Crash cart—recently asked questions

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Last updated: October 13, 2026

Please see the main article: Crash cart supply & equipment checklist. Below are more questions and answers related to that article, which we couldn’t fit on the page.

Questions

  • ACLS guidelines added procainamide to the essential medication list for the crash cart. Is this a required medication or is there an alternative?

    The AHA does not establish facility-specific requirements for what medications must be stocked on a crash cart. The AHA provides recommendations for treatment, while applicable laws, regulations, accrediting requirements, and facility policies determine crash-cart requirements. The 2025 AHA ACLS guidelines include procainamide as an option for certain patients with stable wide-QRS tachycardia, but this does not mean every facility is required by the AHA to stock it. Whether procainamide or an alternative should be stocked depends on your applicable requirements, facility policies, and clinical needs.

  • Can a malignant hyperthermia (MH) cart be combined with an ACLS crash cart?

    Whether a malignant hyperthermia (MH) cart and an ACLS crash cart can be combined depends on applicable state and facility requirements. If a combined cart is permitted, it would need to contain all equipment and medications required for both emergencies and be immediately accessible when needed. Check with your state licensing agency and accrediting organization to confirm that combining the carts meets all applicable requirements.

  • If a hospital has one crash cart shared between two departments, how quickly should the crash cart be able to reach the other department according to AHA guidelines? Is there a specific number of minutes?

    The AHA does not specify a required number of minutes for a crash cart to reach another department. Crash carts should be readily accessible and located based on the needs of the facility and the areas they serve. Facilities should consider physically mapping crash-cart locations and measuring response times to ensure the cart can be accessed quickly when needed.

  • Are there resources for the medication checklist and equipment?

    Crash-cart checklists are based on the purpose of the crash cart—to provide the medications and equipment needed to respond to life-threatening emergencies. The treatment recommendations for these emergencies are published in the American Heart Association’s Guidelines for CPR and ECC and are based on evidence reviewed through the international resuscitation science process. The medications and equipment included on our checklists are selected based on their use in these resuscitation recommendations.

  • Can a facility customize a crash cart with labeled drawers?

    Crash-cart labeling is generally determined by the facility’s policies and procedures, along with any applicable state regulations and accreditation requirements. Facilities may label the cart or drawers to make medications and equipment easier to locate, provided the labeling is clear, consistent, and does not conflict with applicable requirements.

  • Can atropine be used for bradycardia with pauses? When should a transcutaneous pacer be used for bradycardia?

    Atropine may be appropriate for acute symptomatic bradycardia with cardiopulmonary compromise, although its effectiveness can be limited in high-grade AV block. If atropine is ineffective, transcutaneous pacing and/or an epinephrine or dopamine infusion may be used. The 2025 AHA guidelines do not specify a pacing rate of 40 or 80; the pacer should be adjusted to achieve electrical and mechanical capture and improve the patient’s condition.

  • Is there a regulation requiring the crash-cart log to be physically attached to the crash cart or maintained as a physical log book, or can an electronic version be used?

    Requirements for crash-cart checks and documentation can vary by state, facility type, and accrediting organization. There is not a general AHA requirement that the checklist be physically attached to the cart or maintained as a paper log. An electronic log may be acceptable if it meets all applicable regulatory, accreditation, and facility requirements. Your facility should confirm this with its licensing and accrediting agencies.

  • Is there a difference in what type of 3-way stopcock is used in the Broselow cart bottom-drawer bag?

    No. A standard 3-way stopcock is appropriate. Although different brands are available, any stopcock that is appropriate for the intended use and compatible with the equipment may be used.

  • Is it still standard practice, or best practice to have a backboard on the back of the crash cart?

    A backboard is not universally required by the AHA. Whether one is kept on or with the crash cart depends on the facility’s policies and the type of beds, stretchers, or other surfaces used. Many modern hospital beds and stretchers have features that provide a firm surface for CPR.

  • There is no AHA-standardized layout for pediatric crash-cart equipment. If you use the Broselow system, the cart can be organized according to the system’s recommendations and your facility’s needs. Otherwise, you can arrange the equipment in a way that allows your staff to locate and access it quickly and consistently.

  • A razor is commonly kept on or near the crash cart to facilitate removal of excessive chest hair when needed for proper placement and adhesion of defibrillation pads. The specific type and location should follow your facility’s policies and procedures, but it should be readily accessible when needed.

  • The AHA does not require an AED to be kept on or with the crash cart. The important consideration is that a defibrillator appropriate for the setting is immediately accessible when needed. In an outpatient IR suite, the facility should determine the location based on its emergency-response plan, applicable requirements, and the time needed to access the equipment.

  • What items should be included in a crash cart for a medical office?

    There is no universal AHA-required list of crash-cart items for every medical office. The equipment and medications needed depend on the type of practice, patient population, and emergencies that could reasonably occur. Requirements may also vary by state and by the type of facility. Your clinic should check applicable state regulations, licensing requirements, and accreditation standards to determine whether specific items are required.

  • What items should be included for a crash cart in a nursing home?

    For a BLS code cart, commonly needed supplies include an automated external defibrillator (AED), bag-mask ventilation device, pocket mask or other barrier device, gloves, and basic airway equipment as appropriate for your facility and staff training. The specific contents should be based on your facility’s emergency-response needs and applicable state and regulatory requirements.

  • Can Ativan be included in a crash cart?

    Crash-cart contents are determined by the facility based on the emergencies that could reasonably occur in that setting. Ativan (lorazepam) is not a standard AHA-required crash-cart medication, but a facility may choose to stock it when seizure treatment is part of its anticipated emergency needs. Applicable state, regulatory, and facility requirements should also be considered.

  • How often should a crash cart be checked?

    The frequency for checking a crash cart is determined by the facility’s policies and applicable regulatory or accreditation requirements. Many facilities check the cart or security seal at least daily or each shift and perform a more detailed check, including expiration dates, on a regular schedule. There is no specific AHA requirement that the cart be checked per shift or on the first day of each month.

  • Is an AED appropriate for an outpatient clinic that performs cardiac stress testing?

    An AED may be appropriate for an outpatient cardiac stress-testing clinic if it meets the facility’s emergency-response needs and applicable requirements. The ability to monitor the patient’s rhythm with the stress-testing equipment does not by itself determine whether an AED or manual defibrillator is appropriate. The facility should follow its emergency plan and applicable regulatory and accreditation requirements.

  • Which is preferable for hyperkalemia, calcium gluconate and chloride?

    Calcium gluconate is generally preferred when treating hyperkalemia through a peripheral IV because it is less irritating to the veins. Calcium chloride contains more elemental calcium and may be preferred in cardiac arrest or when central venous access is available. Both can be used to stabilize the myocardium in patients with hyperkalemia and ECG changes.

  • When must crash carts be restocked?

    There is no universal AHA requirement specifying when a crash cart must be restocked. As a best practice, the cart should be checked and restocked after it is opened or the security seal is broken, before it is returned to service. Facilities should also routinely check the cart, including medication expiration dates, according to their policies and applicable regulatory or accreditation requirements.

  • How can we prevent items from being removed from a crash cart for non-emergency situations?

    Most facilities utilize a plastic breakaway lock or security seal so that if it is broken, the cart must be checked and restocked before being returned to service. If the seal is intact, staff know the cart has not been opened. Facilities should also have a process requiring staff to report and replace any items removed from a checked cart so that the cart remains fully stocked.

  • A pulse check should not be performed between compressions. During CPR, pulse checks are performed about every 2 minutes when indicated, such as during rhythm checks, while minimizing interruptions in chest compressions.

  • Who can administer ACLS medications in a clinic setting?

    ACLS does not authorize or certify anyone to administer medications; that is determined by the individual’s professional licensure, scope of practice, and facility policies. The medications and equipment kept on a crash cart should be based on the types of emergencies and patients encountered in the facility, along with applicable regulatory and accreditation requirements.

  • What are the approved meds and equipment needed for a crash cart?

    There is no single standardized list for a pediatric crash cart. The contents should be based on the type of practice, the pediatric patients treated, and the emergencies that could reasonably occur. A pediatric surgery center, hospital emergency department, inpatient unit, and physician practice would each have different needs.

  • We are going to have Jhaco in our facility soon. The list that you have on your website about the medication and equipment needed in the ACLS (crash cart) cart, are they approved nationwide? If not how can I know what are the approved meds and equipment needed for our crash cart in our center which we are based in Michigan

    There is no single nationwide requirement for crash-cart contents. Requirements can differ depending on the state, accrediting organization, and type of facility. In general, the crash cart should contain the medications and equipment needed to respond to emergencies that may reasonably occur in your facility. For specific requirements, you should check with your state licensing agency and accrediting organization.

  • Regarding the crash cart

    1. Does it have to be in a locked box?

    3. How often does it need to be checked?

    Crash-cart requirements can vary depending on the type of practice and applicable state and regulatory requirements. The cart should contain the equipment and medications needed to respond to emergencies that could reasonably occur in your practice. If a security seal is used, the cart should be checked and restocked whenever the seal is broken, and medications should be checked for expiration according to your facility’s policies and applicable requirements.

  • Is a crash cart required for a center performing conscious sedation?

    The requirements vary by state, facility type, and the type and level of sedation being provided. In California, certain offices performing sedation are specifically required to have readily accessible emergency equipment and medications. For example, California regulations for offices administering oral conscious sedation require an emergency cart or kit containing appropriate emergency drugs and age- and size-appropriate equipment to resuscitate a nonbreathing or unconscious patient and provide continuous support during transport. Other California outpatient settings are required to have on-site equipment, medications, and trained personnel capable of handling medical emergencies. The specific requirements therefore depend on the type of office and sedation being provided, rather than a universal requirement that every office performing “conscious sedation” must have a crash cart.

  • Are infusion centers required to have crash carts, if so what type of infusion medication are required?

    Requirements for crash carts and emergency equipment vary by state, facility type, accrediting organization, and the services provided. Infusion centers should have the medications and equipment needed to respond to emergencies that can reasonably be expected based on the types of treatments they provide. Whether a “full” crash cart is required, and what it should contain, depends on the applicable requirements and the types of medications and treatments administered at the facility.

  • What type of crash cart is required for a clinical research trial center?

    Requirements vary by state, facility type, regulatory or accrediting organization, and the procedures being performed. A traditional crash cart may not be required if emergency equipment and medications appropriate for the anticipated emergencies are readily accessible. The facility should check its applicable state and regulatory requirements.

  • What is best practice for charging a defibrillator?

    Defibrillators should be maintained according to the manufacturer’s instructions. Many are designed to remain plugged in when not in use, but this is not universal. Each facility decides what actions to take for the defibrillator to be ready for an emergency.

  • What is the standard time limit for removing medications from a crash cart? Is 90 days the standard?

    Medications may generally remain in the crash cart until their labeled expiration date, provided they are stored properly. Removing them 90 days early is a facility practice, not a universal requirement, and may allow time to replace or redistribute medications before they expire.

  • Vasopressin is not included in the current AHA ACLS cardiac-arrest algorithm. It was removed as an alternative to epinephrine in the 2015 guidelines. The current AHA recommendation is epinephrine 1 mg IV/IO every 3–5 minutes during cardiac arrest. Vasopressin is not recommended as a substitute for epinephrine.

  • There is no universal minimum or maximum number of crash carts. The number and location should ensure that appropriate emergency equipment is readily accessible based on the facility’s patient population, procedures, and physical layout. A crash cart may be located in a staff hallway if it is readily accessible and does not interfere with required egress.

  • How long are QC checklists for the crash carts and defibrillators required to be maintained for records?

    Most hospitals keep crash-cart and defibrillator QC records for a period such as one year, but retention is generally determined by applicable regulations and facility policy.

  • Is a crash cart required for a substance abuse inpatient rehab unit?

    Requirements depend on the facility and applicable VA policies. A crash cart may not be required on every inpatient unit, but appropriate emergency equipment must be readily available. The facility should check its applicable VA requirements and emergency-response policy for that specific unit.

  • Does Texas have regulations requiring a crash cart in cardiology offices?

    Texas does not require every cardiology office to have a crash cart. Requirements depend on the services provided, particularly whether sedation or anesthesia is administered. For offices providing certain levels of anesthesia or sedation, Texas regulations specifically require a crash cart with appropriate emergency drugs and equipment.

  • Does a crash cart need to be locked?

    Crash carts should be secured to prevent tampering while remaining immediately accessible. A breakaway seal is commonly used, allowing staff to detect when the cart has been opened without creating a delay during an emergency. Whether the cart must be locked depends on the facility and applicable requirements.

  • The neonatal checklist is intended for newborns and is not appropriate as the primary checklist for a pediatric unit. Pediatric units should have emergency equipment and medications appropriate for infants and children. A pediatric crash cart can be organized using a length-based system such as Broselow, but this is not required.

  • If the office performs injections that could cause allergic reactions or other medical emergencies, it should have appropriate emergency equipment and medications readily available. The specific contents should be based on the procedures performed, patient population, and applicable facility or regulatory requirements. AHA guidelines do not establish a universal “10-minute cart” requirement.

  • Is there a specific regulation that oxygen tanks should always be set-up and readily assembled in the emergency cart?

    Emergency equipment should be immediately available and ready for use. Oxygen should be set up according to the manufacturer’s instructions and facility policy, and expired or unusable supplies should be replaced promptly.

  • Is there a required scope of practice responsible for checking the code carts? Is a breakaway seal required?

    The facility’s policy should determine who checks the crash cart and how often. A breakaway seal can be checked routinely, while a full inspection of contents and expiration dates should be performed according to the facility’s written policy. There is no universal requirement that the cart be opened daily or monthly. A list of items or medications due to expire from the time of inspection to a full restock is recommended, thus not needing to break a seal each time if the cart has not been used.

  • What are the recommendations for a code cart in an oral surgery office?

    An oral surgery office providing IV sedation should have emergency equipment and medications appropriate for managing sedation-related emergencies, including advanced airway equipment, resuscitation medications, and an appropriate defibrillator. The specific requirements depend on the level of sedation and applicable state regulations.

  • Would it be acceptable to have a non-removable “emergency box” that contains the drugs listed on your site (with the exception of narcan), defibrillator, and king airway?

    A crash cart does not have to be a specific type of cart. The important consideration is that appropriate emergency medications and equipment are immediately available to manage emergencies that could occur during stress testing. A dedicated emergency box may be acceptable if it meets applicable VA requirements and facility policy.

  • Is there a recommendation of where in the room the crash cart should be?

    There are no such guidelines. That would depend upon the convenience of the providers.

  • Is a portable suction machine required in a a crash cart if every patient area has it’s own suction?

    If wall suction is readily available and immediately accessible wherever an emergency may occur, a portable suction unit may not be necessary on the crash cart. Follow applicable requirements and facility policy.

  • How often should resuscitator bags and oxygen tubing be replaced if it has a manufacturing date but no expiration date?

    They should be inspected regularly for damage, deterioration, or other signs of wear and replaced according to the manufacturer’s instructions. If no expiration date is provided, the manufacturer should be contacted for the recommended replacement interval.

  • Is there a requirement that any room/closet/space that contains a crash cart be labeled on the door?

    I am not aware of a general requirement that a room or closet containing a crash cart must have a specific sign on the door or use particular wording. Signage requirements may depend on facility policy or applicable state and accreditation requirements.

  • For the cardiac arrest algorithm pVT/VF, will PEA happen followed by a pulseless VT/VF after AED?

    PEA is not treated with defibrillation. If the rhythm changes to VF or pulseless VT, defibrillation is indicated. For PEA, continue CPR, give epinephrine, and identify and treat reversible causes such as hypovolemia, hypoxia, and other Hs and Ts.

  • Are there any recommendations if defibrillator pads need to be connected to the defibrillator when not in use?

    Defibrillator pads should be stored and maintained according to the manufacturer’s instructions. They do not universally need to remain connected to the defibrillator when not in use, but they should be immediately available and ready for rapid use during an emergency.

  • You can use any pediatric medication-dosing system approved by your hospital, as long as it provides accurate weight- or length-based dosing. Broselow is one option, but the dosing system and medication concentrations should be consistent with each other.

  • The defibrillator should be evaluated according to the manufacturer’s recommendations and facility requirements; the 2025 AHA guidelines still specify 360 J for monophasic defibrillation. For cardiac arrest, epinephrine 1 mg/10 mL (1:10,000) IV/IO every 3–5 minutes should be available. The facility should ensure that its defibrillator and medications are functional and appropriate for emergency use.

  • Who is allowed to administer ACLS medications during a code? ACLS certified staff only, or BLS certified RNs under the verbal order from a physician/ACLS certified provider?

    ACLS training does not determine whether someone is authorized to administer medications. Medication administration is governed by the individual’s professional license, scope of practice, applicable laws, and facility policy. Licensed professionals such as RNs and physicians may administer medications within their scope of practice; ACLS training itself does not expand that scope.

  • What is your recommendation if a crash cart is brought into an isolation room? Do you recommend wiping off supplies that are wipe-able? Or do you recommend discarding everything in the cart?

    If a crash cart enters an isolation room, it should be cleaned and disinfected according to the facility’s infection-control policy and the manufacturer’s instructions. Wipeable equipment and surfaces can generally be disinfected with an appropriate EPA-registered disinfectant; disposable or contaminated items should be discarded when required.

  • What emergency equipment and supplies should be readily available on nursing floors during a code, and which items can be provided by the ACLS/PALS response team?

    This approach can be appropriate if the hospital has reliable 24/7 code-team coverage and emergency equipment needed for initial resuscitation is immediately available. The hospital should establish response-time and equipment requirements through its policies and applicable regulations.

  • Is it necessary to have a crash cart at a cardiac rehab facility?

    Cardiac rehabilitation programs should have appropriate emergency equipment, including a defibrillator, immediately accessible. The AHA does not specify a maximum distance or response time, but equipment should be close enough to allow rapid resuscitation.

  • Does a solo primary care practitioner need a crash cart in office?

    Cardiac rehabilitation programs should have appropriate emergency equipment, including a defibrillator, immediately accessible. The AHA does not specify a maximum distance or response time for a crash cart; equipment should be located where it can be accessed quickly enough to support effective resuscitation.

  • What essential emergency equipment and supplies should be included in portable emergency lock boxes for ICU patient transport?

    There is no universal requirement that every primary care office have a crash cart. Emergency equipment should be appropriate for the patients, procedures, and emergencies that could reasonably occur, with applicable state and facility requirements considered. The contents should be based on patient acuity, transport duration, distance from emergency resources, and the hospital’s resuscitation protocols. The goal is to ensure that staff can begin immediate lifesaving interventions while waiting for the code team, without unnecessarily duplicating every item in a full crash cart.

  • If the crash cart doesn’t have medications, is it required for the crash cart to remain locked?

    There is no universal AHA requirement that a crash cart be locked. A breakaway seal is commonly used so the cart remains secure but immediately accessible; requirements depend on facility policy and applicable regulations.

  • Are there recommendations for crash carts in Ghana for radiology settings?

    Crash-cart requirements vary by country and facility. In Ghana, you should check the applicable Ministry of Health and facility requirements; if contrast, sedation, or other procedures that could cause medical emergencies are performed, appropriate emergency equipment should be immediately available.

  • Who is the regulatory organization or guidance issuer for having a crash cart?

    There is no single regulatory organization that requires a crash cart in every clinic. Requirements depend on the services provided, patient population, state regulations, accreditation requirements, and facility policy. Clinics should have emergency equipment appropriate for the emergencies that could reasonably occur in that setting.

  • How often should sealed, medication-free airway supply boxes on crash carts be opened and inspected?

    The frequency for checking airway supplies should follow your facility’s policy and applicable requirements. Documenting expiration dates does not necessarily eliminate the need for periodic inspection of the equipment for damage, deterioration, or missing items.

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Oct 13, 2026

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Oct 11, 2026

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Dec 9, 2015

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