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Run: Stock Epinephrine Auto-Injector Placement and Use Log

Track where school-stocked epinephrine auto-injectors are stored, when they were inspected, and whether any dose was used. This log helps staff document read...

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Log Entry Details

Log entry type (required)

Entry date (required)

Entry time

Recorded by (required)

Recorded by role (required)

Auto-Injector Placement and Inventory

Storage location (required)

Enter the specific room, cabinet, wall mount, or emergency kit location.

Device brand (required)

Device dose (required)

Quantity on hand (required)

Lot number (required)

Expiration date (required)

Package and device condition (required)

Routine Inspection and Readiness

Storage is accessible and unobstructed

Confirm the device can be reached quickly in an emergency.

Yes No N/A

Seal or packaging is intact

Yes No N/A

Expiration date checked

Yes No N/A

Any concern about temperature exposure or storage conditions? (required)

Describe the storage issue

Administration Event

Administration date (required)

Administration time (required)

Recipient age group (required)

Observed symptoms (required)

Dose administered (required)

Administration site (required)

Was a second dose needed? (required)

Were emergency services called? (required)

Post-administration notes

Document observation, transfer of care, parent/guardian notification, and any follow-up actions.

Replacement, Follow-Up, and Audit Trail

Replacement needed (required)

Replacement reason

Replacement order date

Follow-up actions completed

Audit trail notes

Add any additional documentation needed for compliance, chain of custody, or internal review.

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