Information
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Personnel Completing Check (Dept. ID Number)
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Conducted on
Primary Squad Long Check Tuesday
Basic Information
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Squad Number
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Fuel Level - Refuel If Less Then 1/2
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Knox Key Present
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Lights, Horn, Sirens
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Map Book/Clipboard/Run Reports
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Check Portable Radios
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Check/Charge/Reset Active 9-11 iPad/Clear Active 9-11 Runs<br>(Ensure screen is off when not in use)
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Check/Charge iPad for Patient Reports
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Delete Photos in the Camera Roll
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Clear HIPAA/Refusal Forms
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Close all Apps
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On-board Oxygen Pressure Change at 500psi
- <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
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Drug Box Seal Color
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Drug Box Seal Color
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Portable Oxygen Pressure: 1000psi minimum
- 1000 psi
- 1100 psi
- 1200 psi
- 1300 psi
- 1400 psi
- 1500 psi
- 1600 psi
- 1700 psi
- 1800 psi
- 1900 psi
- 2000 psi
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Spare Oxygen Pressure: 1000psi minimum (Located Under Bench Seat)
- 1000 psi
- 1100 psi
- 1200 psi
- 1300 psi
- 1400 psi
- 1500 psi
- 1600 psi
- 1700 psi
- 1800 psi
- 1900 psi
- 2000 psi
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Check/Charge Cell Phone
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Check Lucas Device/Batteries x2
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Check King Vision<br>(Turn on unit without blade attached and ensure there is a green light in the top left hand corner, change batteries if green light is not present or if there is a red light, ensure there are spare batteries)
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Check Laryngoscopes<br>(Check both the Adult and Pediatric Laryngoscopes. Pediatric handle is located in the Peds bag)
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Check Life-Pak/Batteries
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Check Cot Batteries
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Check SCBA's
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Vehicle Equipment In Place
Long Check Information
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Vehicle Mileage
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Oil Level (15W40)
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Brake Fluid Level
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Power Steering Level
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Transmission Fluid Level
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Radiator Level
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Check Rear Heater/Air Cond.
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Check On-Board Suction
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Check Interior Lights
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Check Tire Pressure (110 front/110 rear)
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Transmit Test 12-lead
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Check Radios
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Change Cot Battery
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Check Toolbox
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Check Extingushers
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Check Windshield Wipers/Fluid
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Sanitize Squad
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Complete Inventory Per Toolbook
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Click to View Toolbook
Comments
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Would you like to leave any additional comments regarding defects, damage and/or missing equipment?
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Please list any defects, damage and/or missing equipment here.
Personnel Information
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Personnel Completing Check (List the Last Name of All Personnel Completing The Check)
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Conducted On