Cracking the Code: Emergency Drug Cart Stocking Practices in North Carolina Hospitals
By: Dr. Meghan E. Peterson Dr. Greene Shepherd
Abstract Background Emergency drug carts (EDC) have become a cornerstone in hospitals throughout the world. An EDC is a self-contained mobile unit that houses essential medications and equipment most frequently used in various emergency situations. Although the role of EDCs is well established, medication stocking trends and practices are less defined. Objective To increase knowledge surrounding EDC medication stocking trends and practices in hospitals throughout North Carolina. Methods This observational cohort study was conducted utilizing telephone and electronic surveys with key pharmacy team members at 97 health systems throughout North Carolina from August 2020 to February 2021. All hospitals in North Carolina were eligible for participation, and there were no exclusion
criteria. Descriptive statistics were utilized for the analysis of demographics and stocked medication. Data from each hospital were compared to determine similarities and differences in medication contents and stocking practices. Results A 77% (97/126) response rate was achieved, and 84 of 97 hospitals surveyed provided adult EDC content lists. On average EDCs contained 17 medications. A total of 33 different medications were stocked across hospitals with varying concentrations. Results also indicate that medication stocking aligned with evidence-based practice guidelines for Advanced Cardiovascular Life Support (ACLS), as 100% of hospitals stocked amiodarone and epinephrine in their adult EDCs. Restocking practices were wide-ranging, with numerous methods deployed for cart security, monitoring, expiration dates, and replenishing times. Page 26
Conclusion These results indicate that EDC medication stocking varies greatly between hospitals in North Carolina; however, evidenced-based guidelines are upheld at all surveyed hospitals. Introduction In 2018 there were an estimated 200,000 cases of in-hospital cardiac arrest, with successful resuscitation dependent on high-quality cardiopulmonary resuscitation, team speed, and medication administration.1,2 Survival to discharge following in-hospital cardiac arrest ranges between 15-20%.3,4 When a patient is in cardiac arrest, each minute resuscitation is delayed can lead to a 7%-10% reduction in survival.5 In an effort to increase rapid access to medications and equipment needed in cardiac arrest, Emergency Drug Carts (EDCs) have become a cornerstone in hospitals throughout the world. An EDC is a self-contained, mobile, multi-draw-