ELECTRIC SHOCK MOCK DRILL REPORT – SAMPLE

Mock Drill Report

Project:

Date:

Time:

Drill Scenario: During welding work being carried out at Location name here, suddenly welder was electrocuted during the welding work. Welder is spotted by their peer group member found electrocuted. Team member informs the work supervisor and work supervisor informs all as per information Protocol. Work Supervisor raises emergency and activate the Company name here ERT (Emergency Response Team) .

Points to be checked:

Line of communication

Response time of Ambulance.

Check the response of entire team which include workforce&

Awareness of workforce regarding the emergency contact no.

Response time during Emergencies:

Event/Drill sequence	Time line	Remark
Welder got electrocuted	11:35
Nearby worked cautioned others and alerted Supervisor.	11:35
The Electrician has disconnected power supply to the portable welding machine out.	11:36:35
Supervisor inform to HSE and HSE informed to Ambulance on emergency contact no through IS Phone (Explosion & Fire proof phone for battery area).	11:36
Site first Aider attended to IP	11:37
Ambulance arrived with Medic Team	11:37
Male Nurse provided the Cardio-Pulmonary (CPR) treatment to the injured worker and was restored	11:38
The victim immediately shifted to the First Aid center by Ambulance for further treatment.	11:39
Attended by Medical Team and declared IP is in normal condition.	11:40
Debriefing done and explained them	11:42

Observer:

Observer Name Here (Designation)

Observer Name Here (Designation)

The following observation were noted during the mock drill.

Positive Observation/Notes:

1. Ambulance siren was in working condition.
2. Communication was well enough to reach the incident place in right time.
3. Response time of electrician was excellent to disconnect the power supply.
4. Flagman was available at site to control vehicle movement.
5. Site first aider immediately attended victim and given first aid until arrival of ambulance.
6. Incident controller reached to the location once received information.

Deficiencies observed during the mock drill:

1. IP was shifted by their collogues to another place.
2. Belt was not tighten during shifting by stretcher to Ambulance.
3. Shoes & Helmet of victim has not been removed during transportation to First Aid Center.
4. Ambulance driver left from his cabin and did not reverse & kept it in ready position for immediate escape towards first aid center.

Welder electrocuted during welding work

Site Electrician Disconnected power supply

Emergency Call received by Medical team.

Ambulance reached at location

First Aid treatment given by first aider until arrival of Ambulance/medical team.

Injured Person Shifted to First Aider Centre for observation and better treatment.

Observation and checked by Paramedic & Declared his health condition is okay.

Debriefing done and explained them about area of improvements & importance of Mock Drill.