Crash Cart Essentials for Outpatient Surgery Centers

 Keeping a well-stocked and organized crash cart is critical for patient safety in outpatient surgery settings, where rapid response to emergencies can make all the difference. Unlike inpatient hospitals, outpatient facilities must be especially deliberate about stocking supplies and medications tailored to the patient population and procedures performed that support immediate stabilization and transfer to a higher level of care if needed.  

Airway & Breathing  

Facilities must have availability of oxygen supplies, bag-valve masks (adult and pediatric), oral and nasal airways, laryngoscopes with multiple blade sizes, endotracheal tubes, stylets, and suction equipment appropriate for the patient population served. Capnography devices are highly recommended for confirming airway placement.  

Circulation & IV Access
Facilities must stock IV catheters of various sizes, saline flushes, IV fluids (normal saline, Lactated Ringer’s), pressure bags, and intraosseous access kits for emergencies when IV access is difficult. Include blood pressure cuffs, a stethoscope, ECG leads, defibrillator pads, tourniquets, and alcohol swabs.

Emergency Medications
QUAD A facilities must maintain a standardized set of drugs (applicable to class A, B, C facilities *unless otherwise noted), including:

• Adenosine - 18 mg
• Epinephrine (1:10,000 solution, 1 mg per 10 ml) - Minimum - 5 mg
• Anti-Hypertensives – Minimum is per facility policy or facility drug formulary.
• Lidocaine HCl 2% - Minimum 100 mg
• Atropine - Minimum 3 mg
• Nitroglycerin (sublingual tablets or spray) – Minimum is per facility policy or facility drug formulary.
• Narcan – Minimum is per facility policy or facility drug formulary.
• Intravenous corticosteroids (e.g., dexamethasone) – Minimum is per facility policy or facility drug formulary.
• Amiodarone - Minimum 450 mg
• IV Antihistamine (e.g., diphenhydramine) – 50 mg
• Short-Acting beta-blocker (e.g., esmolol or labetalol)
• Neuromuscular blocking agent (e.g., succinylcholine or rocuronium) (applicable to class C facilities)
• Benzodiazepine reversing agent (e.g., flumazenil) if benzodiazepines are used (applicable to class B & C facilities)
• Bronchospasm-arresting medication (inhaled beta-agonist, e.g., albuterol)
• Seizure-arresting medication (a benzodiazepine, e.g., midazolam)
• Facilities administering regional or tumescent anesthesia containing bupivacaine must always have 20% emulsion available

Clearly label and routinely check expiration dates.

The above medications are the minimum requirements. Facilities must have enough medications available to run a code until EMS arrives. Facilities should consider performing a risk assessment to assist in determining the amount of medications to have available above the minimum by taking into consideration the amount of time that it would take EMS to respond to your location. 

 QUAD A strongly encourages facilities to verify requirements at the state level. Some states have specific requirements for emergency medications and quantities, including specific amounts of Dantrolene. The stricter requirement prevails.  

Defibrillation & Monitoring
Facilities are required to have a fully functional defibrillator or automated external defibrillator (AED). Ensure spare batteries, electrodes, and conductive gel are readily available.

Specialty Supplies
Items for managing anaphylaxis, malignant hyperthermia kits (if triggering agents are used), and emergency obstetric or pediatric supplies if applicable to your patient population must also be maintained.

Documentation & Protocols
Current laminated ACLS algorithms, malignant hyperthermia algorithms if applicable, emergency contact numbers, and transfer protocols are required components of the cart. Quick access to these resources supports efficient team response and improved patient outcomes.

Routine Checks
Facilities must implement at least weekly checks, equipment functionality testing, and a formal restocking process after each use. Assign responsibility to specific staff and document compliance.

A well-prepared crash cart reflects a culture of safety—regular review and staff training are just as important as the supplies themselves. Preparedness isn’t optional—it’s essential.

Thank you for your continued dedication to safety and excellence.

Questions 

If you have any questions or require further clarification, please email standards@quada.org.

Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.