Title Page
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Document No.
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PTS 2 Vehicle Equipment (Yellow Fiat) v2 11.2016
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Vehicle Registration Number
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Base Location
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Conducted on
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Name of Person completing report:
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Location
Cab Area
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Please confirm that the items are present and functional. If not functional please inform your supervisor and complete the appropriate documentation.
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Vehicle Information folder (driver's door pocket)
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Mobile Telephone
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Tom tom sat nav tracker
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Rechargeable Torch
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Bulb Kit (Glovebox)
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Vehicle first aid kit (driver's door pocket)
Main Medical Compartment
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Response Bag (see separate contents list) Tags Intact.
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Pocket Mask (on Vehicle Wall)
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Click Stop oxygen flow meter nearside
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Click Stop oxygen flow meter offside
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Carry Chair (Ferno compact 2) Present / Functional.
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Enduro Hand Sanitizer & Dispenser / Minimum 25% - Less than 25% Inform Supervisor
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Hand towel dispenser , Present / 50% full - otherwise restock
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Fire Extinguisher, Tagged - In green on pressure gauge.
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Clock
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Latex Free examination gloves (Boxes of each size in holder)
- Small
- Medium
- Large
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Bacticlean drum of wipes in holder
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Umbrella (by HX O2 Bottle)
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Spare CD O2 Bottle
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Roma Wheelchair & Pressure Cushion
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Bedpan & Disposable Inserts x4
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Dustpan & Brush (Yellow)
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Broom (Yellow)
Back Door
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Scoop Stretcher
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Headblocks (If not complete = NO)
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Fracture Straps
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Spider Strap
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Foot Strap
Wall of Main Medical Compartment
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Cleaning Schedule
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Patient Feedback poster
Cupboard A
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Automated External Defibrillator (AED) Lifepak 1000
- Correct Serial for Vehicle
- Incorrect Serial for Vehicle
- Black X in function Window
- Red X in function Window
- Adult Pads - In date
- Adult Pads - Out of date
- Skin prep Razor sealed
- Skin prep Razor unsealed
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Oxygen Mask Pack(s)
- Adult Pack Sealed
- Adult Pack Unsealed
- Paediatric Pack Sealed
- Paediatric Pack Unsealed
Cupboard B
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Blankets (CLEAN - FOLDED Appropriately) (Standard is Four)
- None
- one
- Two
- Three
- Four
- More than Four
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Sheets (Linen - Clean Folded) (Standard is Four)
- None
- one
- Two
- Three
- Four
- More than Four
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Pillow Slips (Linen - Clean Folded) (Standard is Four)
- None
- one
- Two
- Three
- Four
- More than Four
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Disposable Bed pack(s)_- Sealed (Standard is Four)
- None
- one
- Two
- Three
- Four
- More than Four
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Reusable Quilt - (Clean, Undamaged) (One)
Cupboard C
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Patient Handling equipment
- Handling Belt Small
- Handling Belt Medium
- Handling Belt Large
- Slide Board (Banana)
- Slide Sheets x3 Tubular
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Pedimate
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Carry Canvas(s) Disposable
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Seatbelt Pads (Standard is Two)
Cupboard D
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Disposable Vomit Bowls (Standard 6)
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MALE Urine bottles DISPOSABLE
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FEMALE Urine bottles DISPOSABLE
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Incontinence Pads (Standard is 10)
Cupboard E
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Polystyrene Cups & Straws (Standard is Four)
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Bottled Water (Standard is Four)
Cupboard F
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Absorbent Granules Pack
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Bacticlean Spray Bottle (FULL)
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Antibakspray bottle & Sachet
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Waste Bags (pouch)
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Infection control pouch
Cupboard G
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Domestic Waste Bag
Cupboard H
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Clinical Waste bag
Cupboard I
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Wheelchair tie down set & occupant restraints
