Resuscitation TrolleyDaily Checklist

………………... Ward Trolley Tag No……….. / Date / Date / Date / Date / Date / Date / Date
Month………………… Year 20…………..
Top of Trolley
Defibrillator + pad + razor + gloves in carry case
Defibrillator battery status “OKAY” with 2 or more charge indicator bars. If ‘No’ or only 1charge bar report to Medical Physics Glenfield Hospital ext. 73 - 3511
Model Physio Control Lifepak 1000 series / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No
Suction machine + tubing
Is suction machine working? Yes/No.
(If not working, report to Medical Physics Glenfield Hospital ext. 73 – 3511) / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No
Resuscitation audit forms available on trolley
Drawer 1
Laryngoscope with size 3 blade
Pocket mask with valve
Oropharyngeal airway size 2 green
Oropharyngeal airway size 3 orange
Oropharyngeal airway size 4 red
Nasopharyngeal airway size 6
Nasopharyngeal airway size 7
Nasopharyngeal airway size 8
I-GEL size 3
I-GEL size 4
I-GEL size 5
Syringe 10ml unpacked and labelled AIR
ET tube size 7
ET tube size 8
ET tube size 9
Cotton tie for ET tube
Single use McGill forceps
Scissors 100mm x 1 pair
Yankauer sucker x 2
Micropore tape 25mm x 1
Bandage x 2
Ligature cutters x 1 pair
Lubricating Jelly
Pen Torch (working)
Drawer 2
Cannula size 14g Orange x 2
Cannula size 16g Grey x 2
Cannula size 18g Green x2
Cannula size 20g Pink x 2
Occlusive dressing for cannulas x 2
Hypodermic needle size 19g cream x 5
Hypodermic needle size 21g green x 5
Hypodermic needle size 23g blue x 5
Hypodermic needle size 25g orange x 5
Syringe 10mls x 10
Syringe 20mls x 20
Blood gas syringe x 2
Skin cleaning swab x 6
Tourniquet blue single use x 2
Drawer 3
I.V. fluids giving set x 2
Blood giving set x 2
Normal saline flushes 10ml x 20
Gelofusin solution x 1
In date Yes/ No reorder via pharmacy
Dextrose solution 5%500mls x 1plus 10% 500mls x 1
In date Yes/No reorder via pharmacy
Normal saline solution 0.9% 500mls x 1
In date Yes/No reorder via pharmacy
Drawer 4
Red drug box in date and still sealed
White drug box in date and still sealed
Drawer 5
Ryles tube 14g x 2
Gauze swabs x 2 packs
Bag valve mask x 1
Spare defibrillator pads
ECG electrodes in carry case
Gloves latex free small, medium, large
Side of Trolley
Suction catheter size 12 white x 1
Suction catheter size 14 green x 1
Suction catheter size 16 orange x 1
Tracheal tube introducer
Oxygen cylinder + O2 100% face mask non rebreathe attached.. Is cylinder dial above ¼ full?
Replace cylinder when showing ¼ full on dial, date and initial when changed / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No / Yes
No
Bag valve mask hanging on drip pole
Print + signature of staff checking trolley
Time of daily check