TASMANIAN AMBULANCE SERVICE NEANN RCB FEEDBACK FORM
This feed back form is for the NEANN RCB - Oxygen Resuscitator.
Name Rank/Position Years of Service Stationed at
How long has the kit been in service?
Approximately how many times has the unit been used for oxygen therapy?
Approximately how many times has the unit been used to ventilate a patient (IPPV)?
Before you used the RCB were you given training on:
Design features of the unit? Yes No
Cleaning the unit? Yes No
How to store equipment in RCB? Yes No
How to set up & store the resuscitation system? Yes No
Any Comments
Is the quality of manufacture of the RCB satisfactory? Yes No Unsure
If you answered No or Unsure please outline issues and offer suggestions.
Is the quality of the materials used in the RCB satisfactory? Yes No Unsure
Are the zips coping with the work load? Yes No Unsure
Is the waterproof base protecting the base from liquids, weather and dirt? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
Are the carry handles comfortable to use? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
Have you used the backpack harness yet? Yes No How many times? Longest time worn as a backpack?
Was the harness comfortable? Yes No If you answered No please outline issues and offer suggestions.
Is there enough reflective tape on the kit for your safety? Yes No
If you answered No please outline issues and offer suggestions.
Are you pleased with the way how the RCB opens? Yes No Unsure
Are you pleased with the oxygen cylinder holder? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions. Is the cylinder easy to change? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
If you have a lift up flap or end pocket version which allows access to the cylinder valve, do you like it? Yes No Unsure
If you have the external suction pocket, do you like it? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
Do you like the internal pocket labels? Yes No Unsure
Are you pleased with the layout of the unit? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
Is equipment easy to access? Yes No Unsure If you answered No or Unsure please outline issues and offer suggestions.
Do you have access to the operators manual sent out with the Resuscitator? Yes No Unsure Would you like a manual sent out to you? Yes No Please indicate your address where we will send the manual to: It will either go via the post, or we can email it. Recipients Name Street Address Suburb/Town/City State Post Code or E-mail to:
Are there any specific improvements you would like to see in the kit?
Please add your personal details below so we can follow up any issues
Name E-mail Tel FAX
