Audit

Timely Response

ICU RN

Respiratory Therapist

Hospitalist

Lab

ADON

EKG

Neurologist

Other

Was patient already receiving respiratory treatments and/or oxygen?

Vascular Access

No Issues

Delay

Infiltration/Disconnection

Medications/Respiratory Treatments

No issues

Delay

Selection

Dose

Equipment/Supply Issues

No issues

Availability

Function

Comments

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.