A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit. (February 2018)

• Record Type: Journal Article
• Authors: Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J. Gordon
• Is Part Of: Intensive and critical care nursing. Volume 44(2018)
• Page Start: 40
• Page End: 44
• Publication Date: 2018-02
• Subjects: Crash cart -- Crash trolley -- Emergency trolley -- Hypertonic saline -- Intracranial pressure -- Mannitol -- Medication safety -- Medication turnaround time -- Neurocritical care -- Status epilepticus; Intensive care nursing -- Periodicals; Critical Illness -- nursing -- Periodicals; Intensive Care -- Periodicals; Nursing Care -- Periodicals; Intensive care nursing; Periodicals; Electronic journals; 616.028
• DOI: 10.1016/j.iccn.2017.09.003
• Languages: English
• ISSNs: 0964-3397

Abstract

Abstract: Objectives: To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. Research methodology/design: In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. Setting: 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Main outcome measures: Time to medication administration. Results: In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10 minutes, p = 0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. Conclusion: The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times.