Emergency equipment daily check

• Conducted on

  Date

• Prepared by

• Location
  Address

• Glyceryl trinitate (GTN) spray

  Date

• Salbutamol aerosol inhaler

  Date

• Adrenaline injection (1:1000, 1mg/ml) (2 Units)

  Date

• Glucagon injection 1mg (in fridge)

  Date

• Dispersible aspirin (300mg)

  Date

• Oral glucose solution gel

  Date

• Midazolam 10mg

  Date

Defibrilator

• Is defibrillator in tact with battery pack?

  Yes

  No

  N/A

• Does defibrillator turn on

  Yes

  No

  N/A

• Is oxygen available and in date

  Yes

  No

  N/A

• Is there a rebreathe mask available?

  Yes

  No

  N/A