Drug Date

• Document No.

• Audit Title

Drug Date Check Off

• Drug Date Checked

  Date

• Unit

  Select Squad 1 Quint 1 Engine 2 Squad 2 Engine 4 Engine 3 Squad 3 Engine 5

  • Squad 1
  • Quint 1
  • Engine 2
  • Squad 2
  • Engine 4
  • Engine 3
  • Squad 3
  • Engine 5

FIB BAG

• Accucheck Srtrips

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Adenosine 6mg

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Adenosine 12mg

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Adult Bicarb

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Adult BVM

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Albuterol

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Amiodorone

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Atropine

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Atrovent-Ipratropium Bromide

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Baby ASA

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Benadryl-Diphenhydramine

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Betadine Preps

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Dextrose 50%

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Epi 1:1000

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Epi 1:10,000

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Glucagon

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• L.R. 1000cc

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Lidocaine 100mg

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Narcan

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Nitro Tabs

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• N.S. 500cc

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Oral Glucose

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Pedi BVM

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Thiamine

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Vasopressin

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Combi Tube

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Zofran (Ondansetron)

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Blood Draw (Green)

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Blood Draw (Purple)

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Sodium Chloride (INT)

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

TRAUMA BAG

• L.R. 1000cc

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Sterile Water

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

I.V. WARMER

• N.S. 500cc

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• L.R. 1000cc

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

LIFE PACK 10

• Adult Electrode

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Pedi Electrode

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Defib Pads

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

• Pacing Pads

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

AED

• AED Pads

  In Date (>3)

  In Date (<3)

  Expires (<1)

  Expired

  Not on Unit

• New Date for Expired Drug

  Date

• Quantity

Additional Info

• Other Info

• Report Completed by:

  Sign