| Error Identified | Consequence Grading | Likelihood Grading | Overall Risk Grade |
|---|---|---|---|
| Paraldehyde out of stock in A+E | Major | Almost certain | Extreme |
| Bag and mask not connecting to oxygen source (massive leak in connecting tubing) | Major | Likely | Extreme |
| Resuscitaire out of stock on the neonatal unit (NNU) | Major | Possible-likely | High |
| ‘Resus grab bag’ – staff unaware of its introduction | Major | Possible | High |
| Junior medical staff unaware of location of resuscitation equipment (UVC) on NNU | Moderate | Unlikely-possible | Moderate |
| Need for educating staff about CPAP identified | Moderate | Unlikely | Moderate |