A crash cart or code cart (crash trolley in UK medical jargon) or "MAX cart" is a set of trays/drawers/shelves on wheels used in hospitals for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support protocols ( ACLS/

ALS Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or Lou Gehrig's disease, is a neurodegenerative disease that results in the progressive loss of motor neurons that control voluntary muscles. ALS is the most comm ...

) to potentially save someone's life. The cart carries instruments for cardiopulmonary resuscitation and other medical supplies while also functioning as a support litter for the patient. The crash cart was originally designed and patented by

ECRI Institute ECRI (originally founded as Emergency Care Research Institute) is an independent nonprofit organization tasked with "improving the safety, quality, and cost-effectiveness of care across all healthcare settings worldwide." History In the early 19 ...

founder, Joel J. Nobel, M.D., while a surgical resident at Philadelphia's Pennsylvania Hospital in 1965. MAX helped enhance hospital's efficiency in emergencies by enabling doctors and nurses to save time, thereby increasing the chances of saving a life. The contents and organization of a crash cart vary from hospital to hospital, country to country, and specialty to specialty, but typically contain the tools and drugs needed to treat a person in or near

cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possi ...

or another life-threatening condition. These include but are not limited to: * Monitor/

defibrillator Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''coun ...

s, suction devices, and

bag valve mask A bag valve mask (BVM), sometimes known by the proprietary name Ambu bag or generically as a manual resuscitator or "self-inflating bag", is a hand-held device commonly used to provide positive pressure ventilation to patients who are not breathin ...

s (BVMs) of different sizes * Advanced cardiac life support (ACLS) drugs such as

epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and ...

atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically given ...

amiodarone Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias. This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrillat ...

lidocaine Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia. When used for local anaesthesia or in nerve blocks, lidoc ...

, sodium bicarbonate, dopamine, and

vasopressin Human vasopressin, also called antidiuretic hormone (ADH), arginine vasopressin (AVP) or argipressin, is a hormone synthesized from the AVP gene as a peptide prohormone in neurons in the hypothalamus, and is converted to AVP. It then travel ...

* First line drugs for treatment of common problems such as:

adenosine Adenosine (symbol A) is an organic compound that occurs widely in nature in the form of diverse derivatives. The molecule consists of an adenine attached to a ribose via a β-N9-glycosidic bond. Adenosine is one of the four nucleoside building b ...

dextrose Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...

, epinephrine for IM use, naloxone, nitroglycerin, and others * Drugs for rapid sequence intubation:

succinylcholine Suxamethonium chloride, also known as suxamethonium or succinylcholine, or simply sux by medical abbreviation, is a medication used to cause short-term paralysis as part of general anesthesia. This is done to help with tracheal intubation or ele ...

or another paralytic, and a sedative such as

etomidate Etomidate (USAN, INN, BAN; marketed as Amidate) is a short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation for short procedures such as reduction of dislocated joints, tracheal intubation, cardiove ...

, propofol or midazolam;

endotracheal tube A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. Many different types of tracheal tubes ar ...

s and other intubating equipment * Drugs for peripheral and central venous access * Pediatric equipment (common pediatric drugs, intubation equipment, etc.) * Other drugs and equipment as chosen by the facility Hospitals typically have internal

intercom An intercom, also called an intercommunication device, intercommunicator, or interphone, is a stand-alone voice communications system for use within a building or small collection of buildings which functions independently of the public telephon ...

codes used for situations when someone has suffered a

or a similar potentially fatal condition outside of the

emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pat ...

or intensive care unit (where such conditions already happen frequently and do not require special announcements). When such codes are given, hospital staff and volunteers are expected to clear the corridors, and to direct visitors to stand aside as the crash cart and a team of physicians, pharmacists and nurses may come through at any moment. (''See'' Code Blue.)

History in the United States

The first cardiac crash cart was created in 1962 at Bethany Medical Center in

Kansas City, Kansas Kansas City, abbreviated as "KCK", is the third-largest city in the U.S. state of Kansas, and the county seat of Wyandotte County. It is an inner suburb of the older and more populous Kansas City, Missouri, after which it is named. As of t ...

, home to the first Cardiac Care Unit in the country.Colby, William H. ''Unplugged: Reclaiming Our Right to Die in America'' The first crash cart was designed by a nurse and fabricated by the father of one of the doctors. It contained an Ambu bag, defibrillator paddles, a bed board and endotracheal tubes.

In computing

In the computer industry, the term crash cart is used, by analogy to its original meaning in medicine, to mean a cart that can be connected to a server that is malfunctioning so badly that remote access to it is impossible, the intention being to "resuscitate" the server to the point where remote administration works again. Crash carts most commonly include a keyboard, mouse, and monitor, because most servers in a modern high-density environment do not have user input/output devices. Crash carts are a method of last resort in data centers which employ various forms of out-of-band management. In those cases it is used for equipment which does not support the requisite out-of-band infrastructure (OOBI) features or in cases where the OOBI devices (concentrators, switches, terminal servers, etc.) or services themselves have failed. The term "crash cart" can also refer to a bootable removable medium containing an operating system and any relevant software used to recover computer equipment (such as a server or PC) from a state of failure. This is done when such recovery is not possible using the computer's existing operating system and software. Crash carts in this sense are historically tape cartridges ("carts") or more recently, external or removable

hard drives A hard disk drive (HDD), hard disk, hard drive, or fixed disk is an electro-mechanical data storage device that stores and retrieves digital data using magnetic storage with one or more rigid rapidly rotating platters coated with magn ...

References

;Notes

External links

360-degree view of a crash cart and all its contentsCrash Cart Inventory Checklist
(PDF)
Max, The Lifesaver; Life
{{DEFAULTSORT:Crash Cart Medical equipment Out-of-band management