Medic 2 Daily

• Personnel Completing Check (Last Name)

• Conducted on

  Date

Medic 7

Cab

• Miles

• Fuel

  Full

  3/4

  1/2

• Oil Level

  Full

  Needs

• Coolant Level

  Full

  Needs

• Powering Steering Level

  Full

  Needs

• Vehicle Starts

  Yes

  No

• Lights (All Lights)

  Yes

  No

• Siren

  Yes

  No

• Main Radio

  Yes

  No

• L Gloves

  Yes

  No

• XL Gloves

  Yes

  No

• Map/Preplans

  Yes

  No

• Garage Door Opener

  Yes

  No

• Lock Box w/ 2 keys

  Yes

  No

• Digital Camera

  Yes

  No

Oxygen Compartment

• Main 0xygen Pressure (Change at 500 psi)

  Select 500 psi 600 psi 700 psi 800 psi 900 psi 1000 psi 1100 psi 1200 psi 1300 psi 1400 psi 1500 psi 1600 psi 1700 psi 1800 psi 1900 psi 2000 psi

  • 500 psi
  • 600 psi
  • 700 psi
  • 800 psi
  • 900 psi
  • 1000 psi
  • 1100 psi
  • 1200 psi
  • 1300 psi
  • 1400 psi
  • 1500 psi
  • 1600 psi
  • 1700 psi
  • 1800 psi
  • 1900 psi
  • 2000 psi

Bunker Gear Compartment

• SCBA Units x3

  0

  1

  2

  3

  4

• Hand Lights

  0

  1

  2

Backboard Compartment

• Vacuum Splints

  Yes

  No

• KED

  Yes

  No

• Reeves

  Yes

  No

• Stair Chair/Straps x3

  Yes

  No

• Adult Backboard/Straps x3

  0

  1

  2

  3

  4

• Obese Pt Carrier

  Yes

  No

• Peds Backboard

  Yes

  No

• Pedi mate

  Yes

  No

• Baby Seat

  Yes

  No

Pt Area

• Cell phone

  Yes

  No

• Ipad

  Yes

  No

• Suction w/tubing and tips

  Yes

  No

• CPAP unit with circuit

  Yes

  No

LifePak 15

• Batteries Fully Charged

  Yes

  No

• Battery #

• Battery #

• BP Cuff

  Yes

  No

• Pulse Ox

  Yes

  No

• 12-Lead Cables

  Yes

  No

• Adult D-fib Pads x2

  Yes

  No

• Peds D-fib Pads x2

  Yes

  No

• EKG Paper

  Yes

  No

• Spare Electrodes

  Yes

  No

Front Bulkhead Cabinet

• Lucas Batteries Full

  Yes

  No

• Peds Jump Bag

  Yes

  No

• Drug Box Seal #

• Spare O2 Tanks (1500 psi)

  Select 500 psi 600 psi 700 psi 800 psi 900 psi 1000 psi 1100 psi 1200 psi 1300 psi 1400 psi 1500 psi 1600 psi 1700 psi 1800 psi 1900 psi 2000 psi

  • 500 psi
  • 600 psi
  • 700 psi
  • 800 psi
  • 900 psi
  • 1000 psi
  • 1100 psi
  • 1200 psi
  • 1300 psi
  • 1400 psi
  • 1500 psi
  • 1600 psi
  • 1700 psi
  • 1800 psi
  • 1900 psi
  • 2000 psi

• Trauma Kit

  Yes

  No

• Protocol Book

  Yes

  No

• IV Kit/ Blood Draw Tubes

  Yes

  No

Cot

• O2 Bag PSI (Refill at 500 psi)

  Select 500 psi 600 psi 700 psi 800 psi 900 psi 1000 psi 1100 psi 1200 psi 1300 psi 1400 psi 1500 psi 1600 psi 1700 psi 1800 psi 1900 psi 2000 psi

  • 500 psi
  • 600 psi
  • 700 psi
  • 800 psi
  • 900 psi
  • 1000 psi
  • 1100 psi
  • 1200 psi
  • 1300 psi
  • 1400 psi
  • 1500 psi
  • 1600 psi
  • 1700 psi
  • 1800 psi
  • 1900 psi
  • 2000 psi

• NC

  Yes

  No

• NRB

  Yes

  No

• Nebulizer

  Yes

  No

• Peds NC

  Yes

  No

• Peds NRB

  Yes

  No

• Peds Nebulizer

  Yes

  No

• Clipboard

  Yes

  No

• Smith Cot

  Yes

  No

Blue Jump Bag

• Glucometer

  Yes

  No

• Airway Kit

  Yes

  No

• BVM

  Yes

  No

• EZ-IO

  Yes

  No

• King Vision & king Airways

  Yes

  No

Personnel Information

• Personnel Completing Check

  Select Michael McConville Robert Zaucha Joe Lecznar James Harry Gary Thozeski Ryan Cervanka Steve Kordas Kyle Higginbotham Bob Perko III Jerry Alex Lou Bottone Marc Bishop Sean Cottrell Ted Delancey Matt Ditlevson Brian Dougan James Gaffney Andrew Green Brad Hoffman John Kandzer Stevie Kordas Jr David Kren Danny Messich Ryan Milligan Steve Pasek Bob Perko Michael Santora Jeff Satow Damon Schreiber Joe Simerale Todd Skinner Tim Smith Dale Stefanini David Stepka Michael Tusai Chuck Vinyard Derek Von Der Vellen Jeff Wagner Ryan Watson Matt Ziemba

  • Michael McConville
  • Robert Zaucha
  • Joe Lecznar
  • James Harry
  • Gary Thozeski
  • Ryan Cervanka
  • Steve Kordas
  • Kyle Higginbotham
  • Bob Perko III
  • Jerry Alex
  • Lou Bottone
  • Marc Bishop
  • Sean Cottrell
  • Ted Delancey
  • Matt Ditlevson
  • Brian Dougan
  • James Gaffney
  • Andrew Green
  • Brad Hoffman
  • John Kandzer
  • Stevie Kordas Jr
  • David Kren
  • Danny Messich
  • Ryan Milligan
  • Steve Pasek
  • Bob Perko
  • Michael Santora
  • Jeff Satow
  • Damon Schreiber
  • Joe Simerale
  • Todd Skinner
  • Tim Smith
  • Dale Stefanini
  • David Stepka
  • Michael Tusai
  • Chuck Vinyard
  • Derek Von Der Vellen
  • Jeff Wagner
  • Ryan Watson
  • Matt Ziemba

• Signature

  Sign

• Conducted On

  Date