The Emergency Department Crash Cart: A systematic review and suggested contents

doi:10.5847/wjem.j.1920-8642.2018.02.002

Abstract

Abstract:

BACKGROUND: As the field of Emergency Medicine grows worldwide, the importance of an Emergency Department Crash Cart (EDCC) has long been recognized. Yet, there is paucity of relevant peer-reviewed literature specifically discussing EDCCs or proposing detailed features for an EDCC suitable for both adult and pediatric patients.
METHODS: The authors performed a systematic review of EDCC-specific literature indexed in Pubmed and Embase on December 20, 2016. In addition, the authors reviewed the 2015 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, the 2015 European Resuscitation Council (ERC) guidelines for resuscitation, and the 2013 American College of Surgeons (ACS) Advanced Trauma Life Support (ATLS) 9th edition.
RESULTS: There were a total of 277 results, with 192 unique results and 85 duplicates. After careful review by two independent reviewers, all but four references were excluded. None of the four included articles described comprehensive contents of equipment and medications for both the adult and pediatric populations. This article describes in detail the final four articles specific to EDCC, and proposes a set of suggested contents for the EDCC.
CONCLUSION: Our systematic review shows the striking paucity of such a high impact indispensable item in the ED. We hope that our EDCC content suggestions help enhance the level of response of EDs in the resuscitation of adult and pediatric populations, and encourage the implementation of and adherence to the latest evidence-based resuscitation guidelines.

Key words: Resuscitation, Crash cart, Emergency department

Gabrielle A. Jacquet, Bachar Hamade, Karim A. Diab, Rasha Sawaya, Gilbert Abou Dagher, Eveline Hitti, Jamil D. Bayram. The Emergency Department Crash Cart: A systematic review and suggested contents[J]. World Journal of Emergency Medicine, 2018, 9(2): 93-98.

Figures/Tables 4

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Table 1

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Norepinephrine	Dobutamine	Vacant	Phenylephrine	Hydrocortisone
Adenosine	Metoprolol^*	Verapamil	Procainamide	Magnesium
Vecuronium⁺	Etomidate	Vacant	Isoproterenol	Atropine
Epinephrine	Amiodarone	Vacant	Sodium Bicarbonate	Calcium Chloride

Glucagon	Thyroxine	Oxytocin	Thiamine	Optional
Valproate	Levetiracetam	Phenytoin	Pyridoxine	Furosemide
Albuterol	Ipratropium	Racemic Epinephrine	Dexamethasone	Diphenhydramine
Labetalol	Nicardipine	Hydralazine	Naloxone	Glucose

Item	Pediatric sizes	Adult sizes
Oral airway	0, 1, 2	3, 4, 5
Laryngoscope handle	Small	Large
Laryngoscope blade	Straight 0, 1, 2 Curved 2	Straight 3, 4 Curved 3, 4
Endotracheal tube	2.5 to 6.5	7 to 9.5
Stylet	3, 6	14, 16
Nasal trumpet	12-22 F	24-34 F
Laryngeal mask airway	1, 2	3, 4, 5
Tracheostomy tube	2.5-6.5	7-10
Nasogastric tube	8-12	14-18
Bougie	10 F	15 F

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