Crash cart
Encyclopedia
A crash cart or code cart (crash trolley in UK medical jargon) is a set of trays/drawers/shelves on wheels used in hospital emergency room
s for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support protocols (ACLS
/ALS
) to potentially save someone's life.
The contents of a crash cart vary from hospital to hospital, but typically contain the tools and drugs needed to treat a person in or near cardiac arrest
. These include but are not limited to:
Hospitals typically have internal intercom
codes used for situations when someone has suffered a cardiac arrest
or a similar potentially fatal condition outside of the emergency room or intensive care unit (where such conditions already happen frequently and do not require special announcements). When such codes are given, hospital staff and volunteers are expected to clear the corridors, and to direct visitors to stand aside as the crash cart and a team of physicians and nurses may come through at any moment. (See Code Blue.)
, home to the first Cardiac Care Unit in the country. The first crash cart was fabricated by one of the doctor's fathers. It contained an Ambu bag
, defibrillator paddles, a bed board and endotracheal tubes.
that is malfunctioning so badly that remote access to it is impossible, the intention being to "resuscitate" the server to the point where remote administration works again. Crash carts most commonly include a keyboard, mouse, and monitor, because most servers in a modern high-density environment don't have user input/output devices.
The phrase, as applied to computing, was coined independently from its usage in a medical context. The term "crash" has long been used to describe computer systems failures which require or placement of a computer monitor, keyboard and other peripherals on a rolling "cart" leads rather obviously to the resulting phrase.
Crash carts are a method of last resort in data centers which employ various forms of out-of-band management
. In those cases it is used for equipment which does not support the requisite out-of-band infrastructure
(OOBI) features or in cases where the OOBI devices (concentrators, switches, terminal servers, etc.) or services themselves have failed.
The term "crash cart" can also refer to a bootable removable medium containing an operating system and any relevant software used to recover computer equipment (such as a server or PC
) from a state of failure. This is done when such recovery is not possible using the computer's existing operating system and software. Crash carts in this sense are historically tape cartridges
("carts") or more recently, external or removable hard drives.
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
s for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support protocols (ACLS
Advanced cardiac life support
Advanced cardiac life support or Advanced Cardiovascular Life Support refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.Extensive medical knowledge...
/ALS
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
) to potentially save someone's life.
The contents of a crash cart vary from hospital to hospital, but typically contain the tools and drugs needed to treat a person in or near cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
. These include but are not limited to:
- Monitor/defibrillators and suction devices
- Advanced Cardiac Life Support (ACLS) drugs such as epinephrineEpinephrineEpinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...
, atropineAtropineAtropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...
, amiodaroneAmiodaroneAmiodarone is an antiarrhythmic agent used for various types of tachyarrhythmias , both ventricular and supraventricular arrhythmias. Discovered in 1961, it was not approved for use in the United States until 1985...
, lidocaineLidocaineLidocaine , Xylocaine, or lignocaine is a common local anesthetic and antiarrhythmic drug. Lidocaine is used topically to relieve itching, burning and pain from skin inflammations, injected as a dental anesthetic or as a local anesthetic for minor surgery.- History :Lidocaine, the first amino...
, sodium bicarbonateSodium bicarbonateSodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula Na HCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It has a slightly salty, alkaline taste resembling that of washing soda . The natural mineral form is...
, dopamineDopamineDopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...
, and vasopressinVasopressinArginine vasopressin , also known as vasopressin, argipressin or antidiuretic hormone , is a neurohypophysial hormone found in most mammals, including humans. Vasopressin is a peptide hormone that controls the reabsorption of molecules in the tubules of the kidneys by affecting the tissue's... - First line drugs for treatment of common problems such as: adenosine, dextrose, diazepamDiazepamDiazepam , first marketed as Valium by Hoffmann-La Roche is a benzodiazepine drug. Diazepam is also marketed in Australia as Antenex. It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms , restless legs syndrome, alcohol withdrawal,...
or midazolamMidazolamMidazolam is a short-acting drug in the benzodiazepine class developed by Hoffmann-La Roche in the 1970s. The drug is used for treatment of acute seizures, moderate to severe insomnia, and for inducing sedation and amnesia before medical procedures. It possesses profoundly potent anxiolytic,...
, epinephrine for IM use, naloxoneNaloxoneNaloxone is an opioid antagonist drug developed by Sankyo in the 1960s. Naloxone is a drug used to counter the effects of opiate overdose, for example heroin or morphine overdose. Naloxone is specifically used to counteract life-threatening depression of the central nervous system and respiratory...
, nitroglycerin, and others - Drugs for rapid sequence intubation: Succinylcholine or another paralytic, and a sedativeSedativeA sedative or tranquilizer is a substance that induces sedation by reducing irritability or excitement....
such as etomidateEtomidateEtomidate is a short acting intravenous anaesthetic agent used for the induction of general anaesthesia and for sedation for short procedures such as reduction of dislocated joints, tracheal intubation and cardioversion...
or midazolam; endotracheal tubes and other intubatingIntubationTracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic or rubber tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs...
equipment - Drugs for peripheral and central venous access
- Pediatric equipment (common pediatric drugs, intubation equipment, etc.)
- Other drugs and equipment as chosen by the facility
Hospitals typically have internal intercom
Intercom
An intercom , talkback or doorphone is a stand-alone voice communications system for use within a building or small collection of buildings, functioning independently of the public telephone network. Intercoms are generally mounted permanently in buildings and vehicles...
codes used for situations when someone has suffered a cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
or a similar potentially fatal condition outside of the emergency room or intensive care unit (where such conditions already happen frequently and do not require special announcements). When such codes are given, hospital staff and volunteers are expected to clear the corridors, and to direct visitors to stand aside as the crash cart and a team of physicians and nurses may come through at any moment. (See Code Blue.)
History in the United States
The first cardiac crash cart was created in 1962 at Bethany Medical Center in Kansas City, KansasKansas City, Kansas
Kansas City is the third-largest city in the state of Kansas and is the county seat of Wyandotte County. It is a suburb of Kansas City, Missouri, and is the third largest city in the Kansas City Metropolitan Area. The city is part of a consolidated city-county government known as the "Unified...
, home to the first Cardiac Care Unit in the country. The first crash cart was fabricated by one of the doctor's fathers. It contained an Ambu bag
Bag valve mask
A bag valve mask is a hand-held device used to provide positive pressure ventilation to a patient who is not breathing or who is breathing inadequately. The device is a normal part of a resuscitation kit for trained professionals, such as ambulance crew...
, defibrillator paddles, a bed board and endotracheal tubes.
In computing
In the computer industry, the term crash cart is used, by analogy to its original meaning in medicine, to mean a cart that can be connected to a serverServer (computing)
In the context of client-server architecture, a server is a computer program running to serve the requests of other programs, the "clients". Thus, the "server" performs some computational task on behalf of "clients"...
that is malfunctioning so badly that remote access to it is impossible, the intention being to "resuscitate" the server to the point where remote administration works again. Crash carts most commonly include a keyboard, mouse, and monitor, because most servers in a modern high-density environment don't have user input/output devices.
The phrase, as applied to computing, was coined independently from its usage in a medical context. The term "crash" has long been used to describe computer systems failures which require or placement of a computer monitor, keyboard and other peripherals on a rolling "cart" leads rather obviously to the resulting phrase.
Crash carts are a method of last resort in data centers which employ various forms of out-of-band management
Out-of-band management
In computing, out-of-band management involves the use of a dedicated management channel for device maintenance...
. In those cases it is used for equipment which does not support the requisite out-of-band infrastructure
Out-of-band infrastructure
The concept of out-of-band infrastructure has been used throughout the telecom industry for voice communication since the mid-1950s...
(OOBI) features or in cases where the OOBI devices (concentrators, switches, terminal servers, etc.) or services themselves have failed.
The term "crash cart" can also refer to a bootable removable medium containing an operating system and any relevant software used to recover computer equipment (such as a server or PC
Personal computer
A personal computer is any general-purpose computer whose size, capabilities, and original sales price make it useful for individuals, and which is intended to be operated directly by an end-user with no intervening computer operator...
) from a state of failure. This is done when such recovery is not possible using the computer's existing operating system and software. Crash carts in this sense are historically tape cartridges
Magnetic tape data storage
Magnetic tape data storage uses digital recording on to magnetic tape to store digital information. Modern magnetic tape is most commonly packaged in cartridges and cassettes. The device that performs actual writing or reading of data is a tape drive...
("carts") or more recently, external or removable hard drives.