Public Access Trauma Kit Inspection Checklist Form
Complete this checklist to document the condition and readiness of a publicly accessible trauma kit.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Trauma Kit
*
Kit Identification Number or Label
Is the trauma kit accessible and visible?
*
Yes
No
Is the kit seal intact and untampered?
*
Yes
No
Are all required contents present and in usable condition?
*
Yes
No
Checklist of Key Kit Components
*
Rows
Present
Expired
Damaged
Tourniquet
1
2
3
Trauma Shears
4
5
6
Gloves
7
8
9
Hemostatic Gauze
10
11
12
Chest Seal
13
14
15
Emergency Blanket
16
17
18
Is the kit clean and free from visible damage?
*
Yes
No
Does the kit require restocking or maintenance?
*
Yes
No
Inspector's Name
*
Submit Inspection
Should be Empty: