Nursing Medium1. What is a crash cart?
A crash cart, also called a resuscitation trolley or code cart, is a mobile, organised supply point for emergency medicines and equipment. It brings essential resources close to a patient who needs urgent resuscitation.
The cart supports the team during cardiac arrest and other emergencies. It does not replace trained staff, prompt recognition or a working emergency-call system. Its exact stock depends on the patient group and clinical area.
2. Contents: think in six groups
Illustration only — not a universal drawer layout.
Follow the approved inventory for your unit. Not every item has to be in the trolley itself; some specialist resources may arrive with the resuscitation team.
| Group | Examples | Readiness focus |
|---|---|---|
| Airway | Size-appropriate oral/nasal airways; intubation or supraglottic equipment for trained staff. | Correct size, packaging, light/source and device readiness. |
| Breathing & oxygen | Bag-valve-mask, reservoir, masks, oxygen tubing and suction. | Oxygen supply secured and sufficient; suction and bag-mask functional. |
| Defibrillation & monitoring | Defibrillator/AED, compatible pads, ECG leads and monitoring supplies. | Manufacturer self-test, power/battery and pad expiry. |
| IV / IO access | Cannulas, syringes, flushes, giving sets and IO equipment where indicated. | Sizes, packaging, labels and approved access supplies. |
| Medicines & fluids | Approved emergency formulary and prescribed resuscitation fluids. | Name, strength, quantity, expiry and storage conditions. |
| Protection & records | PPE, sharps container, labels, resuscitation records and algorithms. | Availability, safe disposal and legible documentation. |
Sources: [1] Resuscitation Council UK: Acute care equipment and drug lists.
3. Emergency drugs: indication comes first
A drug being stocked on a cart does not mean it is given in every arrest. Identify the clinical problem, verify the prescribed protocol and check the medicine label before administration.
| Medicine / situation | Selected adult reference | Nursing distinction |
|---|---|---|
| Epinephrine: cardiac arrest | 1 mg IV/IO every 3–5 minutes (AHA). | Arrest dose and route differ from initial anaphylaxis treatment. |
| Epinephrine: anaphylaxis | 500 micrograms (0.5 mg) IM using 1 mg/mL; repeat after 5 minutes if no improvement (RCUK). | IM first-line treatment; do not substitute the cardiac-arrest IV dose. |
| Atropine: symptomatic bradycardia with a pulse | 1 mg IV; repeat every 3–5 minutes; maximum total 3 mg (AHA). | Used in the bradycardia pathway, not as routine asystole treatment. |
| Amiodarone: refractory VF / pulseless VT | 300 mg IV/IO first dose, then 150 mg if indicated (AHA). | An antiarrhythmic option in the shockable-arrest pathway; CPR and shocks remain priorities. |
| Lidocaine: alternative in refractory VF / pulseless VT | 1–1.5 mg/kg IV/IO first dose; further dosing follows the algorithm (AHA). | Alternative to amiodarone in this pathway, not an automatic additional drug. |
| Calcium / sodium bicarbonate | Specific indications only; not routine for undifferentiated adult cardiac arrest. | Do not give merely because the drug appears on the cart. |
| Glucose / naloxone | Indication-specific treatment under the relevant protocol. | Consider hypoglycaemia or opioid toxicity; airway and ventilation support remain essential. |
Sources: [2] AHA 2025: Adult Cardiac Arrest Algorithm, [3] AHA 2025: Adult Bradycardia With a Pulse Algorithm, [4] Resuscitation Council UK 2025: Special circumstances (anaphylaxis), [5] AHA 2025: Adult Advanced Life Support.
Medication check: Read the actual strength in mg/mL, verify the route, use the appropriate syringe, label prepared medicines and communicate the dose and time clearly. A familiar colour or ampoule shape is not a substitute for reading the label.
4. Airway, breathing and oxygen equipment
- Airway adjuncts: select the appropriate device and size; advanced airway placement requires training and confirmation.
- Bag-valve-mask: check that all components are connected and ready, with the required oxygen source and mask sizes.
- Suction: confirm that the unit operates and compatible tubing and catheters are available.
- Oxygen: secure cylinders and check supply, connections and device readiness according to policy.
5. IV supplies, syringes and fluids
Keep the approved access equipment and administration supplies together. Use aseptic technique, single-use sterile needles/syringes, clear labels and regular IV-site assessment. Fluid type, volume and rate depend on the patient and treatment plan; a rapid litre is not appropriate for every emergency.
| Peripheral IV gauge | Common hub colour |
|---|---|
| 14G | Orange |
| 16G | Grey |
| 18G | Green |
| 20G | Pink |
| 22G | Blue |
| 24G | Yellow |
Lower gauge numbers generally indicate a larger catheter diameter. Confirm the printed gauge and product label; colour is an identification aid, not the only check.
Sources: [6] BD: Medication Delivery Solutions catalogue (IV catheter colour coding).
6. Defibrillator versus ECG monitoring
Shockable arrest
VF / pulseless VTDefibrillation with CPR and the shockable-arrest pathway.
Non-shockable arrest
Asystole / PEACPR, epinephrine and treatment of reversible causes. No shock for these rhythms.
Exam trap: Not all VT is pulseless. VT with a pulse is assessed using the tachyarrhythmia pathway. An ECG monitor displays electrical activity; a monitor reading alone does not confirm effective circulation.
7. Crash-cart checking and maintenance
Use the approved checklist at the frequency set by your organisation and after use. An intact tamper seal does not replace the equipment checks required by policy.
- Access: trolley location is known, route is clear, drawers and wheels work.
- Devices: defibrillator power/self-test, pads and suction are ready.
- Supply: oxygen, medicine quantities, sterile packs and consumables meet the checklist.
- Expiry: identify expired, damaged, opened or missing items and replace them.
- Record: document the check, defects and corrective action; hand over unresolved problems.
- Restore: replenish after use, clean reusable equipment and reseal only when ready.
8. Drawer labels and colour coding
Use the same clearly labelled arrangement throughout your organisation. The red/airway, yellow/breathing and other colour combinations seen in study posters are not a universal crash-cart standard. Learn your hospital’s labels and layout rather than relying on a colour mnemonic alone.
Sources: [1] Resuscitation Council UK: Acute care equipment and drug lists.
9. Nurse’s role during an emergency
Recognise deterioration, activate the emergency response and start the indicated care within your training. For recognised cardiac arrest, begin the BLS response and obtain the AED/defibrillator; do not delay CPR for a full trolley inventory or complete ABCDE survey.
For a deteriorating patient who is not in arrest, use the appropriate structured assessment and escalate. During resuscitation, prepare equipment, communicate clearly, administer protocol-directed medicines, record events and help restore readiness afterward.
10. One-minute revision
VF/pVT: shockable. Asystole/PEA: non-shockable. Drawer colours: local policy.
10 Nursing MCQs with rationales
Choose an answer, then open the explanation. These are original practice questions, not claimed previous-year questions.
Q1. What is the main purpose of a crash cart?
- To store all ward stationery
- To keep emergency medicines and equipment readily accessible
- To replace the emergency response team
- To transport every stable patient
Show answer & rationale
Answer: B. To keep emergency medicines and equipment readily accessible
The trolley organises essential resources so the team can access them during resuscitation. It does not replace trained staff or the call-for-help system.
Q2. Which pair contains only shockable cardiac-arrest rhythms?
- Asystole and PEA
- Sinus bradycardia and asystole
- VF and pulseless VT
- PEA and atrial fibrillation
Show answer & rationale
Answer: C. VF and pulseless VT
VF and pulseless VT are the shockable arrest rhythms. Asystole and PEA follow the non-shockable pathway.
Q3. An adult is in confirmed asystole. Which statement is correct?
- Prioritise CPR and the non-shockable-arrest pathway
- Defibrillate asystole routinely
- Give atropine as the routine arrest drug
- Wait for all medicines before starting compressions
Show answer & rationale
Answer: A. Prioritise CPR and the non-shockable-arrest pathway
Asystole is non-shockable. High-quality CPR, early epinephrine and treatment of reversible causes are priorities in the adult algorithm.
Q4. A study poster assigns a fixed colour to each crash-cart drawer. What should a nurse rely on in practice?
- The poster’s colours in every hospital
- Drawer colour without checking labels
- The cart manufacturer’s logo only
- The approved local layout, inventory and drawer labels
Show answer & rationale
Answer: D. The approved local layout, inventory and drawer labels
Standardisation within an organisation is useful. A single universal drawer-colour scheme should not be assumed.
Q5. A defibrillator readiness check fails at the start of a shift. What is the best response?
- Document it and leave the cart unavailable
- Arrange working replacement equipment promptly and report/escalate the defect
- Wait until an arrest occurs
- Reseal the cart to hide the fault
Show answer & rationale
Answer: B. Arrange working replacement equipment promptly and report/escalate the defect
A known defect needs corrective action and a reliable replacement plan. Documentation alone does not restore emergency readiness.
Q6. Which adult epinephrine regimen matches the AHA cardiac-arrest algorithm?
- 0.5 mg IM as the routine cardiac-arrest regimen
- 1 mg orally every 30 minutes
- 1 mg IV/IO every 3–5 minutes
- 5 mg IV for every rhythm check
Show answer & rationale
Answer: C. 1 mg IV/IO every 3–5 minutes
AHA lists epinephrine 1 mg IV/IO every 3–5 minutes for adult arrest. The initial anaphylaxis route and dose differ.
Q7. In the AHA adult bradycardia-with-a-pulse algorithm, the initial atropine dose is:
- 1 mg IV
- 0.1 mg orally
- 10 mg IM
- 300 mg IV
Show answer & rationale
Answer: A. 1 mg IV
The adult algorithm uses atropine 1 mg IV, repeated every 3–5 minutes up to 3 mg total if indicated. This is not a paediatric dose.
Q8. Which statement about sodium bicarbonate and calcium in adult cardiac arrest is correct?
- Both must be given in every arrest
- They replace CPR
- Cart availability is enough reason to give them
- They are not routine treatments for undifferentiated arrest
Show answer & rationale
Answer: D. They are not routine treatments for undifferentiated arrest
Routine administration is not recommended. Specific indications require the relevant protocol and clinical context.
Q9. A peripheral IV cannula with a pink hub is commonly labelled:
- 18G
- 20G
- 22G
- 24G
Show answer & rationale
Answer: B. 20G
The common manufacturer coding is 20G pink. Always confirm the printed gauge and product label.
Q10. After the cart is used during resuscitation, the best next step is to:
- Leave used items for the next shift
- Replace medicines but ignore equipment
- Restock, clean/check equipment, document and restore readiness
- Apply a new seal before checking the contents
Show answer & rationale
Answer: C. Restock, clean/check equipment, document and restore readiness
Post-use restoration includes replenishing supplies, checking equipment and recording readiness before resealing under local policy.
Sources & editorial note
- Resuscitation Council UK: Acute care equipment and drug lists
- AHA 2025: Adult Cardiac Arrest Algorithm
- AHA 2025: Adult Bradycardia With a Pulse Algorithm
- Resuscitation Council UK 2025: Special circumstances (anaphylaxis)
- AHA 2025: Adult Advanced Life Support
- BD: Medication Delivery Solutions catalogue (IV catheter colour coding)
Prepared as an original revision article from the topic supplied, with clinical distinctions checked against the sources above. The supplied social-media screenshots are not reproduced. Independent specialist review is not claimed. Use current local resuscitation protocols and supervised skills training for clinical practice.