Comp Checks Yes No NA
Know Staff able to explain the frequency of crash trolley checks
Know Staff able to state the concentrated electrolytes available in
crash cart
Know Staff able to state the crash call number
Know Staff able to list the CPR team members
Know Staff able to list the Paediatric CPR team members
Know Staff able to explain the location and use of Broslew tape in the crash cart (only applicable for ED, SSW & OT)
Know Staff able to explain what to do if defib is not working
Know Staff able to explain who brings the emergency box during
crash call
Know Staff able to explain what to do with the filled CPR
record after attending the crash call
Skill Staff able to demonstrate use of defib and shows the paed
paddles
Docum Crash Trolley checklist is signed daily (From July
2013)
Docum Partial checking of crash cart completed once per day (From
July 2013)
Docum Complete checking of crash trolley is done at least once per
week and after each use (From July 2013)
Docum Checking records available for 4 months
Docum Defibrillator is charged, tested and discharged on the day of
audit
Docum Defibrillator test strip with"TEST PASSED' available
(One per day for a week)
Docum Blank/ unfilled CPR Record form is available
Docum Lock No: on crash cart matches the No: mentioned in the
check list
Observ Trolley is clean and in easily accessible place
Observ Defibrillator is plugged to the electrical outlet
Remarks
y applicable for ED, SSW & OT)
Comp Checks Yes No NA
Observ Defibrillator ECG record roll is adequate
Observ PPM on Defibrillator is valid
Observ PPM on suction machine valid
Observ Crash cart is locked with coded plastic lock
Observ Extra plastic lock kept in DDA cupboard
Observ Medication drawers are locked
Observ Medication drawers/Trays are properly labeled
Observ Drawer partitions are clearly labeled
Observ Concentrated Electrolytes (Magnesium Sulphate) is labeled
and separated from other medications
Observ Items kept in unlocked areas are stored as per checklsit
Observ Light is functioning
Observ Sharps container lid available
Observ Suction machine is functioning
Observ Oxygen Cylinder pressure is above the refill level (>
300 psi for old regulators)
COMMENTS:
NA - Lab, Pharmacy, NICU
ED x 3, OPD x 2, OT x2, Minor OT x 1, Radiology x 1, ECG room x 1
Remarks