DAILY CRASH CART CHECKLIST
MONTH / YR
/
CART #
DATE:
LOCK CHANGES
REASON
LOCK #
INIT.
NURSE’S SIGNATURE
DATE
DEFIBRILLATOR / AED MONITOR TEST
CRASH CART SEALED X 1
DEFIBRILLATOR/ AED PLUGGED IN
BATTERY SWITCHED FOR CHARGING
O2 TANK W/ REGULATOR
SUCTION W/ YANKAUER ATTACHED
ACLS ALGORITHMS / CRASH CART INVENTORY LIST
SHARPS BOX
MONITORING ELECTRODES ( 1 SET) ADULT
LEAD WIRES ATTACHED
DEFIBRILLATOR PADDLES
ADULT / PEDIATRIC PACER PADS
STETHOSCOPE/BP CUFF
I.V. POLE WITH AMBU BAG / MASK / AIRWAYS
BACK BOARD (BACK OF CART)
CONDUCTION GEL (1)
CODE BLUE FORM / CHARTING BOARD
CRASH CART CHECKLIST / ACLS PROTOCOL
CRASH CART LOCK #
© 2011 Progressive Surgical Solutions, LLC
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