Instrument Cart

Everything there is to know about an instrument cart 

An instrument cart is a trolley commonly used in hospitals to carry various instruments to and from the site where they are needed. This cart is usually made up of stainless steel and has four wheels on which it can move. Depending upon the nature of the surrounding environment and ward of use, there are various types of these trolleys known by different names in different places. In emergency settings, this trolley is known as a crash cart or code cart. It has places to store all the necessary medications and instruments needed during emergency times. Similarly, in the anesthesia department, anesthesia trolleys are used.

History of instrument carts

Carts have existed for as long of a period as the second millennium B.C. Its origin is related to the invention of the wheel. Humans used carts for transport and to carry things from place to place. Carts of different types have a variable number of wheels on them, four-wheeled wain have found their use in the medical field since the early 1960s. Instruments used in surgery are sterilized and should not get carried in hands to the site of their need; they must move via the sterilized carts. The Crash Cart was created in 1962 and contained an Ambu bag, Endotracheal Tube, Defibrillators.

Uses of an instrument cart

Trolleys are used in the medical setup in different ways depending upon the ward of use.

  1. In Emergency. In an emergency setting, the cart is called the Crash Cart. It is one of the most critical things in a hospital. These units are available in every ward to deal with the sudden onset of an emergency to save a human life. It has drawers, trays, and shelves and enables the doctor to perform life-saving procedures on the patients. The most widely present pieces of equipment in the crash cart are monitors, defibrillators, ECG machines, bag valve masks, endotracheal tubes, and other intubating equipment. This life-saving unit contains drugs to support life and save lives. These drugs include epinephrine, amiodarone, atropine, lidocaine, sodium bicarbonate, dopamine, and vasopressin. In addition to these drugs, drugs to deal with everyday problems are also available in it, including adenosine, midazolam, diazepam, dextrose, naloxone, epinephrine, and more. The crash cart also has the equipment to gain peripheral and venous access. This cart should be present in all the medical units because no one knows when an emergency can arise.
  2. In Operation Theatre. During surgery, instruments cannot be used randomly on the human body. The risk of infection would be so high if doctors use the same tools repeatedly without cleaning and disinfecting them. For this reason, instruments get sterilized before the surgery. But carrying these to the operation theatre will contaminate them; that is why instrument carts are needed. These sterilized trolleys are quickly loaded with the disinfected and sterilized instruments and then carried to the theatre. The instrument cart is straightforward to use because of its design and easy mobility.
  3. Dispensing Carts in The Wards. Working in the wards means dealing with a large number of patients. To provide every patient with medication, the doctor and nurses cannot move to and from between the patients and the drug station. Here comes the role of an instrument cart in the ward as a dispensing trolley. Doctors load the trolley with all the drugs, fluids, drip sets, and injections; then, the trolley is carried to the patients so that appropriate drugs and care reach them without any setbacks.
  4. In Anesthesia Department. Another essential role of an instrument trolley is in the operation theatre during the induction of anesthesia. Apart from the anesthesia machine to make a patient numb, the anesthesiologists also have an instrument cart. In this cart, they have medications to push an extra bit of anesthetic agents, instruments to reverse the anesthesia, and keep all the devices that are needed closer to the anesthesiologist for accessible location. The Anesthesia tools should be very well-organized to help doctors in providing appropriate care to the patients. These instrument carrying units in anesthesia are known as anesthesia carts.

Complications or disadvantages of an instrument trolley

There is no harmful effect of the instrument cart as such, but it can be a health hazard when it malfunctions. In operation theatres, the trolley should be well disinfected and covered with an article of sterilized clothing for placing surgical instruments. But when the person who prepares the cart is irresponsible, this instrument unit becomes a serious source of infection for the patient. The infected trolley will infect the instruments, which will eventually harm the person undergoing surgery.

Another risk of instrument trolley is any sharp edge of the old worn-out cart, which may injure the surgeons or operation theatre assistants.

General specifications

The instrument carrying units are available in a variety of sizes, again, depending upon the area of their need but the general specification of the trolleys to be used in an operation theatre are as follows:

  1. Dimensions – 900mm long x 600mm wide x 850mm high
  2. Material – The tubular frame made up of iron, which is coated with paint or epoxy to avoid rust. Two shelves made up of heavy stainless steel are fit in the frame.
  3. Mobility – The cart should be easily movable and should have four castors of nearly 7.5cm for smooth movement without extra effort. They must have push and pull rails.
  4. Security – The shelves and the frame must have blunt ends so that they do not harm the operator. Besides, the shelves must have protective railings on three sides of the instrument cart. The fourth side is left alone so that picking up an instrument would be easy and quick.

How they work

The cart is used to take surgical instruments safely from the sterilization chamber to the operation theatre. It is first lined with the sterilized cotton towels and then with a disinfected plastic sheet. Then a tray having all the surgical instruments is placed on the side of the cart. The instruments are placed over the plastic sheet so that the instruments' tips do not touch the sheets. The surgical equipment pieces are utilized according to their needs and used items placed back into the tray on the table. After the surgery, the trolley goes back to the sterilization chamber, and all the equipment and instruments are cleaned and sterilized again.

Market leaders:

The medical cart business is growing daily and is expected to grow at a rate of 14.2% from 2018 to 2023. The stakeholders are attempting to stay in the race by making the product cost-effective as well as efficient. Numerous companies are known for their instrument carts and trolleys, and some are below:

  1. Midmark Corporation – this Ohio-based company is the biggest in the market of carts and trolleys. It was founded in 1915 and is known to manufacture various medical and surgical equipment like chairs, vacuums, diagnostic solutions, and more.
  2. Harloff Company Inc. – another US-based company founded in 1951, provides the healthcare system with a variety of carts and cabinets and solves storage problems. The company has a tagline of "Innovating Storage for Care."
  3. Capsa Healthcare – this company was also founded in 1951 and also has headquarters in the United States. This healthcare company has manufacturing units in over 70 countries and has a large global market value.
  4. The Bergmann Group – the Bergmann Group was founded in the early 1980s and had two sub-companies to deal with their work in the healthcare department: Waterloo Healthcare and Phoenix LTC. Phoenix LTC is the one that has its feet well established in the field of medical and surgical instrument carts.
  5. Afc Industries, Inc. – founded in the 1990s, this company is making furniture based on the ergonomics and offers a wide range of mobile carts, trolleys, and workstations.

Conclusion:

Instrument carts have long been used in medicine and surgery and should always be present in any clinical setup. This thing not only makes equipment readily available but can also boost the confidence level of the doctor. The doctor can be more efficient in his work and can give the patients adequate treatment if he has all the necessary drugs and pieces of equipment. Every good clinic and hospital should have its crash trolley, dispensing unit, and an instrument cart. This will help organize the stuff and appeal to the patient that a particular doctor has all sorts of instruments in his clinic or hospital. This will boost the input of the patients as well as the working skills of the doctor.

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