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REHAB KIT SO-1

Old Seal #

New Seal #

Top (Behind Black Mesh)

2 Burn Sheets

2 Trauma Dressings

Top Flap (Silver/Gray)

1 Pen Light

4 Tweezers

2 Crash Shears

2 Bandage Shears

1 First Aid Flip Chart

Center (Left Side)

2 Sterile Water Bottles 500ml

Expiration Date

1 Adult BVM

15 2x2's

Expiration Date

15 4x4's

Expiration Date

2 Digital Thermometers

1 Box of Probe Covers

1 SAM Splint

1 Eye Patch Kit

5 Emesis Bags

1 Bag of Large Gloves

1 Box of Particle Masks

10 Red Bio Hazard Bags

5 Non-Adhering Dressings

2 Eye Irrigation Kits (2 NC, 2-20 Drips & 2 1000 NSS)

Center Right Side

8 Cold Packs

8 Hot Packs

5 - 1" Rolls of Tape

5 Large rolls of Kling

Expiration Date

4 Small rolls of Kling

Expiration Date

5 Triangle Bandages

1 Bag of assorted Band Aids

2 CPR Masks (1 egg shell plastic & 1 orange bag)

REHAB GREEN BAG SO-1

Old Tag #

New Tag #

3 Nasal Cannulas

3 Non-Rebreather Masks

1 Bottle of Oxygen

Oxygen psi

2 Stethoscopes

1 Finger Tip PulseOx with case & spare battery

1 BP Cuff with case

1 Glucometer with case

ADDITIONAL NOTES

MEDIA IF NEEDED
Add media
CREW SIGNATURES
Add signature
Add signature

Incident Rehab Checklist

Created by: White Oak EMS | Industry: Emergency Services | Downloads: 65

White Oak EMS

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Audit

REHAB KIT SO-1

Old Seal #

New Seal #

Top (Behind Black Mesh)

2 Burn Sheets

2 Trauma Dressings

Top Flap (Silver/Gray)

1 Pen Light

4 Tweezers

2 Crash Shears

2 Bandage Shears

1 First Aid Flip Chart

Center (Left Side)

2 Sterile Water Bottles 500ml

Expiration Date

1 Adult BVM

15 2x2's

Expiration Date

15 4x4's

Expiration Date

2 Digital Thermometers

1 Box of Probe Covers

1 SAM Splint

1 Eye Patch Kit

5 Emesis Bags

1 Bag of Large Gloves

1 Box of Particle Masks

10 Red Bio Hazard Bags

5 Non-Adhering Dressings

2 Eye Irrigation Kits (2 NC, 2-20 Drips & 2 1000 NSS)

Center Right Side

8 Cold Packs

8 Hot Packs

5 - 1" Rolls of Tape

5 Large rolls of Kling

Expiration Date

4 Small rolls of Kling

Expiration Date

5 Triangle Bandages

1 Bag of assorted Band Aids

2 CPR Masks (1 egg shell plastic & 1 orange bag)

REHAB GREEN BAG SO-1

Old Tag #

New Tag #

3 Nasal Cannulas

3 Non-Rebreather Masks

1 Bottle of Oxygen

Oxygen psi

2 Stethoscopes

1 Finger Tip PulseOx with case & spare battery

1 BP Cuff with case

1 Glucometer with case

ADDITIONAL NOTES

MEDIA IF NEEDED
Add media
CREW SIGNATURES
Add signature
Add signature