Guideline

Meets the National Safety and Quality Health Services Standards (NSQHSS)
1. Clinical governance. 2. Partnering with consumers. 3. Preventing and controlling healthcare associated infections. 4. Medication safety. 5. Comprehensive care.
6. Communicating for safety. 7. Blood management. 8. Recognising and responding to acute deterioration

Rural and Remote Emergency

Services Standardisation Guideline:
Resuscitation trolley
This guideline is applicable state-wide

QH-GDL-962-4:2020
Custodian: Executive Director Rural and
Remote Clinical Support Unit
Version no: 3.2
Applicable to: Rural and remote health
care facilities throughout Queensland
with Emergency Services that have been
assessed as Level 1 or Level 2 services
(or adapted for use by higher level
facilities in Queensland and interstate
jurisdictions on advice of local health
services) under the Clinical Services
Capability Framework Version 3.2
(2014).
Approval Date: May 2020
Effective Date: May 2020
1. Purpose
This Guideline provides recommendations regarding best practice
for standardisation of resuscitation equipment in all rural and remote
health care facilities throughout Queensland with Emergency
Services that have been assessed as Level 1 or Level 2 services (or
adapted for use by higher level facilities in Queensland and
interstate jurisdictions on advice of local health services) under the
Clinical Services Capability Framework Version 3.2 (2014).
With a mobile workforce, standardisation promotes consistency of
evidence based practice and benefits patient outcomes and safety.
The resuscitation trolley content configuration follows the airway,
breathing and circulation format complemented by emergency
procedural kits for advanced and interventional treatments.

Next review date: June 2021 This guideline is aligned to the Australian Resuscitation Council,
Authority: A/Deputy Director-General Basic Life Support (BLS) and Advanced Life Support (ALS)
Approving Officer: Professor Keith
Principles.
McNeil
Paediatric resuscitation requirements differ significantly from adults.
Supersedes: Rural and Remote
Emergency Services Standardisation
The resources and guidelines from Children's Health Queensland
Guideline – Resuscitation trolley v3.1 Hospital and Health Service are available from:
https://qheps.health.qld.gov.au/childrenshealth/html/lcch/met
Key Words:
guideline, rural, remote, emergency,
services, standardisation, resuscitation,
trolleys 2. Scope
This Guideline provides information for all Queensland Health
employees (permanent, temporary and casual) and all organisations and individuals acting as its
agents (including visiting Medical Officers and other partners, contractors, consultants and volunteers)
working in rural and remote health care facilities throughout Queensland with Emergency Services that
have been assessed as Level 1 or Level 2 services (or adapted for use by higher level facilities in
Queensland and interstate jurisdictions on advice of local health services) under the Clinical Services
Capability Framework Version 3.2 (2014).

Printed copies are uncontrolled

Effective from: [May 2020] Review date: [June 2021] Version: [3.2] Page 1 of 10
3. Related documents
• Clinical Services Capability Framework Version 3.2 (2014). Available from:
https://www.health.qld. gov.au/clinical-practice/guidelines-procedures/service-delivery/cscf
• Health (Medications and Poisons) Regulation 1996. Available from:
https://www.legislation.qld.gov.au/view/html/inforce/current/sl-1996-0414
• The Australian Resuscitation Council suite of emergency protocols. Available from:
https://resus.org.au

4. Procedures, guidelines and protocols

• Rural and Remote Emergency Services Standardisation Guideline – Emergency equipment
• Rural and Remote Emergency Services Standardisation Guideline – Emergency procedural
kits
• Rural and Remote Emergency Services Standardisation Guideline – Emergency response
pack
• All procedures, guidelines and protocols are available from:
https://www.health.qld.gov.au/rrcsu/html/rress

5. Forms and templates

• Checklist – Resuscitation trolley contents
• Checklist – Procedural kits contents
• Checklist – Emergency response pack contents
• Ordering forms – Resuscitation trolley
• Ordering forms – Procedural kits
• Ordering forms – Emergency response pack
• All forms and templates are available from: https://www.health.qld.gov.au/rrcsu/html/rress

6. Guideline for Rural and Remote Emergency Services

Standardised - Resuscitation trolley
Resuscitation trolley choice and maintenance
The resuscitation trolley should be configured with five (5) clearly labelled
drawers configured as follows:

Drawer Description
A Airway
B Breathing
C Circulation
D Drugs
E Extras

It is the responsibility of each Hospital and Health Services (HHSs) jurisdiction

to determine compliance or alteration to the resuscitation trolley taking into
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 consideration fiscal impacts of items e.g. disposable items versus items
requiring sterilisation.
The contents and layout of the Resuscitation trolley should be established,
maintained and restocked immediately after use as per Appendix A.
Resuscitation trolley for rural and remote emergency services – Basic contents
in each rural and remote health care facility governed within the local HHS.
The resuscitation trolley should be easily accessed by all staff in a designated
emergency area.
Airway and breathing support procedural kit
The Airway and breathing support emergency procedural kit is a vital part of the
equipment required for resuscitation and must be located:
within close proximity to the Resuscitation trolley OR
on/in the resuscitation trolley
The resuscitation trolley and the Airway and breathing support emergency
procedural kit should be easily accessible by all staff in a designated
emergency area.
Quality assurance and maintenance
All contents contained within the resuscitation trolley are supported by evidence
based best practice at time of signed approval.
Local alteration, but not removal, of resuscitation trolley contents is acceptable
after:
consultation and approval by the local HHS Director of Medical Services
and
consultation and approval by the local HHS Quality, Safety and Risk unit
Resuscitation trolley contents will vary according to current local HHS Standing
Offer Arrangements (SOA) for clinical resources.
Resuscitation trolley checking requirements:
the facility clinical manager should assign responsibility to an appropriate
clinician in each facility to check, maintain and stock all resuscitation trolley
equipment and medications
the clinician assigned responsibility should check the resuscitation trolley at
least daily
checking of resuscitation trolleys any less than daily should be
accompanied by risk management documentation
if equipment is not present or within date, then replace immediately
the signature of the person conducting the checking verifies items are
present, charged (if applicable), functional and are within product expiry
dates
Resuscitation trolley audit requirements:
the facility manager should conduct 6 monthly audits of the Resuscitation
trolley checklist for compliance
any anomalies should be addressed and accompanied by risk management
documentation
any anomalies requires audits to be undertaken monthly for a minimum of 3
months or until compliance has been restored
the resuscitation trolley contents must be consistent with the Appendix A.
Resuscitation trolley for rural and remote emergency services – Basic
contents
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 The Hospital and Health Service Quality, Safety and Risk Unit should regularly
audit all rural and remote facilities under their jurisdiction.
Medication compliance
Facility managers must ensure the storage of resuscitation trolley medications
kept in an emergency room complies with the Health (Medications and Poisons)
Regulation 1996 which requires that all Schedule 8 (S8) Controlled and
Schedule 4 (S4) Restricted medications:
are secure from public access
that signage indicates restricted public access to the area and
all staff actively monitor the approved restriction
To comply with state legislation all resuscitation trolley compartments containing
S8 or S4 medications must be secured with a single use locking tag system.
The locking tag system:
will alert clinicians to any tampering of compartments
choice is at the discretion of the governing HHS
should be easily identifiable with a serial number
should be easily removed in the event of an emergency
should be checked daily, with serial numbers recorded next to the clinician
signature
if checked less than daily, should be accompanied by risk management
documentation
Where emergency medications are available for patient intervention, facility
managers should satisfy the requirements for on-going maintenance of staff
skills, competencies and/or credentialing to ensure:
safe quality use of medications and
safe and thorough assessment skills
Safe equipment use
Where emergency equipment is available for patient monitoring and support,
facility managers should satisfy the requirements for:
on-going maintenance of staff skills, competencies and/or credentialing
safe competent operation of emergency equipment
regular calibration of emergency equipment to manufacturers specifications
regular testing of emergency equipment for functionality
where applicable, a “C” class manual drivers licence and driver training by
Queensland Ambulance Service (QAS) to ensure the clinician can drive
and operate ambulance equipment safely

7. Definition of terms
• HHSs – Hospital and Health Services.

8. References and suggested resources

• Primary Clinical Care Manual. Available from:
https://www.health.qld.gov.au/rrcsu/html/PCCM
• Clinical Services Capability Framework Version 3.2 (2014). Available from:
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/service-
delivery/cscf/about

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 • Health (Medications and Poisons) Regulation 1996. Available from:
https://www.legislation.qld.gov.au/view/html/inforce/current/sl-1996-0414
• The Australian Resuscitation Council suite of emergency protocols. Available from:
https://resus.org.au
• Queensland Health Paediatric Emergency Care. Available from:
https://www.childrens.health.qld.gov.au/chq/health-professionals/qld-paediatric-emergency-
care
• Queensland paediatric resuscitation tools. Available from:
https://www.childrens.health.qld.gov.au/qpec-paediatric-resuscitation-tools

9. Consultation
• The initiative to standardise equipment in rural and remote emergency services was
developed by an expert Project Reference Group to satisfy a coroners recommendation
following a patient safety incident.
• This review of the guideline sought expert advice from a Reference Group with broad
experience in rural and remote environments, retrieval medicine and supporting rural
networks consisting of representatives from the:
- Aeromedical Retrieval and Disaster Management Branch, (RSQ/TEMSU)
- Australasian College for Emergency Medicine (ACEM)
- Australian College of Rural and Remote Medicine (ACRRM)
- Sunshine Coast Hospital and Health Service (SCHHS)
- Central West Hospital and Health Service (CWHHS)
- North West Hospital and Health Service (NWHHS)
- Queensland Ambulance Service (QAS)
- Royal Flying Doctor Service, Queensland Section (RFDS)
- South West Hospital and Health Service (SWHHS)
- Central Queensland Hospital and Health Service (CQHHS)
- Torres and Cape Hospital and Health Service (TCHHS)
- Metro South Hospital and Health Service (MSHHS)

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10. Guideline revision and approval history

Version No. Modified by Amendments authorised by Approved by

20190717_v2.1 Sean Booth and Tazz Harding RRESS Reference Group Chair Dr Marlow Coates

20190730_v2.2 Sean Booth and Tazz Harding RRESS Reference Group Chair Dr Marlow Coates

20190814_v2.3 Sean Booth and Tazz Harding RRESS Reference Group Chair Dr Marlow Coates

20190828_v2.4 Sean Booth and Tazz Harding RRESS Reference Group Chair Dr Marlow Coates

20191218_v3.0_final Sean Booth and Tazz Harding RRESS Reference Group Dr Marlow Coates (Chair)

20200106_v3.0_final Sean Booth and Tazz Harding RRESS Reference Group Dr Marlow Coates (Chair)

20200406_v3.0_final Sean Booth and Tazz Harding RRESS Reference Group Dr Marlow Coates (Chair)

20200406_v3.1_final Sean Booth and Tazz Harding RRESS Reference Group Dr Marlow Coates (Chair)

20200406_v3.2_final Sean Booth and Tazz Harding RRESS Reference Group Dr Marlow Coates (Chair)

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Appendix A. Resuscitation trolley for rural and remote emergency
services - Basic contents

RESUSCITATION TROLLEY BASIC CONTENTS

N.B. The Airway and Breathing procedural kit is a vital part of the equipment required for resuscitation and
must be located on, or close to the resuscitation trolley. Refer to Rural and Remote Emergency Services
Standardisation Guideline – Procedural Kits available from: https://www.health.qld.gov.au/rrcsu/html/rress

MONITOR/DEFIBRILLATOR TRAY
Lifepak 12/15 monitor/defibrillator with therapy cable
attached
Battery support unit connected to Lifepak
NIBP cable attached NOTE: This equipment may be required
when responding to an emergency incident
SpO2 cable attached
outside of the facility
Quik-Combo Pads adult x 1
Quik-Combo Pads paediatric x 1
ECG/monitoring dots x 8
Scissors (trauma)
Torch (pencil)
OTHER
Sharps bin
IV pole & mount
Sphygmomanometer (manual within 2 metres of trolley)
Stethoscope (hanging on pole) x 1
Bag valve mask self-inflating with PEEP valve - infant x 1 Hanging on IV pole
Bag valve mask self-inflating with PEEP valve - child x 1 Hanging on IV pole
Bag valve mask self-inflating with PEEP valve - adult x 1 Hanging on IV pole
Goggles x 2
Calculator x 1
IV pressure bag 1 litre clear x 1 Hanging on IV pole
DRAWER A - AIRWAY
Laryngeal mask airway (2nd generation with oro-gastric suctioning port) size 1 x 1
Laryngeal mask airway (2nd generation with oro-gastric suctioning port) size 2 x 1
Laryngeal mask airway (2nd generation with oro-gastric suctioning port) size 3 x 1
Laryngeal mask airway (2nd generation with oro-gastric suctioning port) size 4 x 1
Laryngeal mask airway (2nd generation with oro-gastric suctioning port) size 5 x 1
Syringe luer tip 20 mL x 1
Nasopharyngeal airway size 6 x 2
Nasopharyngeal airway size 7 x 2
Nasopharyngeal airway size 8 x 2
Oropharyngeal airway size 000 x 1
Oropharyngeal airway size 00 x 1
Oropharyngeal airway size 0 x 1
Oropharyngeal airway size 1 x 1

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 DRAWER A - AIRWAY continued
Oropharyngeal airway size 2 x 1
Oropharyngeal airway size 3 x 1
Oropharyngeal airway size 4 x 1
Oropharyngeal airway size 5 x 1
Suction catheter size 6 x 2
Suction catheter size 8 x 2
Suction catheter size 10 x 2
Suction catheter size 12 x 2
Suction catheter size 14 x 2
Yankeur sucker x 2
DRAWER B - BREATHING
Mask paediatric Hudson O2 x 1
Mask paediatric non re-breather x 1
Mask paediatric nebuliser x 1
Mask adult Hudson O2 x 1
Mask adult non re-breather x 1
Mask adult nebuliser x 1
Nasal prongs adult x 1
Nasal prongs paediatric x 1
Nebuliser chamber x 2
O2 tubing x 1
DRAWER C - CIRCULATION
Alcohol swabs (Alcowipes) 2% chlorhexidine 70% gluconate x 10
Tourniquet paediatric x 2
Tourniquet adult x 2
Retractable IV cannula 14 g x 2
Retractable IV cannula 16 g x 2
Retractable IV cannula 18 g x 2
Retractable IV cannula 20 g x 2
Retractable IV cannula 22 g x 2
Retractable IV cannula 24 g x 2
Transparent adhesive IV dressing x 5
2.5 cm Micropore roll x 1
IV three-way tap with extension tubing x 2
Blood pump IV giving set x 2
IV burette x 1

DRAWER C – CIRCULATION continued

IV giving set x 1 Appropriate for infusion pump being used
Injection sites (bungs) x 5 Interlink Smartsite
Non-safety needle size 18 g x 5
Non-safety needle size 21 g x 5
Non-safety needle size 23 g x 5

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1 mL syringe x 5
5 mL Luer lock syringe x 2
10 mL Luer lock syringe x 5
20 or 30 mL Luer lock syringe x 5
50 mL Luer lock syringe x 2
DRAWER D - DRUGS
First line
Adrenaline 1:10,000 prefilled syringes x 5
Amiodarone ampoule 150 mg / 3 mL x 3
Aspirin 300 mg dispersible tablet sleeve x 1
Atropine sulphate 600 microg/mL ampoule x 2
Glyceryl trinitrate tablets 600 microg bottle x 1
Second line
Adenosine 6 mg / 2 mL ampoule x 6
Adrenaline 1:1000 ampoule x 10
Calcium gluconate 2.2mmol of calcium in 10mL vial x 4
Ceftriaxone 1 g vial x 2
Droperidol 10 mg / 2 mL vial x 2
Glucose 50% 50 mL vial x 1
Glucose 10% 500 mL bag x 1
Glucose gel 40% 15 g tube x 2
Glucagon 1 mg injection x 1
Glyceryl trinitrate 50 mg / 10 mL ampoule x 1
Magnesium sulfate 10 mmol / 5 mL ampoule x 2
Sodium chloride 3% (hypertonic) 250 mL bag x 1
Midazolam 5 mg / 1 mL ampoule x 5
Naloxone hydrochloride 0.4 mg ampoule x 2
Metaraminol 10 mg / 1 mL ampoule x 5
Noradrenaline 2 mg / 2 mL ampoule x 3
Levetiracetam 500 mg / 5 mL x 3 vials
Sodium bicarbonate injection 8.4% 100 mL vial x 1
Sterile water for injection 10 mL ampoule x 10
Salbutamol 100 microg metered dose inhaler (MDI) x 1
Salbutamol 5 mg / 2.5 mL nebule x 5
Ipratropium bromide 21 microg metered dose inhaler (MDI) x 1
Ipratropium bromide 250 microg/mL nebule x 5
Intranasal Mucosal Atomisation Device (MAD) x 2
Potassium chloride 10 mmol in 100 mL minibag x 1
DRAWER E - EXTRAS
Lifepak12/15 lead ECG cable
Lifepak 12/15 paper
Therapy/pacing cable If paddles attached to Lifepak
ECG electrodes packet x 1
Disposable Quik-Combo pads adult x 2

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Disposable Quik-Combo pads paediatric x 2
ECG printer paper roll x 1
Clippers and or razor x 2
Combine x 2
Sterile gauze packet x 2
Spare torch batteries
Paediatric SpO2 probe x 1
Space blanket x 1
SIDE OF TROLLEY
Yankaeur sucker and tubing x 1
Oxygen tank holder
Oxygen cylinder size C with regulator
Portable suction unit with suction tubing connected
SIDE OF TROLLEY – SWING POCKETS
Top pocket
NIBP cuff infant size x 1
NIBP cuff child size x 1
NIBP cuff small adult size x 1
NIBP cuff adult size x 1
NIBP cuff large adult size x 1
NIBP cuff adult thigh size x 1
Second pocket
0.9% Sodium chloride 1000 mL bag for infusion x 2
0.9% Sodium chloride 100 mL bag for infusion x 2
Glucose (dextrose) 5% 100 mL bag for infusion x 2
0.9% Sodium chloride with 5% glucose (dextrose) 1000 mL bag for infusion x 1
Hook on back of trolley
Extension cord

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