Code cart and supplies. How often are you taking inventory of
your code cart? Every facility should have fully stocked crash
carts with all of the drugs and equipment recommended by the
American Heart Association. You also should have a dedicated malig-
nant hyperthermia plan.
Imagine reaching into your crash cart for the one drug you need to
revive a patient and discovering it's on back order. It's an easy mistake
to make, and it's easily preventable. Do a monthly inventory check
and make sure all your drugs and supplies are available and up to
date. That's also true of your automated external defibrillator. Keep
track of the pads and battery on your AED, and you'll be ready for a
patient who goes into sudden cardiac arrest.
Practice makes perfect. It's one thing to have policies. It's
another to be ready for an emergency. Mock drills help your
staff understand the different roles they'll need to assume in a crisis.
Every few months or so, you should run through an emergency drill
from beginning to end. Your patient has a severe allergic reaction.
What do you do? Who's managing the code cart? What drugs do you
need, and when do you call 911? Everyone should be flexible enough
to step into a different role. Your staff should be trained and certified
in basic and advanced levels of life support, so they're ready at a
moment's notice.
Discharge criteria. Treat 'em and street 'em? Don't do it. You
should never be in a rush to get patients home. Your providers
need to follow your facility's rules and patients must meet discharge cri-
teria before you discharge them. A hasty discharge can have fatal con-
sequences. We've seen several cases where patients died on the car ride
home. Don't make the mistake and think a seemingly stable patient is
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