Bluegrass First Aid Kit Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Required Items of Kit

• In this section please answer yes or no to each question as to contents. After answering each question, please use the notes portion of the response to indicate the actual number of contents.

• 16 Adhesive Bandages, 1"x 3"

  Yes

  No

  N/A

• 1 Adhesive Tape, 2.5 yards

  Yes

  No

  N/A

• 10 Antibiotic Treatment, 0.14 fl. oz. (0.5g) applications

  Yes

  No

  N/A

• 10 Antiseptic, 0.14 fl. oz. (0.5g) applications

  Yes

  No

  N/A

• 1 Breathing Barrier

  Yes

  No

  N/A

• 1 Burn Dressing, 4" x 4"

  Yes

  No

  N/A

• 10 Burn Treatment, 1/32 oz. (0.9g) applications

  Yes

  No

  N/A

• 1 Cold Pack, 4" x 5"

  Yes

  No

  N/A

• 2 Eye Coverings

  Yes

  No

  N/A

• 1 Eye Wash, 1 oz.

  Yes

  No

  N/A

• 1 First Aid Guide

  Yes

  No

  N/A

• 6 Hand Sanitizer, 1/32 oz. (0.9g) applications

  Yes

  No

  N/A

• 4 Medical Exam Gloves

  Yes

  No

  N/A

• 1 Roller Bandage, 2" x 4 yd.

  Yes

  No

  N/A

• 1 Scissors

  Yes

  No

  N/A

• 2 Sterile Pads, 3" x 3"

  Yes

  No

  N/A

• 2 Trauma Pads, 5" x 9"

  Yes

  No

  N/A

• 1 Triangular Bandage, 40" x 40" x 56"

  Yes

  No

  N/A

• Yes

  No

  N/A