What's in your Chemo Cart?

  1. I work on a med/surg unit where we ocassionaly administer chemotherapy. We have dedicated chemotherapy carts for outside the chemo patients rooms but they are very unorganized. I am updating these for a project and am having trouble finding any info about what is recomended to store in these besides basic PPE... Of course we'll have the chemo gloves, gown, mask/safety shield and chemo spill kit. Im wondering if there should be anything else added? How does your facility stock your chemo cart and/or what would you change about it? Thanks in advance!
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    About Robinroo62

    Joined: Feb '08; Posts: 10; Likes: 3


  3. by   mappers
    We don't have chemo carts, but will there be drugs on this cart? We do have emergency boxes with standing orders for if a person has a reaction. If a person is getting certain drugs (Rituxan, first-time taxane, first time herceptin, etc.), we will take the Home Depot Box (It's a bright orange tackle box)to the bedside just in case. I call it my Good Luck box. If I have it a person doesn't react.

    It should have the drugs your standing orders have for reactions. For us it has Benadryl IV, Solucortef, Solumedrol, and an Epipen. It also has syringes with needles, a 50CC bag of NS. Our SOs also call for Demerol for rigors, but that is not kept in the box. Our pharmacy stocks them and there are labels on them with expiration dates, like on a crash cart.

    Also, your chemo cart should have a yellow bucket for disposal of chemo waste.
  4. by   mzjennx
    that is nice you guys have a chemo cart. but maybe because we dont always give chemo all day maybe that what we dont have one.

    i just prepare my supplies before i go into a patient's room. My PPE of mask/google, gown and double gloves, chemo spill kit, hard puncture proof bin with the chemo in it, extra saline flushs, splash proof pads and tapes. We usually bring a chemo waste bin and leave it in the patient room. that is new to us, we never use to do that until now.

    do you guys put up a sign to warn people patient is getting chemo?
  5. by   mzjennx
    Wish we had some standard orders for reactions. we just gotta call the oncall oncology for each episode. it should be standard even if the patient has had multiple treatments you never know when someone suddenly feels nauseous.

    BTW would you consider Rituxan chemo?
  6. by   mappers
    We do even though technically it is a MAB. We treat all the MABs as chemo, like Herceptin, Erbitux, etc.

    Speaking of reactions, I'm not talking about nausea. I'm talking about full-on reactions with BPs through the roof, pt's desating, loss of consciousness, etc. Oxaliplatin reactions are the worst and they don't typically happen until 9-10 treatments in. We had two really bad Erbitux reactions in two days this week. We are lucky that we have standing orders and that we have doctors in our office who can be there within moments. When I was in the hospital, I never saw a reaction, but can't imagine not being able to administer steroids, benadryl, etc within moments of the reaction starting. We've had to call 911, for reactions in the past. (I'm in an outpatient setting where the hospital is across the street. We still have to call 911 in an emergency.)
  7. by   mappers
    do you guys put up a sign to warn people patient is getting chemo?"

    when i was in the hospital we did not. (and i think this might be a privacy issue.) i'm not really sure why you would need to.
  8. by   CarryThatWeight
    Quote from mappers
    do you guys put up a sign to warn people patient is getting chemo?"

    when i was in the hospital we did not. (and i think this might be a privacy issue.) i'm not really sure why you would need to.
    we put up a "chemo precautions" sign on the patient's bathroom door. the urine needs to be flushed twice, not once, with a chux pad over the toilet to avoid unnecessary exposure to the chemo. also, no one but the patient can use the patient's bathroom (no visitors, family, etc.).
  9. by   mappers
    We had flush twice signs on the walls in the bathrooms of all the oncology rooms. I'd forgotten about that.
  10. by   Robinroo62
    These Chemo Carts are out in the hallway in front of the pts room. We are not allowed to keep medications (including saline) or any sharps in them as they public could potentially get into them. Basically PPE, chemo spill kits, and "gator boxes" for chemo wastes. But I was wondering if anyone else kept 4x4s, tubing, educational stuff...
  11. by   Robinroo62
    We are in the process of making warning signs (chemo precaution signs) for staff to take extra precautions and educational handouts for pts and familys regaurding safety and chemo admin. Also the standard orders sets in case of reactions is a great idea, Im going to bring that up at our next meeting! Do your chemo pts wear heart monitors or pulse oxs during administration? Thanks for all the responses!