Title Page
-
Conducted on (Date and Time)
-
Inspected by
-
Location
-
Where something is non-compliant you will be required to complete an action. Ensure you document the amount of items that need replaced due to not being within the first aid box or being out of date. Once you have completed the report ensure you order replenishments.
First Aid Check
General First Aid Box
-
Gloves vinyl x 1 and in date?
-
Guidance leaflet x 1 and in date?
-
Triangular bandage x 4 and in date?
-
Plaster W / P assortment x 20 and in date?
-
Safety pins x 6 and in date?
-
Wipes alcohol free x 10 and in date?
-
Wound dressing - eye x 2 and in date?
-
Wound dressing - large x 2 and in date?
-
Wound dressing - medium x 6 and in date?
Burn First Aid Box
-
Bandage conforming x 2 and in date?
-
Burnblott x 6 and in date?
-
Burnshield 10cm x 10cm x 2 and in date?
-
Burnshield digit dressing x 1 and in date?
-
Eye wash 20ml x 5 and in date?
-
Nitrile Gloves x 2 and in date?
-
Microporous tape x 1 Eye wash 20ml x 5 and in date?
-
Scissors x 1
Eye Wash Kit
-
If an eyewash bottle has been used it MUST be replaced
-
Saline eye wash 500 ml x 2 and in date?
-
Has the eyewash been used?
-
Sterile Eye Pad No 16 x 2 and in date?
Completion
-
Inspector (Name and Signature)
