LASA AND HIGH RISK MEDICINE CHECKLIST
SR.
NO NAME OF DRUG QTY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ. ATROPIN 100ML
2 INJ. DOPAMINE
3 INJ. DOBUTAMINE
4 INJ. KCL
5 INJ. NS 3%
6 INJ.CALCIUM GLUCONATE
7 INJ.ENAXOPYRINE 0.6 ML
8 INJ.ENAXOPYRINE 0.4 ML
9 INJ. HEPARIN 25000
10 INJ. PROPOFOL 10ML
11 INJ.MIDAS
12 INJ. MEGANISUM
13 INJ.PROTAMINE
14 INJ.SODA BI CARD
CHECKED BY
LASA AND HIGH RISK MEDICINE CHECKLIST
SR.
NO NAME OF DRUG QTY 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ. ATROPIN 100ML
2 INJ. DOPAMINE
3 INJ. DOBUTAMINE
4 INJ. KCL
5 INJ. NS 3%
6 INJ.CALCIUM GLUCONATE
7 INJ.ENAXOPYRINE 0.6 ML
8 INJ.ENAXOPYRINE 0.4 ML
9 INJ. HEPARIN 25000
10 INJ. PROPOFOL 10ML
11 INJ.MIDAS
12 INJ. MEGANISUM
13 INJ.PROTAMINE
14 INJ.SODA BI CARD
CHECKED BY
ALKONE BOX CHECK LIST
SR. 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ. ADRENALINE 5
2 INJ. ATROPINE 5
3 INJ.AMEDORONE 5
4 INJ.AVIL 5
5 INJ.ADENOSIS 5
6 INJ.CITICOLINE 5
7 INJ.CORT 5
8 INJ. DROTIN 5
9 INJ.DERIPHYLIN 5
10 INJ. DYNAPHAR 5
11 INJ.DYTOR 5
12 INJ.DEGOXIN 5
13 INJ.EMSET 5
14 INJ. LEVERA 5
15 INJ. LOBET 5
16 INJ.LASIX 5
17 INJ.LESORIDE 2
18 INJ. MIYOSTIGMINE 2
19 INJ. METOLOR 5
20 INJ. MUCOMIX 5
21 INJ. NTG 5
22 INJ.OCTREOTIDE 5
23 INJ.PCM 2ML 5
24 INJ.RANTAC 5
25 INJ.SYLATE 5
26 INJ. SODIUM VALTROATE 5
27 INJ.TRAMADOL 5
28 INJ.PUSE 5
29 INJ.VITAMIN K 5
30 INJ.VIT D3 5
31 INJ.MVI 5
32 POTTASIUM POWDER 5
33 INJ.FLUDOT 5
34 NEB IMPRAMENT 5
35 NEB. DUOLIN 5
36 NEB. ASTHALIN 5
37 NEB.GLYCOHOLE 5
38 NEB-FORACORT 5
CHECKED BY
ALKONE BOX CHECK LIST
SR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ. ADRENALINE 5
2 INJ. ATROPINE 5
3 INJ.AMEDORONE 5
4 INJ.AVIL 5
5 INJ.ADENOSIS 5
6 INJ.CITICOLINE 5
7 INJ.CORT 5
8 INJ. DROTIN 5
9 INJ.DERIPHYLIN 5
10 INJ. DYNAPHAR 5
11 INJ.DYTOR 5
12 INJ.DEGOXIN 5
13 INJ.EMSET 5
14 INJ. LEVERA 5
15 INJ. LOBET 5
16 INJ.LASIX 5
17 INJ.LESORIDE 2
18 INJ. MIYOSTIGMINE 2
19 INJ. METOLOR 5
20 INJ. MUCOMIX 5
21 INJ. NTG 5
22 INJ.OCTREOTIDE 5
23 INJ.PCM 2ML 5
24 INJ.RANTAC 5
25 INJ.SYLATE 5
26 INJ. SODIUM VALTROATE 5
27 INJ.TRAMADOL 5
28 INJ.PUSE 5
29 INJ.VITAMIN K 5
30 INJ.VIT D3 5
31 INJ.MVI 5
32 POTTASIUM POWDER 5
33 INJ.FLUDOT 5
34 NEB IMPRAMENT 5
35 NEB. DUOLIN 5
36 NEB. ASTHALIN 5
37 NEB.GLYCOHOLE 5
38 NEB-FORACORT 5
CHECKED BY
FRIDGE CHECK LIST
SR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ.T.T 5
2 INJ.ARTACIL 10ML 5
3 INJ.ARTACIL 2ML 5
4 INJ.LOPEZ 2ML 5
5 INSUGEN 5
6 NS 1 LIT 5
7 NS 500ML 5
CHECKED BY
OTHER CHECK LIST
SR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
IV FLUID
NS 500ML
RL 500ML
NS 0.45 500ML (HAPNER)
D -50 500ML
DNS 500ML
D25 100ML
LENEZOLID
VASOFIX TRAY
SYRINGE 10ML
SYRINGE 5 ML
3 WAY
VEINOLINE 10CM
VASOFIX 22
VASOFIX 18
VASOFIX 20
VASOFIX 26
CANFIX
MAKINTOSH
TOURNICATE
SHARP DICART COINTENER
COTTON
IV SET
PLAIN TUBE
EDT TUBE
CITRATE
AMPULE CUJTTER
RBS TRAY
GLUCOMETER
LANCET
SHARP CONTENER
INTUBATION TRAY
AMBU BAG
LYRINGOSCOPE WITH BLADE
SURGICAL GLOVES 7.5
ET TUBE 8NO
ET TUBE 8.5NO
ET TUBE 7 NO
ET TUBE 7.5 NO
ET HOLDER
HME FILTER
MOUNTH CATH
VACUMME SET
LOX JELLY 2%
NELCATH 12NO
SUCTION CATH 14 NO
SYRINE 10ML
SYRINE 5 ML
NEEDLE 18 NO
BOUJE
SYLATE
MAGELFORCEF
RT 16 NO
CAP MASK EACH 5
PLASTIC SHEET
CHECKED BY
OTHER CHECK LIST
SR. 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
IV FLUID
NS 500ML
RL 500ML
NS 0.45 500ML (HAPNER)
D -50 500ML
DNS 500ML
D25 100ML
LENEZOLID
VASOFIX TRAY
SYRINGE 10ML
SYRINGE 5 ML
3 WAY
VEINOLINE 10CM
VASOFIX 22
VASOFIX 18
VASOFIX 20
VASOFIX 26
CANFIX
MAKINTOSH
TOURNICATE
SHARP DICART COINTENER
COTTON
IV SET
PLAIN TUBE
EDT TUBE
CITRATE
AMPULE CUJTTER
RBS TRAY
GLUCOMETER
LANCET
SHARP CONTENER
INTUBATION TRAY
AMBU BAG
LYRINGOSCOPE WITH BLADE
SURGICAL GLOVES 7.5
ET TUBE 8NO
ET TUBE 8.5NO
ET TUBE 7 NO
ET TUBE 7.5 NO
ET HOLDER
HME FILTER
MOUNTH CATH
VACUMME SET
LOX JELLY 2%
NELCATH 12NO
SUCTION CATH 14 NO
SYRINE 10ML
SYRINE 5 ML
NEEDLE 18 NO
BOUJE
SYLATE
MAGELFORCEF
RT 16 NO
CAP MASK EACH 5
PLASTIC SHEET
CHECKED BY
FRIDGE CHECK LIST
SR. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ.T.T 5
2 INJ.ARTACIL 10ML 5
3 INJ.ARTACIL 2ML 5
4 INJ.LOPEZ 2ML 5
5 INSUGEN 5
6 NS 1 LIT 5
7 NS 500ML 5
CHECKED BY
DRUG CHECK LIST(ICU)
SR. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
NO NAME OF DRUG QTY
M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N
1 INJ.PANTOCID 40 MG
2 INJ.ZONE 2GM
3 INJ.GERGONE 1.5GM
4 INJ. TRUZOL 4.5 GM
5 INJ.TAXIM 1GM
6 INJ.LACOSAMIDE 20ML
7 INJ.XONE 1 GM
8 ACICLOVIR 250MG
9 ACICLOVIR 500MG
10 INJ.MEROPENOM 1GM
11 INJ.AMOXYCILLIN 1.2GM
12 INJ.TEICOPLANIN 400MG
13 INJ.AZEE 500 MG
14 INJ.DOXYPHYLIN
15 INJ. MOXFOR
16 INJ.LEVOFLOX
17 INJ.FORCAN 200MG
18 INJ.NEOMOL 1GM
19 INJ.ME-12 FORTE
20 DISPOSABLE
21 VASOFIX 20NO
22 VASOFIX 22NO
23 VASOFIX 18NO
24 VASOFIX 26NO
25 NEEDLE 18 NO
26 NEEDLE 26NO
27 3 WAY
28 VEINOLINE 10CM
29 IV SET
30 BT SET
31 PMO LINE
32 CANFIX
33 SYRINE 50ML
34 SYRINE 20ML
35 SYRINE 10ML
36 SYRINE 5ML
37 SYRINE 2ML
38 INSULINE SYRINGE
39 RT 16 NO
40 RT 14 NO
41 SPINAL NEEDLE 18 NO
42 SPINAL NEEDLE 22 NO
43 SPINAL NEEDLE 25NO
44 SPINAL NEEDLE 27 NO
45 OXYGEN MASK
46 NASAL MASK
47 HIGH FLOW MASK
CHECKED BY
