings can
be used to:
• designate that the cart is a crash
cart or emergency cart
• label the various drawers of a
crash cart as to contents (i.e.,
medications, sterile supplies,
equipment and/or Drawer 1,
Drawer 2, etc)
• classify particular sections of a
drawer
• identify the particular items in
the drawer to speed handling
and minimize picking errors
• serve as an indicator as to what
needs to be placed in a drawer
during the restocking task
4
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com
5
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com
• Custom overlays are available that
can be placed over pre-cut foam
inserts used in a tray or box as
described above. They provide a
pre-labeled template that identifies
the drug or supply item that
corresponds with the designated
opening used to hold or secure the
drug or supply item in the box or
tray. They can be a standard black
on white label or color-coded.
5. DRUG/SUPPLIES
EXPIRATION I.D.
TAGS
•Identification tags fit most types of
security seals or fit into self adhesive
pockets to quickly identify the first
drug or supply to expire in a cart,
box, drawer, etc. Two styles of tags
are available: Blank - tags are
completely blank to print your own
information by hand or with a laser
printer
Pre-Printed - These tags are pre-
printed with First Drug/Supply to
Expire and a date line. They are
designed for the nurse or pharmacist
to print or write their drug or supply
information.
6. SECURITY SEALS
AND BAGS
• For crash cart security and
accountability, plastic security seals,
padlock seals and plastic security
bags are available for use. These
items can be integrated into an
institutions’ crash cart exchange
system to prevent pilferage, promote
user accountability, indicate that a
cart is stocked and ready or needing
to be restocked.
• The plastic security seals are one-
piece self-locking units that can be
purchased sequentially numbered or
un-numbered (plain). They are easy
to use and have multiple locking
positions to accommodate most
applications. They are large enough
to permit writing of verification
information (e.g., date, time, initials,
etc). These tamper-evident seals
allow for quick access to the
contents of a tray, box or drawer as
they can be easily broken by hand.
Once the seal is broken, it is evident
that the unit was used and flags the
pharmacy to restock. The plastic
security seals can be integrated into
cart exchange programs in a variety
of ways to mesh with each particular
institutions’ protocols.
•The barrel design on the HCL Pull
Tight Seal is designed to fit into the
holes in the crash cart box lids.This
keeps the seal tucked away so that
the cart drawer can easily open and
close without the seal being in the
way. It also allows numbers on seals
to be easily identified.
• Padlock seals are another useful
device used to secure crash carts or
small emergency medication boxes.
These are also self-locking seals that
resemble small padlocks and are
available in colors and sequentially
numbered. Integrated into a crash
cart or narcotic control system they
provide a heightened level of
security and accountability.
• Crash cart security bags are plastic
bags that slip over and seal crash
cart boxes or trays. They secure the
contents of the box or tray and
provide a level of tamper resistance.
They are easily opened during a
code situation by tearing at a
perforation. Once opened they
indicate usage and need for
restocking or possible pilferage.
7. CART ATTACHMENTS:
OXYGEN TANK
BRACKETS, AMBU
BAG HOLDERS,
CART IV POLES,
EMERGENCY
SUPPLIES DISPENSER,
AND MONITOR/
DEFIBRILATOR SHELF,
•Cart attachments in the form of
holders and brackets can be affixed
to a crash cart to accommodate
larger items such as oxygen tanks
and resuscitating devices.
They usually have adjustable straps
or velcro closures to securely
tighten and hold various sizes of
bags, tanks or equipment. Integrated
into a crash cart system they allow
for a new level of emergency
equipment to be stocked on the cart.
• Often ambu bags are hung from IV
poles and are not secured. The
Ambu Bag Holder offers a convenient
and secure way to store your ambu
bag.
The IV pole provides two storage
hooks for IV bags, eliminating the
need for a doctor or nurse to hold
bags when they could be assisting in
another area. The pole can be
adjusted to different heights.
6
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com
The bag holder can be
closed and easily sealed
with a breakaway security
seal.
•The Emergency Supplies Dispenser
is designed to hold emergency
supplies such as resuscitation
equipment, CPR masks, and tubing
for quick access. It can be mounted
on carts, walls, counters, or any
where supplies and equipment are
needed quickly. The dispenser can
be closed and easily sealed with a
breakaway security seal.
•The Monitor/Defibrilator Cart Shelf
features a swing arm which moves
the monitor/defibrilator without
moving the cart. A hook and loop
closure strap can be adjusted to fit
different monitors and
defibrilators. The Swing Arm
Monitor/Defibrilator Shelf attaches
to most carts with 4 screws. Screws
are included.
8. MOBILE STORAGE
SYSTEM AND
WHEELED SUPPLY
CASE AS
INTERMEDIATE
CRASH CARTS
•Portable units can be used as
intermediate type crash carts and as
a second back up. Their compact
size allows them to be used for ACLS
systems in physicians offices and for
transport to remote locations.
•The Mobile Storage System is a
portable storage station that
transports larger quantities of
supplies and equipment needed by
medical workers in the field or in
supply areas. Zippered pockets and
pantry doors can be secured with a small
padlock or security seal. The system
has a long metal telescoping handle
and two 5" (127mm) diameter wheels
to push or pull with ease.
•The Wheeled Supply Case provides
portable storage for equipment and
supplies. A telescoping aluminum
handle and two rubber wheels allow
pushing or pulling with ease. The
inside of the tote has a padded cloth
interior and a removable hook and
loop liner with removable shelf. The
interior and liner protect supplies
and equipment during transport. The
shelf allows equipment and supplies
to be divided for product safety or
organization. Pouches, pockets, and
the front door on the case can be
secured with a small padlock or
security seal.
7
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com
SUMMARY
• Establishing an efficient crash cart
exchange program is a major
responsibility of the pharmacy. It
needs to be done in conjunction with
those personnel (nurses and
physicians) that will be utilizing the
system and designed with them in
mind. It needs to be well organized
and managed. All personnel involved
with its use need to be well trained
on its proper use.
• The program needs to be well
organized so that all elements of
control, security and accountability
are maintained to assure that any
emergency situation can be dealt
with efficiently and quickly in order
to save lives.
• This technical bulletin touched on
many of the elements of an efficient
crash cart exchange program. It
attempted to inform as to the many
organizational and control
accessories that are available to
build in efficiency.
• If after reading this you have need
to understand any of the items
discussed above or would like to
purchase them, please direct your
attention to the latest Health Care
Logistics catalog or talk to one of
our informed Customer Service
Representatives.
8
Call Free 1 800 848 1633 or 888 HCL INTL
®
(425 4685) • Fax Free 1 800 447 2923
International Call 740 477 1686
• International Fax 740 477 2923
• Web site http://www. hcl-intl. com
• E-mail: HCL@hcl-intl. com

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