MH Drill Log







Did staff identify s/s of MH?


Who did staff notify?



How was it code called over phone?


Was the Code Call Overhead?


If overhead, was the delay > 20 sec?





Staff must verbalize telephone number.


List names/roles with each arrival. Include MD, RT, Pharmacy and if they responded via page or overhead.



Brought from where? By which staff?


Brought from where? By which staff?


Brought from where? By which staff?


Estimated time to arrival



Stopwatch time in Minutes:Seconds


Stopwatch time in Minutes:Seconds











Powered by Smartsheet Forms
Privacy Policy   |   Report Abuse
Your submission is being processed. Please do not close this browser window until complete.