pediatric crash carts

Specialties Emergency

Published

Specializes in ER, peds.,nursery..

i am really curious on the different types of pediatric crash carts you are all using. I believe we have the worst where i am right not. we are using "braslow bags." they are suppose to have everything you need except the meds, for each level of the braslow. yeah right. all of the IO's are the same size. you have to open a "kit" with the right color and just hope all the supplies are there. we have had several really bad codes and we had nothing in a TRAUMA room to support the code. so darn frustrating. we are a large enough unit to be able to have the right stuff.

SO. what are you all using out there?

we are a 15 bed with 2 trauma beds. the adult crash carts are loaded. i find myself hiding supplies just to make sure that at 2 am when i get my usual pediatric rush that i am ready. the other night we had 3 pediatric cases at one time. two intubated. it was so darn challenging cause we just did not have to right stuff.

also.. are there cheat sheets out there for the pediatric sedation drugs.?

we have a great binder of drips for the adults but nothing for the kids. i want to put one together. i have been researching and cant seem to find any at all.

thanks guys. really appreciate your input.

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Specializes in Pediatric Intensive Care, ER.

We don't use the Browlow Bags - generally they were designed more for EMS or for Rapid Response situations. But we DO have Broslow Crash Carts - all color coded. Of course, it is up to your facility to stock them properly. We have been VERY happy with ours. Ours is a Pediatric referral hospital / trauma / burn center. 12 Bed PICU, etc... IM me if you want some good cheat things for drugs.

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Specializes in Emergency.

We also use the Braslow crash carts. Stocked & locked. Our tapes are laminated to boards (same length & width as tape) which keeps them from walking.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Yep, same here -- Broselow carts. Our Broselow tape is stuck between two layers of plexiglass to keep it around/present. :D

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Specializes in icu/er.

we just have dedicated pediatric crash carts. now each cart has a braslow tape in the drug drawer, but no separated bags.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

I put together our peds cart. Although it wasn't the official Broselow cart it followed the general principle. It had two doors that swung open to reveal drawers that were marked by color and weight as listed on the Broselow tape. So the nurse could just call out "get me the purple drawer" or whatever one was appropriate. Each drawer was set up exactly the same way and followed the ABC's with airway stuff on the left, then breathing, then circulation to the right. That way no matter what size kid you had you knew exactly where in the drawer you could find your supplies. The top two drawers had things like laryngoscopes, an extra Broselow tape, pediatric BP cuffs (we didn't have enough for each drawer) a manometer for the neonatal CPAP (sometimes called an anesthesia ) bag and other things like that. One of the drawers held "bereavement" supplies like new baby blankets, caps, booties, baby lotion, t-shirts of various sizes, inkless footprinters, bereavement packets and disposable cameras. I had maintenance put a metal hasp on the cart doors and we locked it with a breakaway lock. The cart was checked to make sure it was locked every shift and I checked it as well. If I found it to be unlocked I would find out which nurse had taken care of a critical peds and would either have them check the entire cart or would do it myself if the nurse was off shift. You can bet they got a nastygram from me about it later. The entire cart took at least 45 minutes to check. If they had done it (or directed a tech to do it which was perfectly acceptable) after the event was over they only would have had to check the one drawer! They learned pretty quickly and I rarely had trouble with it after the first few times. I did a lot of education with the staff regarding taking care of critical peds patients and reinforced how important it was to have the equipment you need available at all times. It took a little while but eventually everybody came on board. In fact, many of the nurses became much more comfortable taking care of really sick kids because they knew where to find the supplies they needed and knew they would be there. Many times I would come into work and a fellow nurse would run up all excited because they got a peds stick on the first try or stabilized a septic infant or handled a premature birth and were able to competently care for the baby until the NICU arrived. It was really cool to see that excitement and the increase in their comfort level. I was given the ncikname "The Peds Nazi" because of my dilligence in maintaining the peds cart but it was said in love of course. Sometimes you just have to be tough.

As far as cheat sheets. Your pharmacy should be able to print some up for you. Just make sure it's not based on the "rule of sixes" which has been used for eons but has also been found to be very inaccurate. The PALS text also has recommended doses for medications as does the actual Broselow tape. Just make sure you have an up to date one because there was a mistake on the ones printed in the 2001-2003 time period. If you have HP monitors (can't remember what name they go by now) they have a feature where you plug in the weight and dose of the drug and it will calculate drip rates. Ours were connected to a printer so we could print them out. Hope this helps.

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Specializes in ICU/ER/TRANSPORT.

what mistake exactly was printed on the broselow tape?

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

I knew someone was going to ask that. It was a med dose but I'll need to investigate further as we threw the old BT out years ago and I purged the info from my memory.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

Found it!

Tennessee Emergency Medical Services for Children - ISMPSafetyBrief

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Dang, I meant to check our Broselow this weekend, but it was just too nuts in our ED and it slipped my mind. Thanks for digging up this link!

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Specializes in ICU/ER/TRANSPORT.

thanks scot, much thanks.

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