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National Guidelines for Improvement of Quality and Safety of ...

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ANNEX 3: Emergency Tray Checklist (Sample)UNIT/WD:Emergency Tray Checklist (Sample)Month…………Year……………No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31DrugsAdrenaline Vial 10Atropine vial 10Diazepam Vial 02Dobutamine Vial 02Dopamine Vial 05Frusemide Vial 10GTN Vial 01Hydrocortisone Vial 10Isoprenaline Vial 05KCI Vial 02Metoclopramide Vial 05Midazolam Vial 02Nor-Adrenaline Vial 02Piriton Vial 05Thiopental Sodium Vial 01SolutionsNormal Saline 045% Dextrose 0250% / 25% Dextrose 02Voluven (Colloid/Starch) 02Other SuppliesAmbu Bags 01Air Ways 02Anaesthetic Mask 01Simple face Mask 01Laryngoscope 01Laryngoscope 0139

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