Title Page
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Document No.
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Vehicle Call Sign
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Vehicle Registration
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Conducted on
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Conducted by
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Location
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Ambulance crew names
External checks
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Date and time completed
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Vehicle mileage
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Oil level within parameters
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Water level within parameters
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Screen wash filled
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Windscreen wipers checked
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Headlights working
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Indicators working
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Blue lights working
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Tyre pressure and tread visual check
Internal checks
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Response bag visual check present
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Photo of response bag
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Zoll visual check
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Self test printout photo
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LSU visual check
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LSU and consumables photo
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AED visual check
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AED self test passed photo
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Drugs back check
- salbutamol
- paracetamol
- ibuprofen
- chlorphenamine