HEALTH AND SAFETY MANAGEMENT SYSTEMS COMPANY LOGO
FIRST AID BOX CHECKLIST FORM
It is the responsibility of the supervisor/project manager or appointed company vehicle driver(s) to ensure that the
First Aid Kits are well maintained, and any contents that are used or used by date have expired from the First Aid Kit
are replenished.
Site Name:
Inspected by: Date:
Description of items required Quantity Received Taken Used Comments
Cotton wool packs/ Absorbent 1 pc
Cotton Wool 20g
Safety Pins 10 pcs
Rolled Elastic Bandages 7.5 X 1 pc
7.5cm
Triangular Bandage 2 pcs
Wooden Splint 2 pcs
Instant Cold Compress 2 pcs
Tongue Depressor 2 pcs
Clinical thermometer 1 pc
Tweezer 1 pc
Disposable gloves 3 pairs
Disposable masks 1 pc
Scissors 5.5” 1 pc
Logbook to record injuries
CPR Mouth to Mouth Barrier 1 pc
Pen Light 1 pc
Eye Shield 1 pc
Sterile Eye Pad 2 pcs
Sterile Burn Dressing 10cm 3 pcs
Sterile Burn Dressing 5cm 5 pcs
Sterile Abdominal Pad 1 pc
Elastic Gauze Bandage 5cm 1 pc
Elastic Gauze Bandage 7.5cm 2pcs
Sterile wound Dressing 2 pc
Crepe Bandage 6cm X 3mtr 1 pc
Sterile Gauze Swab 10cm 7 pcs
Sterile Gauze Swab 7.5cm 2 pcs
Wound wipes (BZK) 2pcs
Wound Cleaning Wipes 7 pcs
Antiseptic Wipes BZK 5 pcs
Cotton Tip Applicator 10 pcs
Adhesive Plaster 19X72 10pcs
Adhesive Plaster Round 5 pcs
Adhesive Plaster 6cm X 10cm 2 pcs
Knuckle Plaster 2 pcs
Finger Tip Plaster 2 pcs
Iodine 1pc
Itch Cream
Hydroperoxide 1pc
Sanitizer
Disinfectant 1pc
It is recommended that remove bandages from boxes and store them in zip lock bags. This saves space and keeps
bandages dry.