Armstrong Medical Cart User Manual Pdf

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Version control: This document is current with respect to drug indications in the 2015 American Heart Association® Guidelines for CPR and ECC — Neonatal Resuscitation as recognized by the AAPNRP Steering Committee. These guidelines are current until they are replaced on October 2020. If you are reading this page (printed or online) after October 2020, please contact ACLS Training Center at support@acls.net for an updated document.

Emergencies in a Neonatal ICU can be nerve-wracking at best. Any time we are caring for our most precious babies and things go wrong, life gets instantly hectic. As healthcare providers, we need our supplies, our medications and our equipment at our fingertips. One of the best ways to make this happen is to organize the “crash carts” according to the Broselow™ Tape. The Broselow™ Tape is placed on the table and the child is placed next to the tape. Based on the length of the baby they will fall in a colored area which lists appropriate medication doses and equipment sizes. If the crash cart is organized correctly, the caregiver simply opens the drawer of the corresponding color and will find the appropriate sizes of equipment and medications. Organization of this type helps to save time and prevent mistakes. The following lists show complete content listing for Broselow™ ColorCode Carts. Compatible parts: PBL-PC-9, PBL-PC-9A.

General Equipment

General equipment may be placed on the cart according to staff preference.

IATA commissioned this Medical Manual to provide up to date information on airline medical issues to its members, especially those which may not have the benefit of an in -house medical advisor. The practice of airline medicine has changed subs tantially since the last edition of the Medical Manual was written and this is reflected. SmartCART Manual User Manual Page iii Table of Contents. Access to Financials to create a cart and then assign that cart to their approver to create the requisition and buy the product(s). Window Shoppers can be set up by filling out the form on the.

  • Laryngoscope handles (small, large)
  • Laryngoscope bulbs (small, large)
  • Batteries (size AA, size C)
  • Miller blades (size 00, size 0, size 1)
  • Wisconsin blades (size 2, size 3)
  • Mac blades (size 2, size 3)
  • McGill forceps
  • Bag valve masks (neonate size, infant size)
  • Manometer
  • Bulb syringe
  • Yankauer suction
  • Dental suction
  • White tape rolls (1-inch, 1/2-inch)
  • Pediatric non-rebreather mask
  • Basic face mask
  • Nasal cannula
  • Nipple adaptors (x2)
  • Double oxygen outlet
  • Respiratory nebulizer
  • Capnography monitor
  • Pulse oximeter
  • Stethoscope
  • Suction canister with tubing
  • Portable suction machine
  • Portable oxygen tank
  • Oxygen masks (size 1, size 2, size 3, size 4, size 5, size 6)
  • Peep valve
  • Albumin 5%
  • Adenosine (x2)
  • Atropine
  • Amiodarone
  • Calcium chloride
  • Dextrose 10% (x2)
  • Dextrose 50%
  • Epinephrine 1:1000
  • Epinephrine 1:10000 (x2)
  • Lidocaine 1%
  • Naloxone (Narcan) 0.4 mg/ml
  • Naloxone (Narcan) 1 mg/ml
  • Sodium bicarbonate 4.2% (x3)
  • Broselow™ tape
  • Central lines (3 Fr single lumen, 4 Fr dual lumen)
  • Normal Saline 1000 ml (x2)
  • D5 and 1/2 NS 500ml
  • Buretrol IV tubing (x2)
  • Blood tubing
  • Infant cutdown tray
  • Umbilical catheter single lumen (3.5 Fr, 5.0 Fr)
  • Tegaderm dressings (x5)
  • IV labels (x5)
  • Gauze 2 in x 2 in (x10)
  • Skin prep (x5)
  • Tourniquet
  • E-Z intraosseous drill
  • Intraosseous needle pediatric
  • Intraosseous needle adult
  • Intraosseous needle geriatric
  • Sterile gloves (size 6 [x2 pr], size 7 [x2 pr], size 8 [x2 pr])
  • Non sterile gloves (small [x1 bx], medium [x1 bx], large [x1 bx])
  • Flashlight
  • D Batteries (x4)
  • Defibrillator/monitor
  • ECG electrodes (x2 pkgs)
  • Sharps container
  • Isolation gowns (x10)
  • Mask with face shield (x4)
  • Isolation masks (x1 bx)
  • Pediatric defibrillation pads (x2 pks)
  • Adult defibrillation pads (x2 pks)
  • Documentation forms/clipboard
  • Inventory sheet

You will notice that the Broselow™ type cart shown here has color coded drawers which match the results from the Broselow™ Tape measurement. This level of organization enhances response time and effectiveness by putting the correct size equipment at your fingertips, already sorted for the size infant or child that you attempting to resuscitate.

The following equipment recommendations are organized by the Broselow™ color chart to be appropriate for infants and children within hose size ranges.

PINK DRAWER (0.5 kg – 8 kg)

  • IV start kit
  • IV catheter (22 gauge [x2], 24 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge ped
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (2.0 mm, 2.5 mm, 3.0 mm, 4.0 mm)
  • Stylet - small
  • Suction catheters (6 Fr, 8 Fr)
  • Nasogastric tube (6.5 Fr, 8.0 Fr)
  • Surgilube®
  • Syringe 35 ml
  • LMA #1
  • Nasal airway Rusch® (12 Fr, 14 Fr)
  • Oral airway (50 mm #0, 60 mm #1)

PURPLE DRAWER (9 kg - 11 kg)

  • IV start kit
  • IV catheter (22 gauge [x2], 24 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge ped
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (3.5 mm, 4.0 mm)
  • Stylet - small
  • Suction catheters (8 Fr, 10 Fr)
  • Nasogastric tube (8 Fr, 10 Fr)
  • Surgilube®
  • Syringe 35 ml
  • LMA #1.5
  • Nasal airway Rusch® (16 Fr, 18 Fr)
  • Oral airway (60 mm #1)

Armstrong Medical Cart User Manual

YELLOW DRAWER (12 kg - 14 kg)

  • IV start kit
  • IV catheter (20 gauge [x2], 22 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge ped
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (4.0 mm, 4.5 mm)
  • Stylet - small
  • Suction catheters (10 Fr)
  • Nasogastric tube (10 Fr)
  • Surgilube®
  • Syringe 35 ml
  • LMA #2.0
  • Nasal airway Rusch® (18 Fr, 20 Fr)
  • Oral airway (60 mm #2)

WHITE DRAWER (15 kg - 18 kg)

  • IV start kit
  • IV catheter (18 gauge [x2], 20 gauge [x2], 22 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge ped
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (4.5 mm, 5.0 mm)
  • Stylet - small
  • Suction catheters (10 Fr, 12 Fr)
  • Nasogastric tube (10 Fr)
  • Surgilube®
  • Syringe 35 ml
  • LMA #2.5
  • Nasal airway Rusch® (18 Fr, 20 Fr)
  • Oral airway (70 mm #2)

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Medical

BLUE DRAWER (19 kg - 23 kg)

  • IV start kit
  • IV catheter (18 gauge [x2], 20 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge ped
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (5.0 mm, 5.5 mm)
  • Stylet - medium
  • Suction catheters (10 Fr, 12 Fr)
  • Nasogastric tube (12 Fr)
  • Surgilube®
  • Syringe 60 ml catheter tip
  • LMA #3.0
  • Nasal airway Rusch® (22 Fr, 24 Fr)
  • Oral airway (70 mm #2, 80 mm #3)

ORANGE DRAWER (24 kg - 50 kg)

  • IV start kit
  • IV catheter (18 gauge [x2], 20 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (5.5 mm, 6.0 mm)
  • Stylet - medium
  • Suction catheters (12 Fr, 14 Fr)
  • Nasogastric tube (14 Fr)
  • Surgilube®
  • Syringe 60 ml catheter tip
  • LMA #3.5
  • Nasal airway Rusch® (26 Fr, 28 Fr)
  • Oral airway (70 mm #2, 80 mm #3)

GREEN DRAWER (over 50 kg)

  • IV start kit
  • IV catheter (14 gauge [x2], 16 gauge [x2], 18 gauge [x2])
  • Butterfly needle 23 gauge (x2)
  • Intraosseous needle 18 gauge
  • Extension set (x2)
  • 3 way stopcock (x2)
  • Normal saline flush (3 ml [x5], 10 ml [x5])
  • Safety needles 1.5' (22 gauge [x2], 25 gauge [x2])
  • Syringes (60 ml [x2], 20 ml [x2], 10 ml [x2], 3 ml [x2], 1 ml [x2])
  • Heparinized syringe for blood gas draw
  • Endotracheal tubes - cuffed (7.0 mm, 8.0 mm)
  • Stylet - large
  • Suction catheters (12 Fr, 14 Fr)
  • Nasogastric tube (16 Fr)
  • Surgilube®
  • Syringe 60 ml catheter tip
  • LMA #4
  • Nasal airway Rusch® (30 Fr, 32 Fr)
  • Oral airway (90 mm #4, 100 mm #5)

NOTE ABOUT COLOR BLINDNESS: Color blindness affects a significant number of people, especially white men (approx. 10% in USA). To increase accessibility of the Broselow™ color-coded crash cart, we recommend explicitly labeling each drawer in high-contrast black-ink labels. We have created a set of shelf labels (standard Avery 5160) that can be downloaded here. For JCAHO, please cover the stickers with clear plastic tape!

Maintenance of Crash Cart

The worst thing ever is to reach for a piece of emergency equipment or an emergency medication and find it inoperable or expired. It is important that the crash cart be checked regularly and maintained so that its contents are there when needed.

The following is a maintenance routine that should be completed at least monthly:

  • Expiration dates on medications should be checked on the first day of the month
  • Expired medications should be promptly removed and replaced
  • Batteries should be checked and battery-operated equipment should be checked for corrosion

Additional Resources

  • Study Guide for Use of the Broselow™ System -- https://www.ncdhhs.gov/dhsr/EMS/pdf/kids/DEPS_Broselow™_Study.pdf
  • Study Comparing Color coded Pediatric Cart vs Standard Cart -- http://www.ncbi.nlm.nih.gov/pubmed/16061568
  • The History of the Broselow™ Tape -- https://www.epmonthly.com/departments/columns/in-my-opinion/from-humble-beginnings-the-birth-of-the-Broselow™-tape/
  • Standard vs Broselow™ Coded Cart and Pediatric Outcomes -- https://pediatrics.aappublications.org/content/116/3/e326.full.pdf

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Frequent Questions

Is there a special backboard needed for the peds/neonatal crash cart?
IT depends upon the policy of your facility. But if you are going to utilize a backboard for pediatrics be sure to have padding of some type available to pad under the torso so that the head does not end up flexed and the airway obstructed.
Hello, I was wondering if you could provide me a list of the up to date current medication list for neonatal crash carts. I was given a have a list of:
dextrose 10% injection 250ml IV bag
epinephrine injection 1mg/10ml syringe
sodium chloride 0.9% inj 250 ml IV bag
sodium chloride 0.9% injection 10 ml syringe
sodium chloride 0.9% injection 10ml vial and I would need evidence to support this. Thank you for your time, Leanna
There is no standard list. It is defined by the policies of your institution.
Hi, I had some questions about your Neonatal Crash Cart Supply & Equipment Checklist / Broselow page. What is the latest version of the pediatric Broselow tape?
2019.
Do you have supply lists for a normal adult crash cart?
Yes! Please see this page.
Do you have any more information for pediatrics?
We offer a full PALS course, please see this page for more information.

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Please email us at support@acls.net and we will be happy to answer any other questions you have. Please share this page on a medical forum you use, this means a lot to us.