DAILY CRASH CART CHECKLIST

© 2011 Progressive Surgical Solutions, LLC

MONTH / YR /

CART #

LOCK CHANGES DATE: 1 2 3 4 5 6 7 8 9 1

0 11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

DATE REASON LOCK # INIT.

NU

RS

E’S

SIG

NA

TUR

E

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 #