Title Page

  • Conducted on

  • Prepared by

  • Location
  • Site

  • Name

  • Date

Areas of work

General Information

  • Does the site have a first aid room?

  • If yes, complete Section 1 - First Aid Room

  • Does the site have an AED (defibrillator)?

  • If yes, complete Section 2 - AED

  • Does the site have external inspectors to inspect the first aid kit?

  • Has the first aid kit been inspected within the last two months?

  • If no, complete Section 3 - First Aid Kits

Section 1 - First Aid Room

  • Is there a first aid kit in the first aid room?

  • Hygienic hand cleanser and disposable paper towels

  • An examination lamp with magnifier

  • A cupboard for storage

  • A container with disposable lining for soiled waste

  • A container for the safe disposal of sharps a bowl or bucket (minimum two litres capacity)

  • Electric power points

  • A chair and a table or desk

  • A telephone and/or emergency call system

  • Be located within easy access to a sink with hot and cold water

  • (where this is not provided in the room) and toilet facilities

  • Offer privacy via screening or a door

  • Be easily accessible to emergency services (minimum door width of 1 metre for stretcher access)

  • Be well lit and ventilated

  • Have an appropriate floor area (14 square metres as a guide)

  • Have an entrance that is clearly marked with first aid signage

Section 2 - AED

  • AED is in signed location

  • Ready light is Green

  • Pads are in date and free from damage

  • Battery is in date and free from damage

  • External unit is free from damage

Section 3 - First Aid Kits

  • Instructions for providing first aid – including Cardio-Pulmonary Resuscitation (CPR) flow chart

  • Notebook and pen 1

  • Resuscitation face mask or face shield 1

  • Disposable nitrile examination gloves

  • Gauze pieces 7.5 x 7.5 cm, sterile (3 per pack)

  • Saline (15 ml)

  • Wound cleaning wipe (single 1% Cetrimide BP)

  • Adhesive dressing strips – plastic or fabric (packet of 50)

  • Splinter probes (single use, disposable)

  • Tweezers/forceps

  • Antiseptic liquid/spray (50 ml)

  • Non-adherent wound dressing/pad 5 x 5 cm (small)

  • Non-adherent wound dressing/pad 7.5 x 10 cm (medium)

  • Non-adherent wound dressing/pad 10 x 10 cm (large)

  • Conforming cotton bandage, 5 cm width

  • Conforming cotton bandage, 7.5 cm width

  • Crepe bandage 10 cm (for serious bleeding and pressure application)

  • Scissors

  • Non-stretch, hypoallergenic adhesive tape – 2.5 cm wide roll

  • Safety pins (packet of 6)

  • BPC wound dressings No. 14, medium

  • BPC wound dressings No. 15, large

  • Dressing – Combine Pad 9 x 20 cm

  • Plastic bags - clip seal

  • Triangular bandage (calico or cotton minimum width 90 cm)

  • Emergency rescue blanket (for shock or hypothermia)

  • Eye pad (single use)

  • Access to 20 minutes of clean running water or (if this is not available) hydro gel (3.5 gm sachets)

  • Instant ice pack (e.g. for treatment of soft tissue injuries and some stings)

  • Comments / Other Observations

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