Minimum of once a day checks for the care area/clinic’s open operating times

Today's Date

What is your badge number?

This is the 4-5 digit number on the back of your ID badge

What is your role?

CS, RN, PCT, etc.

Campus:

Code Cart Location - Arrowhead

Code Cart Location - Avondale

Code Cart Location - East Valley

Code Cart Location: Thomas - East Building

Code Cart Location: Thomas - Rosenberg Building

Code Cart Location: Thomas - Main Building (Inpatient Units and ED)

Code Cart Location: Thomas - Main Building (Other)

Is the unit/department closed?

If the unit/department is closed, please select N/A or leave answers blank on remaining questions.

What is the Code Cart Number?

See sticker with number on top of cart in bottom left corner. If the cart is not numbered or it is a portable defibrillator, please put "N/A"

What is the lock number on the code cart?

Please put N/A if you are checking a portable defibrillator

Is the lock intact?

Please select N/A if you are checking a portable defibrillator

Are the code resource book and paperwork present?

Please put N/A if you are checking a portable defibrillator

Are appropriate tape, glove, and scissors present?

Please put N/A if you are checking a portable defibrillator

Does the daily defibrillation show a green check mark?

What is the expiration date of the pediatric pads?

Leave this blank if not applicable

Open the calendar popup.

What is the expiration date of the adult pads?

Leave this blank if not applicable

Open the calendar popup.

Is the ETCO2 Capnography device plugged in and on stand-by mode?

Please select N/A if device is not present

Is the cart clean and free of fluid spills?

Please put N/A if you are checking a portable defibrillator

What is the expiration date of the first drug to outdate?

Leave this blank if not applicable

Open the calendar popup.

What is the expiration date of the first supply to outdate?

Leave this blank if not applicable

Open the calendar popup.

Is the 02 tank present and more than 1/2 full?

Please select N/A if checking a portable defibrillator. If O2 tank is less than half full, please reach out to Respiratory to obtain new O2 tank.

Is the airway bag present and secured with a plastic lock?

Please select N/A if checking a portable defibrillator

What is the expiration date of the first airway supply to outdate?

Leave blank if not applicable

Open the calendar popup.

Is the suction equipment present, working, and plugged in?

Please select N/A if checking a portable defibrillator

Is a backboard present?

Please select N/A if checking a portable defibrillator

Is the code cart plugged into a red outlet (in locations where available)?

Please select N/A if checking a portable defibrillator

Was the weekly defibrillation test completed and did it pass successfully?

Weekly Defibrillator Check - Complete on Wednesdays and as needed

If “Service Unit” message appears, check equipment manual to resolve. If unable to resolve and/or message continues to appear, call Biomed and identify the location of the nearest available code cart.

Code Cart Check

This Survey is Incomplete!

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