Information
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Document No.
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Audit Title
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White Oak EMS
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Conducted on
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Personnel
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DRUG BOX #
TOP SHELF
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Sodium Bicarbonate =1
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Expiration Date
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Narcan = 2
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Expiration Date
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Expiration Date
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Dextrose =1
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Expiration Date
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Epi 1:10,000 = 1
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Expiration Date
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Atropine = 1
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Expiration Date
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Lidocaine = 1
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Expiration Date
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1cc Syringe = 2
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Expiration Date
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Expiration Date
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3 cc Syringe = 2
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Expiration Date
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Expiration Date
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5 cc Syringe = 2
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Expiration Date
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Expiration Date
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10 cc Syringe = 2
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Expiration Date
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Expiration Date
SECOND SHELF
IV CATH's (2 Each)
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24 g
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Expiration Date
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Expiration Date
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22 g
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Expiration Date
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Expiration Date
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20 g
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Expiration Date
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Expiration Date
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18 g
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Expiration Date
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Expiration Date
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16 g
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Expiration Date
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Expiration Date
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14 g
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Expiration Date
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Expiration Date
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NSS Syringe 3 cc = 2
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Expiration Date
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Expiration Date
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Syringe Needles (2 each) 18 25 22<br>
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Expiration Date = 18
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Expiration Date =18
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Expiration Date =25
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Expiration Date = 25
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Expiration Date = 22
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Expiration Date = 22
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Tourniquet = 2
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Penlight = 1
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MAD Device
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Expiration Date
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Razor = 1
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Blood Tube, Purple =2
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Expiration Date
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Expiration Date
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Blood Tube, Red = 2
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Expiration Date
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Expiration Date
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Tape 1" & 1/2" (1 each)
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Hep locks = 2
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Expiration Date
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Expiration Date
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Blood tube - vac container = 2
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Expiration Date
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Expiration Date
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Blood draw needles (needle less ) =2
THIRD SHELF
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Amiodarone = 3
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Expiration Date
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Expiration Date
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Expiration Date
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Calcium = 2
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Expiration Date
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Expiration Date
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Epi 1:1,000 = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Glucagon = 1
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Expiration Date
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Zofran = 2
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Expiration Date
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Expiration Date
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Benadryl = 2
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Expiration Date
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Expiration Date
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Albuterol (box) = 3
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Expiration Date
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Expiration Date
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Expiration Date
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Albuterol (O2 green bag) = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Ipratropium = 4
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Narcan = 2
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Expiration Date
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Expiration Date
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Adenosine = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Solumedrol = 2
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Expiration Date
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Expiration Date
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Lasix = 5 (total 200mg)
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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NTG Pills = 1 bottle
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Expiration Date
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Mag Sulfate = 4
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Alcohol prep pads = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Band aids = 5
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Carpuject = 1
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Tubex = 1
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Filter needles = 2
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Expiration Date
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Expiration Date
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Diltiazem 100mg / 0.9% ADD-Vantage NSS = 2
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Expiration Date
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Expiration Date
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60 drop = 1
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Expiration Date
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Enalaprilat = 2
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Expiration Date
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Expiration Date
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Tetracaine Opthalmic = 1
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Expiration Date
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Nitro paste single use = 12
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Expiration Date
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Nitro paste papers = 12
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Expiration Date
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Verapamil = 2
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Expiration Date
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Expiration Date
BOTTOM OF BOX
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Dopamine Drip (premix) 60 drop = 1
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Expiration Date
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Dobutamine / 60 drop = 1
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Expiration Date
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NSS 500cc = 1
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Expiration Date
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Lidocaine = 3
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Expiration Date
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Expiration Date
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Expiration Date
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Lidocaine Premix / 60 drop = 1
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Expiration Date
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Epi 1:10,000 = 3
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Expiration Date
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Expiration Date
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Expiration Date
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Atropine = 1
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Expiration Date
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IV Sets 10gtts = 2
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Expiration Date
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Expiration Date
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Kling roll = 1
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Expiration Date
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IN Start Kits = 2
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Expiration Date
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Expiration Date
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Nebulizer = 1
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Expiration Date
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IV extension sets = 2
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Expiration Date
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Expiration Date
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Opsites = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Dressings 4x4 = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Dressings 2x2 = 5
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
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Expiration Date
NARCOTICS
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Valium
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Lot #
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Expiration Date
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Control #
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Valium
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Lot #
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Expiration Date
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Control #
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Versed
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Lot #
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Expiration Date
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Control #
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Versed
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Lot #
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Expiration Date
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Control #
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Morphine
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Lot #
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Expiration Date
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Control #
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Morphine
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Lot #
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Expiration Date
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Control #
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Fentanyl
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Lot #
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Expiration Date
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Control #
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Fentanyl
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Lot #
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Expiration Date
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Control #
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Drug box old seal #
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Drug box new seal #
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Narcotics old seal #
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Narcotics new seal #
COMMENTS
EXPIRING DRUGS NEXT 2 MONTHS
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
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Drug
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Expiration Date
MEDIA (If needed)
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Add media
CREW SIGNATURES
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Add signature
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Add signature
