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WATERSIDE EMS DUTY START FORM
1
Event Name
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2
Event Date and Start Time
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Date
Day
Month
Year
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Hour
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50
00
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30
40
50
Minutes
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3
Members of Staff on site for duty
Add Full Names of All Staff Here
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4
Duty Manager of the day?
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5
Has the Organiser notified you of any suspected issues / changes for the day?
YES
NO
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6
If YES to previous question, please detail the issues/changes here
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7
Clinical Equipment Present?
Check Equipment And Consumables
AED
Drugs Box
Suction Unit
Patient Monitor
Red Grab Bag
Entonox Bag
Oxygen Bag
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8
If any of the previous items are missing, please list below
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9
Any Other Equipment / Resources On Site?
To Include Gazebos, Vehicles, Clinical Equipment etc
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10
Any Other Details
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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11
Name of Staff Member Completing Checks
First Name
Last Name
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12
Signature
Clear
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