AIRWAY Bag

• Conducted on

  Date

• Prepared by

• Date of inspection

  Date

RIGHT COMPARTMENT

• LMA Size 1 (x1)

  Yes

  No

  N/A

• LMA Size 2 (x1)

  Yes

  No

  N/A

• LMA Size 3 (x1)

  Yes

  No

  N/A

• LMA Size 4 (x1)

  Yes

  No

  N/A

• LMA Size 5 (x1)

  Yes

  No

  N/A

• Lubricating Jelly (x10)

  Yes

  No

  N/A

• 60 mL Syringe (x1)

  Yes

  No

  N/A

RIGHT COMPARTMENT

• King Tube Size 3 (x1)

  Yes

  No

  N/A

• King Tube Size 4 (x1)

  Yes

  No

  N/A

• King Tube Size 5 (x1)

  Yes

  No

  N/A

• King Tube Syringe (x1)

  Yes

  No

  N/A

• Lubricating Jelly (x10)

  Yes

  No

  N/A

CENTER COMPARTMENT

• Suction Fully Charged

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Suction tubing attached

  Yes

  No

  N/A

• Yakauer attached to tubing

  Yes

  No

  N/A

• Suction catheter

  Yes

  No

  N/A

• OPA x 8

  Yes

  No

  N/A

• NPA x4 with gel

  Yes

  No

  N/A

Bottom

• Suction Charging Cables x2

  Yes

  No

  N/A

• Infant BVM

  Yes

  No

  N/A

• Child BVM

  Yes

  No

  N/A

Left Compartment

• Stethoscope x1

  Yes

  No

  N/A

• CO Masimo Kit

  Yes

  No

  N/A