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Hello,

We have a freestanding Cardiology clinic that is wondering if they need a crash cart, or if a more simple emergency kit would be appropriate for their clinic. The most complicated testing done at their clinic is echocardiograms/bubble studies. They do use Definity for contrast. They are about 5 minutes from a hospital, although EMS response times may vary as it is a small community. Our emergency kits do contain things like oral airways, Epi pens/Benadryl/famotidine for allergic reactions, ASA and nitro for cardiac emergencies. They also have an AED on site. Would there be any reason why a crash cart would be indicated? 

Thanks for your input! 

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Carrie Karcz, BSN, RN, AMB-BC
Ambulatory Care Nurse Educator
Bellin Health by Emplify
Green Bay, WI
carrie.karcz@bellin.org
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My question would be <

Do you have staff and providers that could use the equipment in a crash cart. Would they remain competent. I find in most ambulatory settings IV access and advanced airway management are not skills that staff stay competent in. Your team may be good with IVs if doing bubble studies. When was the last time your cardiologist ran a code or intubated.

We only have crash carts in sites that do procedures with sedation and usually have anesthesia on site. Providers doing sedation are required to have competency in airway management.

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Ray Snider DNP MSN RN NEA-BC
Director Clinical Operations
Emory Healthcare
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Hi Carrie, 

In my opinion it is more important that your staff are skilled in responding to a medical emergency and can initiate high quality compressions, have access to an AED, and can activate EMS. This takes training and practice and can save lives. 

I have found that many staff in Ambulatory don't have the knowledge and skills to respond quickly and efficiently. Just doing BLS every 2 years is not enough. 

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Susanna Gadsby MSN, MBA, AMB-BC, NPD-BC
Clinical Educator, Ambulatory
AAACN Certified
Nursing Professional Development Specialist
susanna.m.gadsby@hitchcock.org
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