Public Access Bleeding Control Kit Inspection Checklist Form
Use this checklist to inspect and document the status of public access bleeding control kits. Ensure all items are present and in good condition during each inspection.
Kit Identification / Location
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Kit is easily accessible and properly placed
*
Kit is visible and unobstructed
Kit is mounted/placed as per guidelines
Seal/lock is intact and shows no signs of tampering
*
Seal/lock is intact
No signs of tampering
Presence of required kit contents
*
Tourniquet present
Trauma dressing present
Compression bandage present
Gloves present
Shears present
Condition of kit contents
*
All items are clean and undamaged
No items are expired
Expiry status of kit contents
*
All items within expiry date
Items nearing expiry (within 3 months)
Replenishment needed for any kit items
*
No replenishment needed
Replenishment required (list in notes)
Additional notes or observations
Submit Inspection
Should be Empty: