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
Top shelf
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Gloves
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Emesis bags
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Head beds
2nd shelf
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Wings, cards, yellow locks
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Vent tubing: Hamilton & Isolette
3rd shelf
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Defib pads: 1-adult, 1-peds
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Expiration date - Adult
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Expiration date - Peds
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Pressure transducer tubing
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Expiration date
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Blood tubing
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Expiration date
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Restraints: adult & peds
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Ear plugs
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BP cuffs: neonate sizes 1-5
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BP cuffs: peds - light blue, green & orange
4th shelf
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Needles
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Syringes (variety of sizes)
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Tape
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NS flushes
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Expiration date
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60 cc syringes (luer-lock)
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Expiration date
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IV tubing
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Expiration date
5th shelf
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Pressure bags (2)
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Filters, PEEP valves, manometers
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Peds Ambu-bag
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Peds NRB
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Cold packs (2)
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Expiration date
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Hot packs (2)
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Expiration date
6th shelf
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Baby blankets, big blankets, bougie pads
Bottom shelf
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Bears
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Select date
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Crew initials