Title Page
Daily
Cardiac Monitor
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Adult Dfib Pads (Test)
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Pediatric Defibrillation Pads
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4 Lead & 12 Lead Cables
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Adult/Peds Electrodes (12ea)
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CO2 Cable w/ BVM Adaptor
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CO2 Nasal Canula Adapter
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Pediatric SpO2
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Razor
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Spare Monitor Paper
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Rotate The Spare Battery
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Oxygen Levels
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Onboard Main Oxygen >500psi
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Oxygen Level:
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Stretcher Oxygen Cylinder >300psi
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Oxygen Level:
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CPAP Oxygen Cylinder > 300psi
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Oxygen Level:
Jump Bag
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Glucometer
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Vitals Equipment
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Clipboard & Forms (10ea form)
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Drug Bag
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IV Roll Up Bag
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Pediatric Bag
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Other Items
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Onboard/Portable Suction
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Interior Cabinets Stocked
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All Lights Working
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All Fluids Full (Fuel >3/4)
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Cab/Cot/Patient Areas Cleaned
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Radios and Phone Working
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Driver's Side Outside Cabinet 1
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Pressurized Water Can
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Broom
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6' Pike Pole
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Peds & Adult Hare Traction
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K.E.D.
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Vacuum Splints (1Sm, 1M, 1Lg & 1 Pump)
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Driver's Side Outside Cabinet 2
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Body Bag
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Wool Blanket
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Transfer Tarp
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Safety Blanket
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Throw Bag 50' (2)
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Noodle
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Step Chocks (2)
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Caution Tape Roll
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Extension Cord
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P.F.D.
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Water Bottles (1 Case)
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Smoke Detctors (3)
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Bolt Cutters
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Ice Scrapper & Salt Can
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Fire Extinguisher
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Road Triangles
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Driver's Side Outside Cabinet 3
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SCBA Bottle (A) >4000psi
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PSI Level:
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SCBA Bottle (B) >4000psi
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PSI Level:
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Flashlights (2)
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Set of Irons
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Passport Tag Holders (2)
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Helmet Shields (3)
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Passenger's Side Outside Cabinet 4
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Scoop Stretcher
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Backboards with Straps (3)
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Peds Backboard
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Child Car Seat
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Stair Chair
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Adult/Peds/Infant Head Bed (2ea)
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Cervical Collar Bag
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Infant Collar (2)
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Peds Collar (2)
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Adult Collar (2)
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Infant Head Bed
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Peds Head Bed
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Adult Head Bed
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Cab Check
Inside Ambulance Cab
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Vehicle Hours:
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Vehicle Miles:
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Oil Change Needed?
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Exhaust Fluid Needed:
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Fuel >3/4
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Cab Cleaned & Wiped Down
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Windshield Wipers Work
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Binoculars
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Gun Lock
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Heat & Air Conditioning Work
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All Radios Work
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ERG
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File of Life
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District Map Book
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County Map Book
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Bartlett & S.Elgin Map Book
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MABAS 2 FOG Guide
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Insurance & Registration Card
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iPad Charged >75%
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Knox Box Keys
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Box of Large Gloves
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Safety Glasses (3)
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Garage Door Openers (3)
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Outside Ambulance Cab
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Oil Full
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Windshield Washer Fluid Full
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Transmission Fluid Full
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Headlights & Brights Work
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Emergency Lights Work
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Hazard Lights Work
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Scene Lights Work
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Turn Signals Work
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Backup Lights Work
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Engine High Idles
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Ambulance Washed
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Ambulance Damaged
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Front Tire Pressure 90psi
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Rear Tire Pressure 90psi
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Officer's Signature
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Add signature
