Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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155
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156
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157
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Zoll AC adaptor
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Portawarmer
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Pelvic binder
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CVL kit
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Select date
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Portable suction canister w/ tubing / yankaurer
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Hot packs (2) check exp date
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Cold pack (2)
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60 cc catheter tip syringe
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Select date
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Surgical lube (4-6 pks)
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Select date
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NG 1 set of each: 5, 8, 10, 12, 14, 16, 18 fr. Some have exp dates. Change if outdated, damaged, yellow or open.
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Jet ventilation ( 3.0 ETT , 14g 2 inch, 14g 11/4g)
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3.0 ETT
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Select date
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14g angio 2 inch
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Select date
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14g angio 11/4 inch
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Select date
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Add signature
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Select date
