MEDICINE AND SUPPLIES

CHECKLIST DATE:___________________
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MEDICINES EMERGENCY ROOM DELIVERY ROOM OPERATING ROOM
QUANTITY EXPIRATION DATE QUANTITY EXPIRATION DATE QUANTITY EXPIRATION DATE
o  Adenosine 5mg/2mL vial
o  Amiodarone 50mg/3mL amp
o  Aspirin USP grade 325mg tab
o  Atropine 1mg/mL
o  B-adrenergic agonist
(Salbutamol 2mg/mL)
o  Benzodiazepine (Diazepam
10mg/mL, 2mL amp or
Midazolam) in (high alert box)
o  Calcium (usually calcium
gluconate 10% solution in 10mL
amp)
o  Clopidogrel 75mg tab
o  D5W 250mL
o  D50W 50mg vial
o  Digoxin 0.5 mg/2mL amp
o  Diphenhydramine 50mg/ml amp
o  Dobutamine 250mg/5mL amp
o  Dopamine 200mg/5mL amp/vial
o  Epinephrine 1mg/mL amp
o  Furosemide 20mg/2mL amp
o  Haloperidol 50mg/mL amp
o  Hydrocortisone 250mg/2mL vial
o  Lidocaine 10% in 50mL spray
o  Lidocaine 2% solution vial
1g/30mL amp
o  Magnesium sulfate 1g/2mL amp

o  Mannitol 20% solution 500mL

RT LIM FAMILY HOSPITAL CO., 2021 |

 MEDICINE AND SUPPLIES
CHECKLIST DATE:___________________
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o  Methylprednisone 4mg tab
o  Metoclopramide 10mg/2mL amp
o  Morphine sulphate 10mg/mL
amp (high alert box)
o  Nitroglycerin 10mg/mL amp /
Isosorbide dinitrate 5mg sl tab or
10mg/10mL amp
o  Noradrenaline 2mg/2mL amp
o  Paracetamol 300mg amp IV
preparation
o  Phenobarbital 120mg/mL amp IV
or 30mg tab (high alert box)
o  Phenytoin 10mg cap or
10mg/2mL amp
o  Plain LR 1L
o  Plain LR 500mL
o  Plain NSS 1L (0.9% Sodium
Chloride)
o  Plain NSS 500mL
o  Potassium chloride 40mEq/20mL
vial (high alert dose)
o  Sodium Bicarbonate
50mEq/50mL amp
o  Verapamil 5mg/2mL amp
o  Vitamin B1 B6 B12 vial (1g B1, 1g
B6, 0.01 B12 in 10mL vial)

RT LIM FAMILY HOSPITAL CO., 2021 |

 MEDICINE AND SUPPLIES
CHECKLIST DATE:___________________
_

MEDICAL SUPPLIES EMERGENCY ROOM DELIVERY ROOM OPERATING ROOM

 Airway Adjuncts
 Airway/intubation kit (with stylet
and bag valve masks)
 Alcohol disinfectant
 Aseptic bulb syringe
 Capillary Blood Glucose (CBG) Kit
 Cardiac Board
 Endotracheal Tubes ( all size )
 Flashlight or Pen Light
 Gloves, Sterile
 Gloves, Non-Sterile
 Laryngoscope with different sizes
of blades
 Nasal Cannula
 Protective Face shield or Mask or
Goggles
 Standard Face Mask
 Sterile Gauze (pre-folded and
individually packed)
 Syringes ( different volumes )
 Urethral Catheter
 Urine Collection Bag
 Waterproof Aprons

RT LIM FAMILY HOSPITAL CO., 2021 |