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Part 1. Equipment Requirements for Emergency Medical Services

Instructions:
-------------------------------------
1. Specify the quantity of each item in the Intermediate Life Support Ambulance.
2. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
3. Complete audit by providing digital signature.
4. Share your report by exporting as PDF, Word, Excel or Web Link.

Specific Requirements:
-------------------------------------
Unless otherwise stated, all equipment listed below is per vehicle and not per operational base.

Airway Equipment

Oropharyngeal airway No. 00

Oropharyngeal airway No. 0

Oropharyngeal airway No. 1

Oropharyngeal airway No. 2

Oropharyngeal airway No. 3

Oropharyngeal airway No. 4

Yankauer-type hard suction catheter (adult)

Yankauer-type hard suction catheter (paediatric)

Neonatal suction catheters size No. 5 French

Neonatal suction catheters size No. 6 French

Neonatal suction catheters size No 8 French

Paediatric suction catheter size No. 10 French

Adult suction catheter size No. 12 French

Adult suction catheter size No. 14 French

Portable suction apparatus (Combination of battery and electrically operated)

Manual hand operated portable suction apparatus (as a back up device)

Stethoscope (combination of diaphragm and bell type head)

Commercially packaged, disposable sterile Needle Cricothyroidotomy Kit including alcohol swab, 14 gauge IV canula, jet insufflation device and endotracheal tube adapter.

Endotrachael Intubation equipment:

Magill forceps - Adult

Magill forceps - Paediatric

10ml syringes

20ml syringes

Pair sharp, clean scissors

Breathing / Ventilation Equipment:

Adult oxygen masks providing 40% inhaled oxygen with tubing

Adult non-re breather masks providing 100% inhaled oxygen with tubing

Adult oxygen nebuliser masks including tubing and fluid reservoir

Nasal cannula with tubing

Pediatric oxygen masks providing 40% inhaled oxygen with tubing

Pediatric non-re breather masks providing 100% inhaled oxygen with tubing

Pediatric oxygen nebuliser masks including tubing and a fluid reservoir

Oxygen T-Piece with tubing

Adult Bag-Valve-Mask with Reservoir and adult mask (size 4)

Pediatric Bag-Valve-Mask with Reservoir and pediatric mask (size 1)

Neonatal Bag-Valve-Mask with Reservoir and neonatal mask (size 0)

Oxygen Humidification Device

Please proceed to the next section for Part 2.

Part 2. Equipment Requirements for Emergency Medical Services

Oxygen Supply:

Minimum of a portable oxygen cylinder. Size “D”

Portable oxygen cylinder gauge with flow meter

Fitted oxygen cylinder/s, size “F” capable of supplying a minimum of 30 minutes of oxygen at a flow rate of at least 15 liters per minute

Fitted oxygen cylinder gauge with flow meter

Ventilator

Anti-bacterial ventilation circuit filter for use with both manual as well as mechanical ventilation methods

Diagnostic /Therapeutic Equipment:

Sphygmomanometer including adult, pediatric and neonatal cuffs

Pupil torch

Glucometer and blood glucose monitoring strips

Pulse Oximeter (if not included as a feature of an ECG monitor or electronic patient monitor)

Automated External Defibrillator (AED) (annual calibration not required due to self-testing and self- calibration of the unit)

Automated External Defibrillator (AED) that is approved by the manufacturer for use in a moving vehicle, To be used in combination with a Vital Signs Monitor that includes visual 3 lead ECG Monitoring and a ECG rhythm printer/recorder feature (Vital Signs Monitor requires annual calibration certification)

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, 3 lead cable, AED capability, AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, external cardiac pacing, cardioversion, pacing/AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

Defibrillation gel

End Tidal CO2 Monitor – Capnograph (if not included as a feature of an ECG monitor or electronic patient monitor)

Miscellaneous Disposable Equipment:

Boxes of disposable examination gloves (Small)

Boxes of disposable examination gloves (Medium)

Boxes of disposable examination gloves (Large)

Infection Control N95 Face Mask

Wound dressing 254mm x 762mm (multi-trauma dressing)

Wound dressings 100mm x 100mm

Wound dressings 100mm x 200mm

Hydrogel Burn Dressing 100mm x 100mm

Hydrogel Burn Dressing 200mm x 200mm

Hydrogel Burn Dressing 200mm x 450mm

Gauze swabs (100mm x 100mm)

Roll of 25 mm adhesive tape (zinc oxide)

Roll of 10 mm adhesive tape (hypo-allergenic)

75mm elasticised bandages

100mm elasticised bandages

Sealed maternity pack (including 2 x sealed & sterile surgical blades, 4 x sealed sanitary pads, 2 x sealed space blankets, 4 x sealed & sterile umbilical cord clamps, 1 x sealed & sterile mucous extractor)

Regurgitation bags

Large kidney bowl / receiver (may not be a bedpan)

Sealed space blanket

Clear safety goggles

Range of nasogastric tubes

Please proceed to the next section for Part 3.

Part 3. Equipment Requirements for Emergency Medical Services

Intravenous Therapy Equipment:

Alcohol Swab (30mm x 30mm)

14 gauge intra-venous catheters

16 gauge intra-venous catheters

18 gauge intra-venous catheters

20 gauge intra-venous catheters

22 gauge intra-venous catheters

24 gauge intra-venous catheters

60 micro drops / ml – Administration Sets

15 drops / ml or 20 drops / ml- Administration Sets

10 drops / ml – Blood Administration Set

High Capacity 10 drops / ml Administration Set

Volume Control Administration Set (eg. Buretrol,

200ml Normal Saline – IV Fluid

1000ml Ringers Lactate – IV Fluid

1000ml Balsol – IV Fluid

500ml Synthetic Colloid e.g. Haemacell / Haes- sterile

Transparent, waterproof, IV securing dressing (ie. Tegaderm or similar) minimum of 10cm x 12cm dimensions

Infusion flow regulators (eg Dial-a-Flow, Dosi Flow)

3 Way Stopcock

Spencer Wells Artery Forceps

Pressure Infusion Bags

Drugs and Drug Therapy Equipment:

Activated Charcoal

Glucose powder or gel

Entonox with demand value and regulator

50 ml syringes

20 ml syringes

10 ml syringes

5 ml syringes

2 ml syringes

1 ml syringes

16 gauge needles

20 gauge needles

Aspirin

Dextrose 50%

Fenoterol

Ipratropium Bromide

Salbutamol

Drugs according to the HPCSA scope of practice for ECP Paramedics (per ambulance / vehicle)

Please proceed to the next section for Part 4.

Part 4. Equipment Requirements for Emergency Medical Services

Transport and Immobilization Equipment:

Hard/Stiff Neck Cervical Collars – Small

Hard/Stiff Neck Cervical Collars – Medium

Hard/Stiff Neck Cervical Collars – Large

Full set of Soft Cervical Collars (Small, Medium,Large)

Patient Extrication Device – Adult (KED)

Patient Extrication Device – Paediatric (KED)

Long spine board

Scoop stretcher

Vacuum Mattress

Set Head Blocks

Spider harness

Lower extremity traction splint – Adult

Lower extremity traction splint – Paediatric

Long splints – Leg

Short splints – Arm

PASG/MAST suit (optional)

Other:

Pillow

Sheet

Blanket

Bedpan/urinal

Waste disposal facility (enclosed container)

Red, medical waste disposal plastic bags

Enclosed, commercially manufactured, disposable sharps container

Suitably manufactured Jump Bag for safe, clean and secure storage and transportation of medical equipment

Suitably manufactured Drug Pouch for safe, clean and secure storage and transportation of medication and administration accessories

Pair rescue scissors

High visibility, reflective vest and / or jacket

Safety helmet

Fire Extinguisher (minimum of 2KG dry powder)

Thermometer (standard)

Casebook or patient record sheet

Declaration of death book

Map book or fitted GPS device

Completed by:

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Part 1. Equipment Requirements for Emergency Medical Services

Instructions:
-------------------------------------
1. Specify the quantity of each item in the Intermediate Life Support Ambulance.
2. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
3. Complete audit by providing digital signature.
4. Share your report by exporting as PDF, Word, Excel or Web Link.

Specific Requirements:
-------------------------------------
Unless otherwise stated, all equipment listed below is per vehicle and not per operational base.

Airway Equipment

Oropharyngeal airway No. 00

Oropharyngeal airway No. 0

Oropharyngeal airway No. 1

Oropharyngeal airway No. 2

Oropharyngeal airway No. 3

Oropharyngeal airway No. 4

Yankauer-type hard suction catheter (adult)

Yankauer-type hard suction catheter (paediatric)

Neonatal suction catheters size No. 5 French

Neonatal suction catheters size No. 6 French

Neonatal suction catheters size No 8 French

Paediatric suction catheter size No. 10 French

Adult suction catheter size No. 12 French

Adult suction catheter size No. 14 French

Portable suction apparatus (Combination of battery and electrically operated)

Manual hand operated portable suction apparatus (as a back up device)

Stethoscope (combination of diaphragm and bell type head)

Commercially packaged, disposable sterile Needle Cricothyroidotomy Kit including alcohol swab, 14 gauge IV canula, jet insufflation device and endotracheal tube adapter.

Endotrachael Intubation equipment:

Magill forceps - Adult

Magill forceps - Paediatric

10ml syringes

20ml syringes

Pair sharp, clean scissors

Breathing / Ventilation Equipment:

Adult oxygen masks providing 40% inhaled oxygen with tubing

Adult non-re breather masks providing 100% inhaled oxygen with tubing

Adult oxygen nebuliser masks including tubing and fluid reservoir

Nasal cannula with tubing

Pediatric oxygen masks providing 40% inhaled oxygen with tubing

Pediatric non-re breather masks providing 100% inhaled oxygen with tubing

Pediatric oxygen nebuliser masks including tubing and a fluid reservoir

Oxygen T-Piece with tubing

Adult Bag-Valve-Mask with Reservoir and adult mask (size 4)

Pediatric Bag-Valve-Mask with Reservoir and pediatric mask (size 1)

Neonatal Bag-Valve-Mask with Reservoir and neonatal mask (size 0)

Oxygen Humidification Device

Please proceed to the next section for Part 2.

Part 2. Equipment Requirements for Emergency Medical Services

Oxygen Supply:

Minimum of a portable oxygen cylinder. Size “D”

Portable oxygen cylinder gauge with flow meter

Fitted oxygen cylinder/s, size “F” capable of supplying a minimum of 30 minutes of oxygen at a flow rate of at least 15 liters per minute

Fitted oxygen cylinder gauge with flow meter

Ventilator

Anti-bacterial ventilation circuit filter for use with both manual as well as mechanical ventilation methods

Diagnostic /Therapeutic Equipment:

Sphygmomanometer including adult, pediatric and neonatal cuffs

Pupil torch

Glucometer and blood glucose monitoring strips

Pulse Oximeter (if not included as a feature of an ECG monitor or electronic patient monitor)

Automated External Defibrillator (AED) (annual calibration not required due to self-testing and self- calibration of the unit)

Automated External Defibrillator (AED) that is approved by the manufacturer for use in a moving vehicle, To be used in combination with a Vital Signs Monitor that includes visual 3 lead ECG Monitoring and a ECG rhythm printer/recorder feature (Vital Signs Monitor requires annual calibration certification)

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, 3 lead cable, AED capability, AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, external cardiac pacing, cardioversion, pacing/AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)

Defibrillation gel

End Tidal CO2 Monitor – Capnograph (if not included as a feature of an ECG monitor or electronic patient monitor)

Miscellaneous Disposable Equipment:

Boxes of disposable examination gloves (Small)

Boxes of disposable examination gloves (Medium)

Boxes of disposable examination gloves (Large)

Infection Control N95 Face Mask

Wound dressing 254mm x 762mm (multi-trauma dressing)

Wound dressings 100mm x 100mm

Wound dressings 100mm x 200mm

Hydrogel Burn Dressing 100mm x 100mm

Hydrogel Burn Dressing 200mm x 200mm

Hydrogel Burn Dressing 200mm x 450mm

Gauze swabs (100mm x 100mm)

Roll of 25 mm adhesive tape (zinc oxide)

Roll of 10 mm adhesive tape (hypo-allergenic)

75mm elasticised bandages

100mm elasticised bandages

Sealed maternity pack (including 2 x sealed & sterile surgical blades, 4 x sealed sanitary pads, 2 x sealed space blankets, 4 x sealed & sterile umbilical cord clamps, 1 x sealed & sterile mucous extractor)

Regurgitation bags

Large kidney bowl / receiver (may not be a bedpan)

Sealed space blanket

Clear safety goggles

Range of nasogastric tubes

Please proceed to the next section for Part 3.

Part 3. Equipment Requirements for Emergency Medical Services

Intravenous Therapy Equipment:

Alcohol Swab (30mm x 30mm)

14 gauge intra-venous catheters

16 gauge intra-venous catheters

18 gauge intra-venous catheters

20 gauge intra-venous catheters

22 gauge intra-venous catheters

24 gauge intra-venous catheters

60 micro drops / ml – Administration Sets

15 drops / ml or 20 drops / ml- Administration Sets

10 drops / ml – Blood Administration Set

High Capacity 10 drops / ml Administration Set

Volume Control Administration Set (eg. Buretrol,

200ml Normal Saline – IV Fluid

1000ml Ringers Lactate – IV Fluid

1000ml Balsol – IV Fluid

500ml Synthetic Colloid e.g. Haemacell / Haes- sterile

Transparent, waterproof, IV securing dressing (ie. Tegaderm or similar) minimum of 10cm x 12cm dimensions

Infusion flow regulators (eg Dial-a-Flow, Dosi Flow)

3 Way Stopcock

Spencer Wells Artery Forceps

Pressure Infusion Bags

Drugs and Drug Therapy Equipment:

Activated Charcoal

Glucose powder or gel

Entonox with demand value and regulator

50 ml syringes

20 ml syringes

10 ml syringes

5 ml syringes

2 ml syringes

1 ml syringes

16 gauge needles

20 gauge needles

Aspirin

Dextrose 50%

Fenoterol

Ipratropium Bromide

Salbutamol

Drugs according to the HPCSA scope of practice for ECP Paramedics (per ambulance / vehicle)

Please proceed to the next section for Part 4.

Part 4. Equipment Requirements for Emergency Medical Services

Transport and Immobilization Equipment:

Hard/Stiff Neck Cervical Collars – Small

Hard/Stiff Neck Cervical Collars – Medium

Hard/Stiff Neck Cervical Collars – Large

Full set of Soft Cervical Collars (Small, Medium,Large)

Patient Extrication Device – Adult (KED)

Patient Extrication Device – Paediatric (KED)

Long spine board

Scoop stretcher

Vacuum Mattress

Set Head Blocks

Spider harness

Lower extremity traction splint – Adult

Lower extremity traction splint – Paediatric

Long splints – Leg

Short splints – Arm

PASG/MAST suit (optional)

Other:

Pillow

Sheet

Blanket

Bedpan/urinal

Waste disposal facility (enclosed container)

Red, medical waste disposal plastic bags

Enclosed, commercially manufactured, disposable sharps container

Suitably manufactured Jump Bag for safe, clean and secure storage and transportation of medical equipment

Suitably manufactured Drug Pouch for safe, clean and secure storage and transportation of medication and administration accessories

Pair rescue scissors

High visibility, reflective vest and / or jacket

Safety helmet

Fire Extinguisher (minimum of 2KG dry powder)

Thermometer (standard)

Casebook or patient record sheet

Declaration of death book

Map book or fitted GPS device

Completed by: