Information
-
1831 Weekly Check
-
Conducted on
-
Personal checking vehicle
- Allen Badger
- Matt Cappelen
- Ben Rittenhouse
- Mike Baumgart
- Scott Lyng
- Andrew Schultz
- Paul Ursini
- Andy Shiner
- Jeff Sherwood
- John Loesch
- Patrick Watson
- Scott Sulak
- Scott Miller
- John Gray
- Scott Birchall
- Steve Tarczynski
-
Vehicle Miles:
-
Vehicle Hours:
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 ( 1 pk )
-
Comments:
-
Peds Electrodes ( 1 pk )
-
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 ( 2 )
-
Comments:
-
CO2 Nasal Monitor ( 2 )
-
Comments:
-
SPO2 Sensor ( 1 )
-
Comments:
-
Peds SPO2 Sensor ( 1 )
-
Comments:
JUMP BAG
Jump Bag
-
Airway Pocket & O2 Side Pocket Tagged ?
-
Comments:
-
Tag#:
-
IV Supplies, Center Pocket, & Top Pocket Tagged ?
-
Tag#:
-
Comments:
-
Vitals Pocket Tagged?
-
Tag#:
-
Comments:
-
Additional Comments:
PEDS BAG
PEDIATRIC BAG
-
Top Pocket Tagged?
-
Tag#:
-
Comments:
-
Center Pocket Tagged?
-
Tag#:
-
Comments:
-
Front Pocket Tagged?
-
Tag#:
-
Comments:
-
Left Pocket Tagged?
-
Tag#:
-
Comments:
-
Right Pocket Tagged?
-
Tag#:
-
Comments:
-
Additional Comments:
IV CABINET
IV Drug Cabinet
-
Bandaids ( 1 )
-
Comments:
-
IV Start Kit ( 4 )
-
Comments:
-
10ml NS Flushes ( 2 )
-
Comments:
-
18g 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:
-
3ml Syringe ( 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 ( 2 )
-
Comments:
-
Delnor Type 18g IV ( 1 )
-
Comments:
-
20g IV ( 2 )
-
Comments:
-
Delnor Type 20g IV ( 1 )
-
Comments:
-
22g IV ( 2 )
-
Comments:
-
Delnor Type 22g IV ( 1 )
-
Comments:
-
24g IV ( 2 )
-
Comments:
-
Additional Comments:
ALS DRUG EQUIPMENT
ALS Drug Equipment
-
Alcohol Preps ( 1 box )
-
Comments:
-
0.9% NaCL Solution 10ml Syringe ( 4 )
-
Comments:
-
0.9% NaCL Solution 3ml ( 5 )
-
Comments:
-
MAD Device ( 2 )
-
Comments:
-
3ml Syringe w/ Needle ( 1 )
-
Comments:
-
1ml Syringe w/ Needle ( 1 )
-
Comments:
-
Spare Test Strips ( 1 box )
-
Comments:
-
Spare Lancets ( 5 )
-
Comments:
-
Filter Straws ( 2 )
-
Comments:
-
Filter Needle ( 2 )
-
Comments:
-
1ml Syringe ( 1 )
-
Comments:
-
Needles
-
18g x 1 1/2"
-
Comments:
-
21g x 1"
-
Comments:
-
22g x 1 1/2"
-
Comments:
-
23g x 1"
-
Comments:
-
ALS Drugs: PLEASE MAKE SURE TO GET DRUGS EXCHANGED 30 DAYS BEFORE EXPIRATION DATE.
-
Amiodarone ( 2 )
-
Expiration Dates:
-
Comments:
-
Aspirin
-
Expiration Dates:
-
Comments:
-
Albuterol ( 2 )
-
Expiration Dates:
-
Comments:
-
Atrovent ( 3 )
-
Expiration Dates:
-
Comments:
-
Atropine ( 5 )
-
Expiration Dates:
-
Comments:
-
Adenosine ( 1 )
-
Expiration Dates:
-
Comments:
-
Benadryl ( 1 )
-
Expiration Dates:
-
Comments:
-
Dopamine ( 1 )
-
Expiration Dates:
-
Comments:
-
Dextrose 50% ( 2 )
-
Expiration Dates:
-
Comments:
-
Epi 1:1000 ( 3 )
-
Expiration Dates:
-
Comments:
-
Epi 1:10,000 ( 7 )
-
Expiration Dates:
-
Comments:
-
Glucagon ( 2 )
-
Expiration Dates:
-
Comments:
-
Lidocaine ( 4 )
-
Expiration Dates:
-
Comments:
-
Magnesium Sulfate ( 2 )
-
Expiration Dates:
-
Comments:
-
Narcan 2ml ( 2 )
-
Expiration Dates:
-
Comments:
-
Narcan 1ml ( 3 )
-
Expiration Dates:
-
Comments:
-
Nitroglycerine ( 1 )
-
Expiration Dates:
-
Comments:
-
Sodium Bicarbonate ( 1 )
-
Expiration Dates:
-
Comments:
-
Tetracaine ( 1 )
-
Expiration Dates:
-
Comments:
-
Vasopressin ( 1 )
-
Expiration Dates:
-
Comments:
-
Zofran ( 1 Vial )
-
Expiration Dates:
-
Comments:
-
Zofran ( 1 Tablet )
-
Expiration Dates:
-
Comments:
-
Additional Comments:
CPAP
CPAP
-
Mask
-
Comments:
-
O2 Bottle
-
PSI:
PORTABLE SUCTION
-
Tubing
-
Comments:
-
Additional Comments:
INTERIOR CABINETS
Interior Cabinet #1
-
BVM
-
Adult ( 1 )
-
Comments:
-
Child ( 1 )
-
Comments:
-
Infant ( 1 )
-
Comments:
-
500ml Sterile Water ( 3 )
-
Comments:
-
1000ml Sodium Chloride ( 3 )
-
Comments:
-
500ml Sodium Chloride ( 2 )
-
Comments:
Interior Cabinet #2
-
1 Nebulizer tx w/ 1 Albuterol & 1 Atrovent
-
Albuterol Dates:
-
Atrovent Dates:
-
Comments:
-
Adult Nasal Cannula ( 5 )
-
Comments:
-
Adult NRB ( 3 )
-
Comments:
-
0.9% NaCl Solution 3ml
-
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:
Interior Cabinet #4
-
Stethoscope w/ Accessories ( 1 )
-
Comments:
-
Multi Cuff BP Bag
-
1 large
-
Comments:
-
1 Child
-
Comments:
-
1 Infant
-
Comments:
-
1 Thigh
-
Comments:
-
Gauge ( 1 )
-
Comments:
-
Spare Child BP Cuffs ( 1 )
-
Amount:
Interior Cabinet #5
-
Cavi Wipes ( 1 )
-
Comments:
Interior Cabinet #6
-
N95 Masks ( 5 )
-
Comments:
Interior Cabinet #7
-
Peds Electrodes 1pk.
-
Comments:
-
Adult Electrodes 1pk.
-
Comments:
-
EKG Paper ( 2 )
-
Comments:
-
Adult 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 ( 3 )
-
Expiration Dates:
-
Comments:
-
60 Drip IV tubing ( 2 )
-
Comments:
Interior Cabinet #10
-
Survival Warp ( 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 ( 3 )
-
Comments:
-
ACE Wraps ( 4 )
-
Comments:
-
4x4 Cling ( 4 )
-
Comments:
-
Eye Pads ( 4 )
-
Comments:
-
Tape ( 4 )
-
Comments:
-
Petrolatum/Vaseline
-
( 2 ) 3x9
-
Comments:
-
( 2 ) 3x18
-
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:
Suction ( All equipment is accounted for, clean, and working )
-
Onboard Suction ( test unit )
-
Comments:
-
Portable Suction ( test unit )
-
Comments:
Bench
-
Wool Blanket ( 1 )
-
Comments:
-
Burn Sheet ( 1 )
-
Comments:
-
Pillows ( 2 )
-
Comments:
Spare Items
-
Oxygen Bottle ( 2 )
-
Comments:
-
Emesis Basin ( 2 )
-
Comments:
-
Sheets ( 3 )
-
Comments:
-
Blankets ( 3 )
-
Comments:
MISC.
-
Stretcher Clean & Made
-
Comments:
-
Patient Area Clean And Sanitized
-
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:
Exterior Cabinet #2
-
Body Bag
-
Comments:
-
Wool Blankets
-
Comments:
-
ABC Extinguisher
-
Comments:
-
Transfer Tarp
-
Comments:
-
Safety Blanket
-
Comments:
-
Water Rescue Rope
-
Comments:
-
Mustang Suit and Life Vest
-
Comments:
-
Flashlight
-
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. :
-
Comments:
-
Flashlights ( 2 ):<br>Both work
-
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 ( 2 Adult, 3 Peds/Infant )
-
Comments:
-
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:
CAB
CAB
-
Portable Radios ( 2 )
-
Comments:
-
Flashlight ( 1 )
-
Comments:
-
iPad Charged ( >75% )
-
Comments:
-
Gloves ( 1XL, 1L, 1M )
-
Comments:
-
Knox Box Key
-
Comments:
-
Passport Tags ( White & Red )
-
Comments:
-
Helmet Shields ( 2 )
-
Comments:
-
Safety Vests ( 2 )
-
Comments:
-
Maps ( FRC, County, Bartlett )
-
Comments:
-
Garage Openers ( Station 1, Delnor, & St. Joes )
-
Comments:
CLIPBOARD
-
IF SHEETS ARE LOW PLEASE PRINT THEM OUT AND REPLACE THEM
-
10 Run Sheets
-
10 Hippa Forms
-
10 AMA/Refusal Forms
-
10 Multiple Release Forms
-
5 EMS Rehab Forms
-
1 School Bus Form
-
1 Involuntary Form
MISC.
-
Cab Vacuumed & Cleaned Out
-
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:
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:
TAGGED ITEMS
INTERIOR CABINETS
-
Cabinet 1 Tagged?
-
Tag#:
-
Comments:
-
Cabinet 2 Tagged?
-
Tag#:
-
Comments:
PMIC DESK
-
SOP's
-
Comments:
-
Cell Phone with Charger
-
Comments:
-
Calculator
-
Comments:
-
Safety Vest
-
Comments:
-
Portable Suction Gun
-
Comments:
-
Suction Tubing
-
Comments:
-
Suction Catheters ( 8, 10, 12, 16, & 18)
-
Comments:
-
On board Suction, test unit ( Equipment all accounted for, clean & ready to use)
-
Comments:
INTERIOR CABINETS CONT.
-
Cabinet 3 Tagged?
-
Comments:
