Title Page
-
Client / Site
-
Conducted on (Date and Time)
-
Inspected by
-
Location
Bleeding and Wounds
-
Various size regular bandages
-
Butterfly bandages
-
Steri-strips
-
Compound tincture of benzoin
-
Liquid bandage (superglue)
-
Finger / knuckle bandages
-
Gauze Dressing Pads (2x2, 4x4)
-
Trauma pads
-
Triangular bandage
-
Hemostatic agent
-
Gauze roll bandages (2 in and 4 in)
-
Nylon sutures (#3 - #5)
-
Needle puller
-
Surgical scissors
-
Eyewash (for wound irrigation)
Burns
-
Burn Jel
-
Burn Dressing (4x4ish)
Fever / Pain
-
Thermometer
-
Aspirin, Ibuprofen, Tylenol, Excedrin
-
Pain relieving spray
-
Oral pain gel
-
Icy Hot
-
Cooling Towel
Other Creams / Sprays / Ointments
-
Sting / bite relief
-
Hydrocortisone
-
Antibiotic ointment
-
Povidone-iodine pads
-
Antiseptic pads
-
Antiseptic hand wipes
-
Lip ointment
-
Sunscreen
OTC Meds
-
Allergy medicine
-
Nausea / diarrhea meds
-
Cold medicine
-
Antacid
-
Cough drops
Sprain / Break
-
Flexible Splint
-
Finger Splint
-
Cold Packs
-
Elastic bandages (3")
Dehydration
-
Medi-Lyte
-
Oral IV
Other
-
Eye pad
-
CM Shield
-
Nitrile gloves
-
EMT Shears
-
Tweezers
-
Waterproof tape
Completion
-
Recommendations
-
Inspector (Name and Signature)