ATLANTA, GA – The crash cart is indispensable during cardiopulmonary arrest. However, their contents are not standardized. In a much needed remedy to this situation, the American Board of Crash Carts (ABCC) released updated Maintenance of Crash Cart (MOCC) guidelines for 2016, which lists the tools, drugs, and other items needed to help health care practitioners in code scenarios. Updated 2016 crash cart recommendations include:
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- A turbocharged 4-cylinder engine for quick acceleration
- A spoiler to improve the crash cart’s aerodynamics
- Racing stripe, endorsement stickers to appeal to NASCAR fans
- A lock for each drawer to ensure immediate frustration when accessing contents
- Monitor affixed with Netflix, Hulu to provide vital signs, shows
- Free WiFi
- Keurig for code team if wee hours of morning
- Dramatic music like they play on medical TV shows
- Press Ganey-meter to assess patient satisfaction waveform
- Prior authorization forms to facilitate denial of life-saving treatment
- Defibrillator to counter a heart in fibrillation
- Refibrillator to counter a heart in defibrillation
- Nasal cannula, rectal cannula
- Bag valve masks, lucha libre masks, and other party favors of different sizes
- Oxygen or other favorite gas of choice
- Intravenous (IV) start kit to start a peripheral IV and an IV finish kit to finish it
- Intraosseous (IO) start kit with DeWalt DCD980MS power drill for brute strength, speed
- Intraocular (IO) start kit with DeWalt DCD980MS power drill for brute strength, speed
- Two incomplete central line kits since it’s the thought that counts
- Gloves, including latex, sterile, winter
- Alcohol preps for sterility
- Alcohol shots for futility
- WD-40 for urgent lubrication
- Saline, both normal and abnormal
- Epinephrine, atropine for advanced cardiac life support (ACLS)
- Orange juice, rest, blankie for not-advanced cardiac life support (NACLS)
- Adenosine, which causes flushing, chest pain, brief asystole to provider who thinks about using it
- Sodium bicarbonate for the hell of it
- Narcan to temporarily reverse opioid epidemic
- Dextrose for moderate hypoglycemia
- Glazed donut for severe hypoglycemia
- Turkey sandwich for severe hunger
- Kosher salt and freshly-ground black pepper to taste
- Spatula
- A powerful paralytic for rapid sequence intubation, such as an admission pager
- Endotracheal tubes and other intubation equipment for suppression of cough
- Two eager medical students in bottom drawer to help with chest compressions
- Reset button, Control-Alt-Delete, or Game Genie if code not going well
- Flashbang grenade for clean escape if code goes awry
Note: Although not part of the crash cart, the ABCC stressed the importance of three people during a code: (1) someone to take charge and run the code, (2) someone to act unnecessarily dramatic during the code and bring much needed stress to an already stressful scenario, and (3) a coder to code the code and ensure life-saving reimbursement.
