Organization of the Regional Anesthesia Cart

It is understandable that there may be variations in personal preferences as to which equipment and medication a regional anesthesia cart should contain and how it should be organized. However, for those trying to establish a regional anesthesia service, the literature does not appear to provide much help as most of what has been suggest is outdated. In this section we describe the basic organization of our regional anesthesia cart at St. Luke's-Roosevelt Hospital Center. The cart is organized and stocked in such a way that just about any regional block procedure can be performed time-efficiently and effortlessly in the block area, on the patient ward or in the operating room.

Image We use a BlueBell® 6-drawer cart, Figure 1. A sharps disposal container (1) and a small discard boxes are attached to the cart and both are extremely useful and practical. An Ambu bag is also attached to the side of the cart (3).
Image The top drawer (Figure 2) contains mostly various needles and syringes: 1ml and 3 ml syringes (1), 5ml, 10 ml syringes and a blank label tape (2), 20 ml syringes (3), 10 ml and control syringes (4), IV catheters and a tourniquet (5), 18G needles (6), 25G 1 ½" needles (7), alcohol swabs (8), stopcocks (9), grounding electrodes or good quality ECG pads (10).
Image The second drawer (Figure 3) contains block needles, local anesthetics and additives: 50 mm long insulated needles (1), 100 mm long insulated needles (2), 150 mm long insulated needles (3), 27 G 127 mm pencil point spinal needle (4), 24 G 90mm and 120mm long Sprotte® spinal needles (5), 22 G 90 mm and 120 mm Quincky-type spinal needles (6), 22 G 80 mm Tuohy epidural needle (these are a good choice for thoracic paravertebral blocks - 7), skin markers (8), 3% chloroprocaine bottles (9), 1% ropivacaine bottles (10), sterile water bottles (11), 0.9% sodium chloride bottles (12), 1 ml 1:1,000 epinephrine ampoules and a label tape (13), 1.5% mepivacaine bottles (14), 0.5% bupivacaine bottles (15), 2% lidocaine ampoules (16), bicarbonate ampoules (17).
Image The third drawer (Figure 4) contains mostly continuous nerve block sets and various dressing material: continuous nerve block set with a 150 mm long needle (1), continuous nerve block set with a 100 mm long needle (2), continuous nerve block set with a 50 mm long needle (3), various other continuous nerve block sets (4), various tubing and nerve stimulator electrode extension sets (5), various clear dressing material (6), adhesive tapes and other accessories for securing the catheters in place (7).
Image The fourth drawer is an emergency set which contains various items for airway management and resuscitation: laryngoscope handle and blades of various types and sizes, oral airways and intubating guide wires, tongue depressors (1), laryngeal mask airway (2), several endo-tracheal tubes of various sizes (3), nasal airways (4), end-tidal CO2 detector (5), various emer-gency and induction drugs (lidocaine, ephedrine, phenyl-ephrine, epinephrine, atropine, calcium, propofol, succinylcholine, flumazenil, naloxone) (6).
Image The fifth drawer contains epidural and spinal trays (1) and nerve stimulator(s) (2).
Image The bottom drawer contains various items such as a couple of bags of intravenous fluids and IV set for emergency use (1), packs of sterile towels (2), oxygen masks (3), 4x4" gauze, iodine and alcohol prep solutions, sterile plastic drape kits (3), sterile gloves of various sizes (5).

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DISCLAIMER: The material presented on this Web page has not been peer-reviewed. The indications, techniques and dosages on this Web page have been recommended in the medical literature and/or conform to OUR clinical practice. The medications and equipment have not necessarily been approved by the Food and Drug Administration (FDA) for use in the techniques and dosages for which they are recommended. The package insert for each drug and/or equipment should be consulted for use and dosage as recommended by the FDA. Because standards, practices and recommendations change, it is advisable to keep abreast of revised recommendations, particularly those concerning new drugs and techniques. While the techniques and dosages described are successfully used in our practice, they should be followed with a discretion since their complications may be dependent on the operator, patient and/or other accompanying clinical circumstances. The development and maintenance of this web page has not been supported by any pharmaceutical or medical manufacturing industry. The medications and/or equipment discussed in the web page is shown solely for teaching purposes. Similar equipment or medications from other manufacturers may produce similar clinical results to ours.