The Emergency Trolley: Perhimpunan Dokter Ahli Emergensi Indonesia

The
Emergency
trolley
PERHIMPUNAN DOKTER AHLI EMERGENSI INDONESIA

• Clinical Emergencies refer to situations where sudden,
unexpected deterioration in a patient’s clinical condition
occurs
• These emergencies pose an immediate threat to a patient’s
life and/or long-term health and well-being, and require staff
to take urgent action
• These may include:
– Any patient who experiences a cardiac or respiratory arrest
– Any patient who suddenly develops a condition that causes:
• deterioration in their vital signs and level of consciousness
• increases their Modified Early Warning Score (MEWS) > 6
• and/or requires immediate resuscitation measures to be taken.
Emergency trolley
Emergency cart/Emergency response cart/Code cart/Crash cart
• It is a multi drawer wheeled cabinet

• With the essential medication and tools that
required in emergency situations.
• A portable trolley used to quickly transport
equipment and medications to the site of a
clinical emergency
Goal of emergency trolley
To begin addressing the emergency

conditions while waiting the emergency team
to arrive:
 Compromised Airway
 Respiratory Distress /Respiratory Arrest
 Cardiac Arrest
 Drug Overdose
 Hypoglycemia
.  Anaphylactic Reaction
CONTENTS OF THE TROLLEY
Top of emergency trolley (External Contents)
1. Oxygen supply
2. Defibrillator with Monitor
3. Portable suction apparatus
4. Laryngoscope
5. Shuttle forceps
6. Sphygmomanometer
7. Stethoscope
8. Emergency Crash Cart Check
Sheet
9. Check List of cart contents.
10. Emergency drug information
sheet
Oxygen supply
• To arise alveolar oxygen tension
• To relieve hypoxemia or hypoxia
Oxygen cylinder
Automated External Defibrillator

Suction apparatus:
Mechanical suction is used when a
patient is unable to clear mouth or throat
of secretions, blood, or vomits.
Sphygmomanometer:
It is an Instrument used to
measure blood pressure
Stethoscope:
It is an instrument used in auscultation of Tissue forceps
heart sounds and also it is used in
measuring blood pressure.
Contents of the trolley
Drawer contents
• Drawer 1- Medications
• Drawer 2- Breathing and Airway
• Drawer 3- Circulation: IV supplies
• Drawer 4- Circulation: I.V. solutions and tubing
• Drawer 5- Cardiac, Chest Procedures
• Drawer 6- Special Procedure Trays
Drawer contents
• Drawer 1- Medications
Drawer contents
• Drawer 2- Breathing and Airway
 Oropharyngeal Airways
 Nasopharyngeal Airways
 Endotracheal tubes
 Tracheostomy tubes
 Face mask
 Pocket mask
 Suction tube
 Tracheostomy mask
 Nasal cannula
 Laryngoscope
 Tongue blades
 Suction catheter
Drawer contents
Laryngoscope:
• It is used to obtain a view of the glottis.
• It is also used in intubation.
Bag valve mask

is a hand-held device used to
provide ventilation to a patient
who is not breathing or who is
breathing inadequately
Drawer contents
• Tracheostomy set :
• Tracheostomy is a surgical procedure on the neck to open a direct airway
through an incision in the trachea to provide immediate relief for a
patient’s upper airway obstruction..
• Patients who must have a higher continues rate of oxygen flow, require a
Tracheostomy that is connected to the oxygen supply.
• The set includes Tracheostomy tubes: B- Plain tube E- Cuffed tube
Drawer contents
Ventilation Devices:
Pocket mask
Designed for mouth-to-mask ventilation of a non-breathing person
It is an alternative to a bag-valve mask device for providing ventilation.
Drawer contents
• Airway adjuncts:
Oropharyngeal Airways:
• known as an oral airway, or OPA. It is used
to maintain a (open) airway It does this by
preventing the tongue from (either
partially or completely) covering the
epiglottis, which could prevent the patient
from breathing.
Nasopharyngeal Airways:
Also known as an NPA or a nasal
trumpet. It is a tube that is designed to
be inserted into the nasal passageway
to secure an open airway.
Drawer contents
Endotracheal tubes:
Drawer contents
Drawer 3- Circulation: IV supplies
Needles different sizes

Syringes different sizes
Butterflies
Sterile water vials
IV cannulas
Tourniquet
Alcohol swabs
Cotton balls
Blood tubes
Tape
Drawer contents
Drawer 4- I.V. solutions and tubing
0.9% sodium chloride 500ml)5%

Dextrose (500ml)
10% dextrose (500ml)
Haes-steril 6% (500ml)
Ringer lactate (500ml)
Blood pump tubing
I.V. Tubing
Drawer contents
Drawer 5- Cardiac, Chest Procedures
ECG electrodes
Sterile gloves
Sutures
Cardiac needle
Sterile towels
Cut down tray
Catheter kit
Chest tubes
Scalpels with blades
Dressings
Drawer contents
Drawer 6- Special Procedure Trays
Drawer contents
Sample supplies
I.V Cannula Butterfly
Syringe Tourniquet
Tourniquet
Drawer contents
Sample supplies
masks Protective gowns

Tongue blades
Kidney bowel Scissors Thermometer

• All emergency trolleys should be checked on a daily basis
• This should be documented on the trolley’s corresponding checklist
• All clinical staff are to maintain familiarity with the emergency trolley
located within their clinical area(s).
• Depending on the clinical area, an adult and/or pediatric trolley may be
available.
• Where both adult and pediatric trolleys exist, staff are expected to
maintain equal familiarity with each trolley type.
• In areas where emergency trolleys are accessed from a nearby
department, a member of staff who is familiar with the trolley will deliver
the cart and assist with the emergency
Common Drugs Utilized
ACLS Airway management

• Adenosine • Pretreatment
• Amiodarone
– Lignocaine
• Atropine
• Digoxin – Fentanyl
• Diltiazem – Atropine
• Epinephrine – Succinylcholine
• Esmolol
• Induction
• Lidocaine
• Magnesium sulphate – Thiopentone
• Sodium bicarbonate – Midazolam
• Vasopressin – Ketamine
• Verapamil
THANK
YOU
Masalah di lapangan
1. Kejadian berada di tempat yang sulit
dijangkau ( gedung bertingkat )
2. Saat melakukan RJPO , apakah sudah
maksimal (kecepatan, kedalaman, Chest
Recoil )
3. Bila saat kejadian pasien tidak berada di
ruangan perawatan (cara memindahkan an
pada saat bersamaan dilakukan RJPO)
4. Bila nadi telah teraba kembali (ROSC) sedang
napas belum adekuat, sampai kapan
dilakukan bantuan napas (tenaga penolong
terbatas dan ventilator tidak tersedia)

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The

PERHIMPUNAN DOKTER AHLI EMERGENSI INDONESIA

• It is a multi drawer wheeled cabinet

To begin addressing the emergency

Automated External Defibrillator

measure blood pressure

Bag valve mask

Needles different sizes

0.9% sodium chloride 500ml)5%

I.V Cannula Butterfly

masks Protective gowns

Kidney bowel Scissors Thermometer

ACLS Airway management

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