Lusail Real Estate Development Company

L&T Construction Power Transmission & Distribution
CP 24
Page 1 of 2
HSE DEPARTMENT Weekly Equipment’s / Materials Checklist

WEEKLY EQUIPMENTS / MATERIALS CHECKLIST
MONTH OF: NAME OF MEDICAL STAFF:
Basic ALS First Responder Bag
Week Week Week Week
1 2 3 4
No. Name of Items Expiry Date Quantity Consumed Remaining
Date Received
1. Sterile surgical Gloves 06/17 04/14/16 1pr.
2. Gauze swab 10cm 03/18 04/14/16 6pcs.
x10cm
3. Bandage Adhesive n/a 04/14/16 1pc
Strips
4. Adhesive tape n/a 04/14/16 2pcs.
5. Elastic bandage 03/20 04/14/16 1pc
6. Gauze roll medium 03/20 04/14/16 3pcs
7. Gauze roll large 03/20 04/14/16 1pc
8. Endotracheal tube 02/20 04/14/16 1pc
French 26
9. Endotracheal tube 06/20 04/14/16 1pc
French 30
10. Endotracheal tube 06/20 04/14/16 1pc
French 32
11. Tweezer n/a 04/14/16 1pc
12. Surgical Blade 05/19 04/14/16 3pcs
13. Mayo Scissor n/a 04/14/16 1pc
14. Curved Forcep n/a 04/14/16 1pc
15. Spatula n/a 04/14/16 1pc
16. Percussion Hammer n/a 04/14/16 1pc
17. Blade Handle n/a 04/14/16 1pc
18. Medasa Forcep n/a 04/14/16 1pc
19. Intubation set n/a 04/14/16 1pc
(Laryngoscope)
20. Portable Suction n/a 04/14/16 1pc
21. Ambubag n/a 04/14/16 1pc
22. Oxygen Mask 09/17 04/14/16 2pcs
23. Portable oxygen 07/19 04/14/16 1pc
24. Suction Catheter 06/20 04/14/16 1pc
French 8
25. Suction Catheter 03/20 04/14/16 1pc
French 10
26. Suction Catheter 11/18 04/14/16 1pc
French 12
27. Guedel Airway 50mm 05/18 04/14/16 1pc
28. Guedel Airway 70mm 09/17 04/14/16 1pc
29. Guedel Airway 100mm 09/17 04/14/16 1pc
30. Bandage Scissors n/a 04/14/16 1pc
Signature of Staff:
LOCATION:

47. 53. 35. Portable BP n/a 04/14/16 1pc. 48. Lusail Real Estate Development Company L&T Construction Power Transmission & Distribution CP 24 Page 1 of 2 HSE DEPARTMENT Weekly Equipment’s / Materials Checklist WEEKLY EQUIPMENTS / MATERIALS CHECKLIST MONTH OF: NAME OF MEDICAL STAFF: Basic ALS First Responder Bag Week Week Week Week 1 2 3 4 No. 43. 57. IV Cannula Gauge 20 03/19 04/14/16 1pc. Signature of Staff: LOCATION: . 37. Tourniquet n/a 04/14/16 1pc 42. Syringe 5 ml 04/20 04/14/16 2pcs 40. 49. Syringe 10 ml 04/20 04/14/16 2pcs 41. 59. Thermometer mercury n/a 04/14/16 1pc. IV Cannula Gauge 18 03/19 04/14/16 1pc 36. 45. 51. IV Cannula Gauge 22 04/19 04/14/16 1pc. Pen light n/a 04/14/16 1pc 34. 38. 54. 56. 58. 55. 32. 44. Infusion set 12/18 04/14/16 1pc. 52. 60. Name of Items Expiry Date Quantity Consumed Remaining Date Received 31. 50. Syringe 10 ml 04/20 04/14/16 2pcs 39. 46. 33.

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