Information

  • 1830 Weekly Check

  • Conducted on

  • Personnel checking vehicle

  • Vehicle Miles:

  • Vehicle Hours:

CAB

CAB

  • Portable Radios ( 2 )

  • Comments:

  • iPad Charged ( >75% )

  • Comments:

  • Gloves ( 1XL, 1L, 1M )

  • Comments:

  • Knox Box & Mabas Keys

  • Comments:

  • Safety Vests ( 2 )

  • Comments:

  • ERG Book

  • Comments:

  • Maps ( FRC, County, South Elgin )

  • Comments:

  • Garage Openers ( Station 3, Delnor, & St. Joes )

  • Comments:

CLIPBOARD

  • IF SHEETS ARE LOW PLEASE PRINT THEM OUT AND THEN HIT YES!

  • 10 Run Sheets

  • 10 Hippa Forms

  • 10 AMA/Refusal Forms

  • 10 Multiple Release Forms

  • 5 EMS Rehab Forms

  • 5 School Bus Form

  • 1 Involuntary Form

MISC.

  • Cab Vacuumed & Cleaned Out

  • Comments:

  • Additional Comments:

EXTERIOR CABINETS

Exterior Cabinet #1

  • Pressurized Water Can

  • Comments:

  • 6' Pike Pole

  • Comments:

  • O2 Bottle

  • Comments:

  • Peds Hare Traction

  • Comments:

  • Adult Hare Traction

  • Comments:

  • Air splints ( 1L, 1M, 1S, & Pump )

  • Comments:

  • KED

  • Comments:

  • Broom ( 1 )

  • Comments:

Exterior Cabinet #2

  • Body Bag

  • Comments:

  • Wool Blanket

  • Comments:

  • Transfer Tarp

  • Comments:

  • Safety Blanket

  • Comments:

  • Throw Bag

  • Comments:

  • Noodle

  • Comments:

  • Water Fins

  • Comments:

  • Life Vest

  • Comments:

  • Spare Cot Straps

  • Comments:

  • Step Chocks

  • Comments:

Exterior Cabinet #3

  • SCBA ( 2 ) :<br>Everything in working order. Bottle full w/ no leaks

  • SCBA ( A ) P.S.I. :

  • SCBA ( B ) P.S.I. :

  • SCBA A Pressure

  • SCBA B Pressure

  • Comments:

  • Flashlights ( 2 ):<br>Both work

  • Comments:

  • Irons ( 1 halligan & 1 flat head axe )

  • Comments:

  • Bolt Cutters

  • Comments:

  • Passport Boards (Red & White)

  • Comments:

  • 3-Helmet Shields

  • Comments:

Exterior Cabinet #4

  • Scoop Stretcher:<br>Clean and in working order

  • Comments:

  • Backboards w/ Straps:<br>1 w/ spider straps, 1 w/ seat-belts, 1 blank. All clean

  • Comments:

  • Child Car Seat

  • Comments:

  • C-Collar Bag

  • Adult Collars ( 2 )

  • PEDS/Infant Collars ( 3 )

  • Baby No Neck Collar

  • Adult Head Immobilizers ( 2 )

  • PEDS/Infant Head Immobilizer ( 1 )

  • Adult Head Immobilizers ( 2 )

  • Comments:

  • Child Head Immobilizers ( 2 )

  • Comments:

  • Peds Backboard:<br>Clean w/ all straps

  • Comments:

  • Stair Chair:<br>Chair in working order and clean

  • Comments:

  • Extra Spider Straps

  • Comments:

  • Additional Comments:

INTERIOR CABINETS

Interior Cabinet #1

  • BVM

  • Adult ( 1 )

  • Comments:

  • Adult CO2 Detector ( 1 )

  • Comments:

  • Exp. Date:

  • Exp. Date:

  • Child ( 1 )

  • Comments:

  • PEDS CO2 Detector ( 1 )

  • Comments:

  • Exp. Date:

  • Exp. Date:

  • Infant ( 1 )

  • Comments:

  • Infant CO2 Detector ( 1 )

  • Comments:

  • Exp. Date:

  • Exp. Date:

  • 500ml Sterile Water ( 2 )

  • Comments:

  • Exp. Dates:

  • Exp. Dates:

  • 1000ml Sodium Chloride ( 3 )

  • Comments:

  • Exp. Dates:

  • Exp. Dates:

  • 500ml Sodium Chloride ( 2 )

  • Comments:

  • Exp. Dates:

  • Exp. Dates:

Interior Cabinet #2

  • 1 Nebulizer tx w/ 1 Albuterol & 1 Atrovent

  • Albuterol Dates:

  • Atrovent Dates:

  • Comments:

  • Atrovent Dates:

  • Albuterol Dates:

  • 1 Inline Nebulizer Kit w/ 1 Albuterol & 1 Atrovent

  • Albuterol Dates:

  • Atrovent Dates:

  • Comments:

  • Albuterol Dates:

  • Atrovent Dates:

  • Oxygen Tubing

  • Comments:

  • Adult Nasal Cannula ( 3 )

  • Comments:

  • Adult NRB ( 3 )

  • Comments:

  • Peds NRB ( 3 )

  • Comments:

  • Peds Nasal Cannula ( 3 )

  • Comments:

  • Infant NRB ( 3 )

  • Comments:

  • Infant Nasal Cannula ( 3 )

  • Comments:

Interior Cabinet #3

  • Triage Tags ( 1 set )

  • Comments:

  • Drug Tags ( 1 bag )

  • Comments:

  • Rubberbands ( 1 bag )

  • Comments:

Action Area

  • Cell phone with charger

  • Comments:

  • Stethoscope

  • Comments:

  • Calculator

  • Comments:

  • St Joes SMO Protocol book

  • Comments:

Captains Chair Compartment

  • Safety Vest ( 1 )

  • Comments:

  • Portable Radio

  • Comments:

Suction Drawer 1

  • 2- 8fr suction catheters

  • Comments:

  • 2- 10fr suction catheters

  • Comments:

  • 2- 12fr suction catheters

  • Comments:

  • 2- 16fr suction catheters

  • Comments:

  • 2- 18fr suction catheters

  • Comments:

Suction Drawer 2

  • 3- Suction Tubing

  • Comments:

  • 3- Yankauers

  • Comments:

  • 1- Manual Suction with canister and assorted tips

  • Comments:

Onboard Suction

  • 1- Suction Canister

  • Comments:

  • 1- Suction Tubing

  • Comments:

  • 1- Yankauer

  • Comments:

SUCTION TESTED TO 300 mmhg

Interior Cabinet #4

  • Stethoscope w/ Accessories ( 1 )

  • Comments:

  • Multi Cuff BP Bag

  • 1 Adult

  • Comments:

  • 1 Large Adult

  • Comments:

  • 1 Child

  • Comments:

  • 1 Infant

  • Comments:

  • 1 Thigh

  • Comments:

  • Gauge ( 1 )

  • Comments:

  • Spare Child BP Cuffs ( 2 )

  • Amount:

  • 1 Stethoscope

  • Amount:

  • 1 Bag of Extra Pieces For Stethoscope

  • Amount:

Interior Cabinet #5

  • Cavi Wipes ( 1 )

  • Comments:

  • Garbage Bags & Soil Linen Bags

  • Comments:

Interior Cabinet #6

  • N95 Masks ( 5 )

  • Comments:

  • Safety Glasses ( 3 )

  • Comments:

Interior Cabinet #7

  • Adult EtCO2 Cannulas ( 2 )

  • Comments:

  • Adult EtCO2 Tube Connectors ( 2 )

  • Comments:

  • Peds Electrodes minimum of 24

  • Comments:

  • Adult Electrodes minimum of 24

  • Comments:

  • EKG Paper ( 2 )

  • Comments:

  • Adult Defib Pads ( 1 )

  • Expiration Date:

  • Comments:

  • Peds Defib Pads ( 1 )

  • Expiration Date:

  • Comments:

Interior Cabinet #8

  • Baby Bottle ( 1 )

  • Comments:

  • OB Kit ( 1 )

  • Comments:

  • Baby Bunting Foil ( 2 )

  • Comments:

Interior Cabinet #9

  • IV Pressure Infusion Bag ( 1 )

  • Comments:

  • 10 or 15 Drip IV Tubing ( 5 )

  • Comments:

  • 1000ml Sodium Chloride IV Bags ( 4 )

  • Expiration Dates:

  • Comments:

  • 60 Drip IV tubing ( 2 )

  • Comments:

  • Blood Tubing ( 2 sets )

  • Comments:

Interior Cabinet #10

  • Survival Wrap ( 2 )

  • Comments:

  • Soft Restraints ( 2 sets )

  • Comments:

  • Towels ( 3 )

  • Comments:

  • Hand Sanitizer

  • Comments:

  • Red Biohazard Bag ( 5 )

  • Comments:

  • Pocket Mask ( 1 )

  • Comments:

Interior Cabinet #11

  • Adult Arm Slings

  • 1 Large

  • Comments:

  • 1 Medium

  • Comments:

  • 1 Small

  • Comments:

  • Peds Slings ( 2 )

  • Comments:

  • SAM Splints ( 3 )

  • Comments:

  • Face Shields ( 5 )

  • Comments:

  • ACE Wraps ( 4 )

  • Comments:

  • 4" Kling ( 2 )

  • Comments:

  • 4 1/2" Kerlix ( 1 )

  • Comments:

  • Eye Pads ( 4 )

  • Comments:

  • Tape ( 4 )

  • Comments:

  • Petrolatum/Vaseline

  • ( 2 ) 3x9

  • Comments:

  • ( 2 ) 3x18

  • Comments:

  • Arm Board ( 1 )

  • Comments:

  • Trauma Shears ( 1 )

  • Comments:

  • Triangle Bandages ( 3 )

  • Comments:

  • ACS Chest Seal Pads ( 1 )

  • Comments:

  • 4x4 Gauze ( 15 )

  • Comments:

Interior Cabinet #12

  • Trauma Dressing ( 4 )

  • Comments:

  • Burn Sheet ( 2 )

  • Comments:

  • Aluminum Foil ( 1 )

  • Comments:

  • Isolation Kits ( 3 )

  • Comments:

  • Cold Packs ( 5 )

  • Comments:

  • Hot Packs ( 5 )

  • Comments:

Bench

  • Mustang Suit w/ Ice Boots

  • Comments:

  • 150' Water Rescue Rope w/ Carabiners ( 1 )

  • Comments:

  • Wool Blanket ( 1 )

  • Comments:

  • Pillows ( 2 )

  • Comments:

  • Umbrella ( 1 )

  • Comments:

Spare Items

  • Oxygen Bottle ( 2 )

  • Comments:

  • Emesis Basin ( 2 )

  • Comments:

  • Sheets ( 3 )

  • Comments:

  • Blankets ( 3 )

  • Comments:

  • Urinals ( 1 )

  • Comments:

  • ABC Extinguisher

  • Comments:

Interior Cabinet 13

  • CPAP ( O2 Bottle, Tubing, Mask w/ Filter, and Regulator )

  • Comments:

  • O2 Pressure:

  • Portable Suction ( Test Unit To 300)

  • Comments:

  • Additional Comments:

PEDS BAG

TOP POCKET PEDS BAG

  • Pediatric NRB Mask ( 1 )

  • Comments:

  • Pediatric Nasal Cannula

  • Comments:

  • Infant Nasal Cannula

  • Comments:

  • Pediatric Simple Mask

  • Comments:

LEFT SIDE POCKET PEDS BAG

  • Bone Marrow Needle

  • Comments:

  • 1000ml NS IV Bag

  • Exp. Date:

  • Comments:

  • IV 10 Drip Tubing

  • Comments:

  • IV Start Kit

  • Comments:

FRONT SIDE POCKET PEDS BAG

  • BP Cuff and Stethoscope

  • Comments:

  • Pen Light

  • Comments:

  • Thermometer

  • Comments:

RIGHT SIDE POCKET PEDS BAG

  • 10ml Syringe

  • Comments:

  • Trauma Shears

  • Comments:

  • Lubricant ( 2 )

  • Comments:

  • Forceps

  • Comments:

  • Laryngoscope Handle with spare batteries

  • Comments:

  • SAM Splint

  • Comments:

  • Saline Flushes ( 2 )

  • Exp. Dates:

  • Comments:

CENTER PEDS BAG

  • Pediatric BVM with ETCO2

  • Exp. Dates:

  • Comments

  • Infant BVM with ETCO2

  • Exp. Dates:

  • Comments:

  • Broselow Tape

  • Comments:

  • 4X4 Gauze ( 2 )

  • Comments:

  • Gauze Rolls and Kling Wrap ( 4 )

  • Comments:

  • Tape

  • Comments

  • Meconium Aspirator

  • Comments:

  • Alcohol Preps ( 5 )

  • Comments

  • Bandaids ( 5 )

  • Comments:

  • ET Tube Holder ( 2 )

  • Comments:

  • Emisis Bag

  • Comments:

  • RED

  • 22-24g IV

  • Comments:

  • 3 & 3..5 UC Tube

  • Comments:

  • 14 French NPA

  • Comments:

  • 0-1 Straight Blade

  • Comments:

  • 40-50mm OPA

  • Comments:

  • PURPLE

  • 20-24g IV

  • Comments:

  • 4 UC Tube

  • Comments:

  • 18 French NPA

  • Comments:

  • 1 Straight Blade

  • Comments:

  • 50-60mm OPA

  • Comments:

  • YELLOW

  • 18-22g IV

  • Comments:

  • 4.5 UC Tube

  • Comments:

  • 20 French NPA

  • Comments:

  • 1-2 Straight Blade

  • Comments:

  • 50-60mm OPA

  • Comments:

  • WHITE

  • 18-22g IV

  • Comments:

  • 5 UC Tube

  • Comments:

  • 22 French NPA

  • Comments:

  • 1-2 Straight Blade

  • Comments:

  • 50-60mm OPA

  • Comments:

  • BLUE

  • 18-20g IV

  • Comments:

  • 5.5 UC Tube

  • Comments:

  • 24 French NPA

  • Comments:

  • 2 Curved or Straight Blade

  • Comments:

  • 60-70mm OPA

  • Comments:

  • ORANGE

  • 18-20g IV

  • Comments:

  • 6 C Tube

  • Comments:

  • 26 French NPA

  • Comments:

  • 2 Curved or Straight Blade

  • Comments:

  • 70-80mm OPA

  • Comments:

  • GREEN

  • 16-20g IV

  • Comments:

  • 6.5 C Tube

  • Comments:

  • 30 French NPA

  • Comments:

  • 3 Curved or Straight Blade

  • Comments:

  • 80mm OPA

  • Comments:

  • Additional Comments:

ALS DRUG EQUIPMENT

Narcotic Box

  • Old Tag Number

  • New Tag Number

  • 80Mg Etomidate

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • Versed 5MG/5ML Total of 15MG

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • Versed 5MG/1ML Total of 10MG

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • Fentynal 200MCG Total

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

ALS Drug box

  • ALS Drugs: PLEASE MAKE SURE TO GET DRUGS EXCHANGED 30 DAYS BEFORE EXPIRATION DATE.

  • 0.9% NaCL Solution 3ml ( 5 )

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • Aspirin 12-81mg Tablets

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2-Atrovent 0.5mg

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2- Albuterol 2.5mg

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2- Amiodarone 150mg Vials

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- 6mg Adenosine Vials

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Benadryl 50 mg

  • Comments:

  • Exp. Dates:

  • Expiration Dates:

  • 3- Epinephrine 1:1000 1mg/1ml Ampules

  • Comments:

  • Exp. Dates:

  • Expiration Dates:

  • 2- Glucagon complete dosages

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2- Magnesium Sulfate 1Gm/2ml Vials

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Nitroglycerine bottle 0.4mg >1/2 full

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Tetracaine bottle

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2- Vasopressin 20 Unit vial

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Zofran 4mg Vial

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Zofran 4mg Tablet

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • MAD Device ( 1 )

  • Comments:

ALS drugs box lower

  • 1- Dopamine 400mg in 250ml IV bag with 60 Drip Tubing

  • Comments:

  • Exp. Dates:

  • Expiration Dates:

  • Filter Straws ( 2 )

  • Comments:

  • Filter Needle ( 2 )

  • Comments:

  • 1ml Syringe ( 2 )

  • Comments:

  • 3ml Syringe ( 5 )

  • Comments:

  • 2- 5ML Syringes

  • Comments:

  • 10mL Syringe ( 2 )

  • Comments:

  • 20mL Syringe

  • Comments:

  • 60mL Syringe

  • Comments:

  • Carpoject ( 1 )

  • Comments:

  • Needles

  • 18g x 1 1/2"

  • Comments:

  • 20g x 1"

  • Comments:

  • 21g x 1"

  • Comments:

  • 22g x 1 1/2"

  • Comments:

  • 23g x 1"

  • Comments:

  • 25g x 1 1/2"

  • Comments:

ALS drugs in drawer

  • 5-Atropine 1mg Preload

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- Dextrose 50% 50ml/25 Gm

  • Comments:

  • Exp. Dates:

  • Expiration Dates:

  • 7- Epinephrine 1:10,000 1mg Preload

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 5-Lidocaine 100mg/5ml Preload

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 2-Narcan 2mg/2ml

  • Expiration Dates:

  • Comments:

  • Exp. Dates:

  • 1- 50mEq Sodium Bicarbonate w/ 60mL Syringe and Needle ( 1 )

  • Comments:

  • Exp. Dates:

  • Expiration Dates:

ALS Drug Drawer equipment

  • Alcohol Preps ( 1 box )

  • Comments:

  • 0.9% NaCL Solution 10ml Flush

  • Exp. Date:

  • Comments:

  • Expiration Dates:

  • Spare Test Strips ( 1 box )

  • Comments:

  • Spare Lancets ( 5 )

  • Comments:

  • Additional Comments:

IV CABINET

IV Cabinet

  • Bandaids ( 10 )

  • Comments:

  • IV Start Kit ( 4 )

  • Comments:

  • 10ml NS Flushes ( 2 )

  • Exp. Dates:

  • Comments:

  • 18g x 1 1/2" Needle ( 2 )

  • Comments:

  • 21g x 1" Needle ( 2 )

  • Comments:

  • 22g x 1 1/2" Needle ( 2 )

  • Comments:

  • 23g x 1" Needle ( 2 )

  • Comments:

  • 25g x 1 1/2" Needle ( 2 )

  • Comments:

  • Filter Straws ( 2 )

  • Comments:

  • Filter Needle ( 2 )

  • Comments:

  • 1ml Syringe ( 1 )

  • Comments:

  • 3ml Syringe ( 1 )

  • Comments:

  • 3ml Syringe with Smartip ( 1 )

  • Comments:

  • 12ml Syringe ( 1 )

  • Comments:

  • Butterfly Needles ( 21g & 23g ): Total of 2

  • Comments:

  • Lancets ( 5 )

  • Comments:

  • MAD Device ( 2 )

  • Comments:

  • Alcohol Preps ( 5 )

  • Comments:

  • Tape ( 2 )

  • Comments:

  • IV Catheters

  • 14g IV ( 2 )

  • Comments:

  • 16g IV ( 2 )

  • Comments:

  • 18g IV ( 5 )

  • Comments:

  • 20g IV ( 5 )

  • Comments:

  • 22g IV ( 3 )

  • Comments:

  • 24g IV ( 3 )

  • Comments:

  • Additional Comments:

ZOLL MONITOR

ZOLL Monitor

  • Tested Monitor

  • Comments:

  • Adult Defib Pads ( 1 )

  • Expiration Date:

  • Comments:

  • Peds Defib Pads ( 1 )

  • Expiration Date:

  • Comments:

  • Defib Test Cord ( 1 )

  • Comments:

  • Adult Electrodes minimum of 12

  • Comments:

  • Peds Electrodes minimum of 12

  • Comments:

  • Spare Battery ( 1 ): Rotate battery

  • Comments:

  • 4 Lead Cables ( 1 ): Cleaned & Wrapped Up

  • Comments:

  • 12 Lead Cables ( 1 ): Cleaned & Wrapped Up

  • Comments:

  • Razor ( 1 )

  • Comments:

  • CO2 ET Tube Connecter ( 1 )

  • Comments:

  • CO2 Nasal Monitor ( 2 )

  • Comments:

  • SPO2 Sensor ( 1 )

  • Comments:

  • Infant SPO2 Sensor ( 2 )

  • Comments:

JUMP BAG

Top Pocket

  • NRB Mask ( 1 )

  • Comments:

  • Nasal Cannula ( 1 )

  • Comments:

  • Neb TX w/ 1 Albuterol & 1 Atrovent ( 1 kit )

  • Albuterol Exp. Date:

  • Atrovent Exp. Date:

  • Comments:

  • Albuterol Exp. Date:

  • Atrovent Exp. Date:

Left Side Pocket

  • Adult BVM w/ CO2 Monitor ( 1 )

  • Exp. Date:

  • Comments:

Right Side Pocket

  • Blood Pressure Cuff ( 1 adult )

  • Comments:

  • SPO2 Monitor

  • Comments:

  • Stethoscope ( 1 )

  • Comments:

  • Glucometer Case

  • Glucometer ( Make sure it is working )

  • Comments:

  • Test Strips ( 5 )

  • Comments:

  • Lancets ( 5 )

  • Comments:

  • Alcohol Preps ( 5 )

  • Comments:

  • Bandaids ( 5 )

  • Comments:

Front Pocket

  • Tape ( 3 total w/ 1 paper )

  • Comments:

  • Thermometer ( w/ covers )

  • Comments:

  • 1- Trauma Dressing

  • Comments:

  • 1- Burn Sheet

  • Comments:

  • 1- SAM Splint

  • Comments:

  • 1- Kerlex

  • Comments:

  • 1- 6 Inch Kling

  • Comments:

  • 1- 4 Inch Kling

  • Comments:

  • 1- 4 X 4 Tray <br>

  • Comments:

  • 1- Ice Pack

  • Comments:

  • 500mL Sterile Water ( 1 )

  • Exp. Dates:

  • Comments:

  • Trauma Shears ( 1 )

  • Comments:

  • 1- Pen Light

  • Comments:

  • Ring Cutter

  • Comments:

Zipper Area in Front Pouch

  • Large Gloves

  • Comments:

  • XL Gloves

  • Comments:

CENTER OF JUMP BAG

Center Compartment Clear Flap

  • King Tubes

  • Size 3 ( 1 )

  • Exp. Dates:

  • Comments:

  • Size 4 ( 1 )

  • Exp. Dates:

  • Comments:

  • Size 5 ( 1 )

  • Exp. Dates:

  • Comments:

  • 1- Pressure Infuser

  • Comments:

  • Intubation Kit

  • Miller Laryngoscope Blades ( 3 ): Put Blade on handle to make sure light works

  • Comments:

  • Mac Laryngoscope Blades ( 3 ): Put Blades on handle to make sure light works

  • Comments:

  • Lubricant Packets ( 2 )

  • Comments:

  • Tube Holders ( 2 )

  • Comments:

  • 10ml Syringe ( 1 )

  • Comments:

  • Benzocaine ( 1 )

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • Forceps ( 2 )

  • Comments:

  • Stylets ( 1s, 1m, 1L )

  • Comments:

  • Nasopharyngeal ( 1 each of sizes 12-34 )

  • Comments:

  • Oropharyngeal ( 5 )

  • Comments:

  • Tape ( 1 )

  • Comments:

  • Surgical Masks ( 2 )

  • Comments:

  • Spare Batteries ( 2 C )

  • Comments:

Cric & Needle Decompression kit

  • 14g IV ( 2 )

  • Comments:

  • 12g IV ( 2 )

  • Comments:

  • 10g IV

  • Comments:

  • Alcohol Preps ( 5 )

  • Comments:

  • Scalpel

  • Comments:

  • 3.0 ET Un-cuffed Tube

  • Comments:

Check ET Tube expiration dates

  • ET Tubes

  • 5.5 ( 1 )

  • Comments:

  • 6.0 ( 1 )

  • Comments:

  • 6.5 ( 1 )

  • Comments:

  • 7.0 ( 1 )

  • Comments:

  • 7.5 ( 2 )

  • Comments:

  • 8.0 ( 2 )

  • Comments:

  • 8.5 ( 1 )

  • Comments:

  • 9.0 ( 1 )

  • Comments:

IV Pouch

  • IV Catheters

  • 14g IV

  • Comments:

  • 16g IV ( 1 )

  • Comments:

  • 18g IV ( 2 )

  • Comments:

  • 20g IV ( 2 )

  • Comments:

  • 22g IV ( 1 )

  • Comments:

  • 24g IV ( 1 )

  • Comments:

  • 1- Saline Bag

  • Comments:

  • 1- 10 Drop Tubing

  • Comments:

  • 2- IV Start Kit

  • Comments:

  • 1-Sharps Shuttle

  • Comments:

ALS Drug Box

  • ALS Drug Box

  • Old Drug Tag Number

  • Comments:

  • New Drug Tag Number

  • Comments:

Center Zipper Compartment

  • 2 Adult EZ-IO Needles

  • EXP:

  • Comments:

  • 2 PEDS EZ-IO Needles

  • EXP:

  • Comments:

  • EZ-IO Gun

  • Comments:

  • Alcohol Preps ( 3 )

  • Comments:

  • 2- Saline Flushes

  • EXP:

  • Comments:

Medication Pull Out Flaps

  • 4- 81mg Aspirin Tablets

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- 150mg Amiodarone Vials

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 3- 6mg Adenosine vials

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Benadryl 50mg Vial

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 3- Epinephrine 1:1000 1mg/1ml Ampules

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Glucagon 1mg powder & 1ml Sterile water

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- Magnesium Sulfate 1Gm/2ml Vial

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1-Nitroglycerin 0.4mg

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- Vasopressin 20 Unit Vials

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1-Verapamil 10mg/4ml vial

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Zofran 4mg Tablet

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Zofran 4mg Vial

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • Etomidate 40 Mg

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Fentynal 100 mcg

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Versed 5mg/5ml

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Versed 5mg/1ml Total of 10MG

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

Boxed Medication Area

  • 1-1mg Atropine Preloads

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Dextrose 50% 25Gm/50ml Preload

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 4- Epinephrine 1:10,000 1mg Preloads

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- 100mg/5ml Lidocaine Preload

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- Narcan 2mg/2ml

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 1- Sodium Bicarbonate 50 mEq

  • Exp. Dates:

  • Comments:

  • Exp. Dates:

  • 2- 15Gm Oral Glucose tubes

  • Comments:

  • Exp. Date:

Syringe Area

  • 2- 1ML Syringe

  • Comments:

  • 2- 3ML Syringe

  • Comments:

  • 2- 10ML Syringe

  • Comments:

  • 1- 20ML Syringe

  • Comments:

  • 2- Filter Straws

  • Comments:

  • 2- Filter Needles

  • Comments:

  • 2- 18g Needles

  • Comments:

  • 2- 21g Needles

  • Comments:

  • 2- MAD Device

  • Comments:

  • Additional Comments:

MAINTENANCE

LIGHTS

  • IF ANYTHING IS NOT WORKING PLEASE WRITE IT UP IN EMERGENCY REPORTING

  • Emergency Lights

  • Comments:

  • Headlights ( High & Low Beam )

  • Comments:

  • Turn signals

  • Comments:

  • Brake Lights

  • Comments:

  • Scene Lights

  • Comments:

  • Running Lights

  • Comments:

  • Reverse Lights

  • Comments:

  • Interior and compartment lighting

  • Comments:

FLUID LEVEL

  • IF FLUIDS ARE LOW PLEASE ADD, IF WE HAVE HERE, THEN PUT IT IN EMERGENCY REPORTING

  • Fuel ( > 3/4 )

  • Comments:

  • Oil

  • Comments:

  • Coolant

  • Comments:

  • Transmission

  • Comments:

  • Power steering

  • Comments:

  • Washer Fluid

  • Comments:

TIRE PRESSURE

  • IF TIRES ARE LOW PLEASE ADD AIR AND THEN PUT IT IN EMERGENCY REPORTING

  • Front Tires

  • Front Left PSI:

  • Front Right PSI:

  • Comments:

  • Rear Tires

  • Left Inner PSI:

  • Left Outer PSI:

  • Right Inner PSI:

  • Right Outer PSI:

  • Comments:

  • Additional Comments:

  • Officers Signature:

AFTER PRESSING FINISH GO TO AUDITS AND SEND AUDIT

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