Health Care Department Operations Manual

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Chapter 3 – Health Care Operations

Article 7 – Emergency Medical Response

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3.7.5 Crash Cart Equipment

  • Policy

    • California Correctional Health Care Services (CCHCS) shall ensure material and equipment required for patient support during a medical emergency is available and operational at all times.

  • Purpose

    • To ensure availability of equipment necessary for Basic Life Support and Advanced Cardiac Life Support measures during a medical emergency.

  • Responsibility

    • The Chief Executive Officer and Warden, or their designees, are responsible for implementation, monitoring and evaluation of this policy.

  • Procedure Overview

    • Crash cart equipment, drawer, and par levels shall be implemented and maintained in accordance with California Department of Corrections and Rehabilitation (CDCR) 7547, Crash Cart Inventory Report.

    • Crash carts shall remain sealed unless performing monthly inventories, replenishing equipment, providing educational in-services, or providing emergency medical response and treatment by licensed health care practitioners lawfully authorized to perform such treatments acting within the scope of their professional licensure.

    • Crash cart medications shall be maintained pursuant to the Health Care Department Operations Manual (HCDOM), Section 3.5.22, Emergency Drug Supplies.  Emergency procedures shall be in accordance with the HCDOM, Section 3.7.1, Emergency Medical Response System.

    • A standardized crash cart shall be available within or at every Triage and Treatment Area and licensed inpatient unit.

  • Procedure

    • Crash carts shall be secured with numbered seals. The number and integrity of the seal shall be checked each shift and documented on CDCR 7544, Crash Cart Daily Check Sheet. If the seal is not intact, staff shall:

      • Immediately notify the Supervising Registered Nurse (SRN) responsible for the area.

      • Immediately notify Pharmacy.

      • Complete CDCR 7547.

      • Secure the crash cart with a yellow seal.

      • Complete sections of CDCR 7544, corresponding to:

        • Name of SRN notified.

        • Crash Cart Inventory Report completed.

        • Name of Pharmacist notified.

        • Date, Time, Signature, and Printed Name of staff completing the form.

    • Staff shall replace missing equipment and comply with applicable sections of the HCDOM, Section 3.5.26, Break-In, Theft/Loss from Pharmacy or Medication Storage Areas.  Numbered seals shall be controlled by the Pharmacy pursuant to the HCDOM, Section 3.5.22 Emergency Drug Supplies. Emergency procedures shall be pursuant to the HCDOM, Section 3.7.1, Emergency Medical Response System Procedure.

    • Crash carts without complete equipment supplies shall be secured with a yellow seal until completely restocked, indicated by a red seal.  Par levels for replacement equipment are not prescribed.  If equipment is not replaced within three business days, the SRN responsible for the area shall be notified.  The SRN shall initiate and continue documentation of the occurrence until resolved, and advance the issue as needed.

    • A defibrillator performance check shall be completed in accordance with manufacturer’s instructions with the defibrillator unplugged. The check shall be documented on CDCR 7548, Defibrillator Performance Test.

    • On the first business day of each month, crash carts shall be inventoried and documented on CDCR 7547.  Equipment shall be restocked as necessary to maintain par levels.  Sterile items shall be checked for package integrity and expiration dates.  Equipment, including sterile items, expiring within 60 calendar days shall be ordered for restocking during the next crash cart inventory.

    • Laryngoscope function shall be checked prior to placement in the crash cart and monthly.

    • Oxygen cylinders with less than 500 psi shall be replaced.

    • Each institution shall adopt Local Operating Procedures to implement, administer, and document the following requirements:

      • Maintain completed CDCR 7544, CDCR 7547, and CDCR 7548 forms for a minimum of one year.

      • Establish and review par levels for replacement crash cart equipment.

  • References

    • California Code of Regulations, Title 22, Division 5, Chapter 1, Article 3, Section 70263, Pharmaceutical Service General Requirements

    • California Code of Regulations, Title 22, Division 5, Chapter 3, Article 3, Section 72377, Pharmaceutical Service – Equipment and Supplies

    • California Code of Regulations, Title 22, Division 5, Chapter 4, Article 3, Section 73375, Pharmaceutical Service – Equipment and Supplies

    • California Code of Regulations, Title 22, Division 5, Chapter 12, Article 3, Section 79671, Pharmaceutical Service – Equipment and Supplies

    • California Code of Regulations, Title 22, Division 5, Chapter 12, Article 5, Section 79817, Pharmaceutical Service – Equipment and Supplies

    • Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.22, Emergency Drug Supplies

    • Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.25, Inspecting Medication Storage Areas

    • Health Care Department Operations Manual, Chapter 3, Article 5, Section 3.5.26, Break-In, Theft/Loss from Pharmacy or Medication Storage Areas

    • American Heart Association Advanced Cardiac Life Support for Healthcare Providers, 2006

    • American Heart Association, Basic Life Support for Healthcare Providers, 2006

  • Revision History

    • Effective: 11/2016