Emed Rescue 24

• Conducted on

  Date

• Audit No.

• Audit Title

• Auditor

• Auditee

Ambulance audit to check if the standard is up to date

• Was the ambulance audited before<br>

  Yes

  No

  N/A

• Emed rescue sop

• Purpose: To ensure compliance of with Ministry of Health ambulance act.

• Scope: E-Med Medical ambulance Operation

New cat

• Is there a SOP

• Documented<br>

  Yes

  No

  N/A

• Is it implemented?

  Yes

  No

  N/A

• Does it conform?

  Yes

  No

  N/A

• Yes

  No

  N/A

1 Documentation and Procedures

• 1.1 Is there a procedure manual published and distributed for the ambulance Operations?

  Conform

  Non-conformity

  Not Applicable

• 1.2 Is there a procedure manual for the paramedics and their activities?

  Yes

  No

  N/A

• 1.2.4 Is the procedure manual approved and up to date?

  Yes

  No

  N/A

• 1.2.2 Is the procedure manual distributed and amendments up to date?

  Yes

  No

  N/A

• 1.2.3 Is the procedure manual approved and up to date?

  Yes

  No

  N/A

• 1.2.5 Is the procedure manual distributed and amendments up to date?

  Yes

  No

  N/A

• 1.3 Is there training records for flight Paramedical crew?

  Yes

  No

  N/A

• 1.4 Is there a procedure published for dealing with contagious and infectious diseases?

  Yes

  No

  N/A

• 1.4.1 Is protective gear available for Paramedical personnel for use when transporting infectious or contagious patients/dangerous scene?

  Yes

  No

  N/A

• 1.5 Is there a quarantine and cleaning procedure for ambulance.(after a infectious ,contagious or bleeding patient have been transported)

  Yes

  No

  N/A

• 1.6 Is there a published procedure for cleaning the ambulance after transportation?(after a infectious ,contagious or bleeding patient have been transported)

  Yes

  No

  N/A

• 1.7 Is there a published procedure for filling the oxygen bottles in the Ambulance?

  Yes

  No

  N/A

• 1.8 Is there published crew requirements for Paramedical staff?

  Yes

  No

  N/A

• 1.9 Is the crew requirements taken into consideration when crew is rostered for Paramedical duty?

  Yes

  No

  N/A

2 Training Records

• 2.1 Is there a training record for each flight paramedical crew member on Medevac duty?

  Yes

  No

  N/A

• 2.1.1 Does the training records comply with the requirements of WWC FOM Part 1, Chapter 9, Annexure C: Curriculum for Flight crew?

  Yes

  No

  N/A

• 2.2 Is there a CPD training record for each paramedical crew member on ambulance duty?

  Yes

  No

  N/A

• 2.2.1 Does the training records comply with the requirements of HPCNA?

  Yes

  No

  N/A

3 Equipment and Ambulance

• 3.1 Is there an approved Standard or modification of the Ambulance Stretchers, Oxygen System installed and other equipment in the Ambulance file and/or the POH?

  Yes

  No

  N/A

• 3.2 Is there a means to secure all loose equipment not used by the medical crew in the Ambulance durin transport?

  Yes

  No

  N/A

• 3.3Are any fire extinguishers fitted in the ambulance and are they checked regularly?

  Yes

  No

  N/A

• 3.6 Is each Ambulance issued with a jump bag/s of medical supplies and equipment and are they checked regularly?

  Yes

  No

  N/A

• 3.6.1 Are records kept to which medical crew member medical supplies and equipment are issued?

  Yes

  No

  N/A

• 3.6.2 Are records kept of medical supplies dispensed to patients?

  Yes

  No

  N/A

• Yes

  No

  N/A

Ambulance

• Quantity of ambulances?<br>

  Conform

  Non-conformity

  Not Applicable

• Car details

Car registration

• Vehicle reg

• Driver name

• Grade cleanliness

General Observations and Recommendations

• Observations

• Recommendations

• Off

  On

Acceptance

• Auditor Signature

  Sign

• Auditee Signature

  Sign