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Based on observation, document review and interview, the hospital did not ensure emergency equipment was readily available for treatment of pediatric emergency cases in the Surgical Services Department. Specifically, the Broselow Bag (a nylon pack with seven color-coded pouches inside for organizing pediatric trauma supplies according to the measured length of pediatric patients) contained expired equipment or lacked equipment. Additionally, the hospital's "crash cart (emergency cart) checklist" did not include checking the Broselow bag per the hospital's policy and procedure (P&P). This could cause the hospital to not be prepared for a pediatric emergency situation in the Surgical Services department.

Findings include:

-- During a tour of the post anesthesia care unit (PACU) on 11/10/2021 at 3:05 pm, the Broselow Bag was noted to have the following expired items:

Red bag
1- ETT 3.5 millimeter (mm) (expired 7/2019)
2- 8 French (Fr) feeding tubes (expired 1/8/2018 and 1/4/2019 respectively)
1- 6 Fr stylet (expired 11/2019)
1- 8 Fr foley catheter (expired 7/2021)
1- 22 gauge angiocatheter (expired 8/2020)
1- 24 gauge angiocatheter (expired 3/2019)
1- BD vaccutainer (expired 5/2013)

Purple bag
1- ETT 4.0 mm (expired 3/2019)
1- 6 Fr stylet (expired 11/2019)
1- 8 Fr foley catheter (expired 7/2021)
1- 22 angiocatheter (expired 8/2020)
1- 24 gauge angiocatheter (expired 5/2020)
1- BD vaccutainer (expired 8/2016)

The yellow, white, blue, orange and green bags contained similar expired items. Additionally the orange bag lacked a foley catheter.

-- Review of the hospital's P&P titled, "Cardio-Pulmonary Crisis Response Codes and Equipment," last reviewed 4/2020, indicated a registered nurse (RN) is assigned to check the contents of crash carts for completeness and intubation equipment for proper functioning. Checks are performed daily and documented in the record provided for this purpose. The specialized code cart utilized by pediatrics is based on the emergency resuscitation tapes utilized in pediatric codes. These are color-coded and based on weight/length measurements of children for determining the appropriate dose of medication and equipment size for pediatric patients. As such, these emergency carts are based on the same color coding for equipment sizes. All locked drawers shall be opened and inspected at least monthly, even if the cart has not been used.

-- Review of the forms titled "Rome Memorial Hospital Crash Cart Checklist," from 9/27/2021 - 11/10/2021 did not specify checking of the Broselow bag. The form contained sections to document daily that all necessary equipment for resuscitation was checked and available for use (i.e., defibrillator, pharmacy tray, IV (intravenous) supplies, intubation drawer-all components checked, IV solutions drawer and Defibrillator grid paper stocked).

-- During interview of Staff A, Director of Perioperations and Maternity, on 11/10/2021 at 3:15 pm, he/she acknowledged the above findings.