Lusail Real Estate Development Company

L&T Construction Power Transmission & Distribution

CP 24
Page 1 of 2
HSE DEPARTMENT Weekly Equipments / 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:
 Lusail Real Estate Development Company
L&T Construction Power Transmission & Distribution
CP 24
Page 1 of 2
HSE DEPARTMENT Weekly Equipments / 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
31. Portable BP n/a 04/14/16 1pc.
32. Thermometer mercury n/a 04/14/16 1pc.
33. Pen light n/a 04/14/16 1pc
34. Infusion set 12/18 04/14/16 1pc.
35. IV Cannula Gauge 18 03/19 04/14/16 1pc
36. IV Cannula Gauge 20 03/19 04/14/16 1pc.
37. IV Cannula Gauge 22 04/19 04/14/16 1pc.
38. Syringe 10 ml 04/20 04/14/16 2pcs
39. Syringe 5 ml 04/20 04/14/16 2pcs
40. Syringe 10 ml 04/20 04/14/16 2pcs
41. Tourniquet n/a 04/14/16 1pc
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
Signature of Staff:
LOCATION: