TO BE COMPLETED EVERY 1ST OF THE MONTH
AIRWAY
4 Adult NRB(Required)
4 Adult NC(Required)
2 Pediatric NC(Required)
2 Pediatric NRB(Required)
2 Nebulizer Pipe(Required)
2 Suction Tubing(Required)
2 Yankour Suction(Required)
1 French Suction (6, 8, 10, 12, 14, 16)(Required)
1 OPA Kit with 8 sizes(Required)
1 NPA Kit with 8 sizes(Required)
8 Lube(Required)
2 Bulb Syringe(Required)
1 Humidified O2 Setup(Required)
TRAUMA
24 2x2(Required)
24 4x4(Required)
10 5x9(Required)
2 Trauma Dressings(Required)
2 Burn Sheets(Required)
3 2 Inch Rolled Gauze(Required)
4 3 Inch Rolled Gauze(Required)
3 4 Inch Rolled Gauze(Required)
2 Quick Clot(Required)
2 Chest Seals(Required)
6 Triangle Bandages(Required)
1 1 Inch Tape(Required)
1 2 Inch Tape(Required)
1 3 Inch Tape(Required)
1 Trauma Shears(Required)
1 Penlight(Required)
1 O2 Wrench(Required)
4 Cold Packs(Required)
2 SAM Splints(Required)
1 Trauma Tourniquet(Required)
1 1000ml Sterile Saline(Required)
1 Roll Clear Wrap(Required)
MISCELLANEOUS
2 Emesis Bags(Required)
1 OB Kit(Required)
2 Isolation Kits(Required)
1 Tissue Box(Required)
6 Sanitary Napkins(Required)
1 Urinal(Required)
1 Bedpan(Required)
2 N95 Masks(Required)
2 Rubber Glove Sets(Required)
LINENS
3 Pillowcases(Required)
3 Stretcher Sheets(Required)
3 Blankets(Required)
4 Towels(Required)
1 Pillow(Required)
NOW THAT YOUR CHECK IS COMPLETE, PLEASE SEAL YOUR CABINET AND PLACE SEAL NUMBER BELOW!
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