Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

C-PAP Checklist

  • 1- C-PAP Unit & Case

  • 1- Sealed package of tubing

  • 1 each- Small/Medium/Large Face pieces

  • 1 E Cylinder with C-PAP connection

  • PSI of E-Cylinder

  • OLD C-PAP TAG NUMBER

  • NEW C-PAP TAG NUMBER

Glucometer Check

  • Minimum of 5 Lancets

  • 5 Alcohol Wipes

  • Minimum 10 Glucometer Strips

Portable Suction

  • Suction working properly

  • Charged Batteries

  • Any Damage?

Crew Signatures

  • Add signature

  • Add signature

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