Information
-
E6 Weekly Check
-
Conducted on
-
Engineer
-
Captain
-
Vehicle Miles:
-
Vehicle Hours:
-
Next Service Due
CAB & CHASSIS
Cab & Chassis
-
Engine Oil
-
Transmission
-
Coolant
-
Washer Fluid
-
Batteries
-
Belts & Hoses
-
Drain Air Tanks
-
Check Undercarriage
-
Visual Check of Body
-
Add media
-
Comments:
-
Tire Condition/ Pressure
-
Comments:
-
Left front tire
-
Left rear inside
-
Left rear outside
-
Right front
-
Right rear inside
-
Right rear outside
OPERATIONS
OPERATIONS
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Engine Starting
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Oil Pressure
-
Comments:
-
Brakes
-
Comments:
-
Pounds per application
-
Air build up time (85-100)
-
Low pressure warning
-
Cab Controls
-
Comments:
-
King Tubes
-
Size 3 ( 1 )
-
Comments:
-
Size 4 ( 1 )
-
Comments:
-
Size 5 ( 1 )
-
Comments:
-
Intubation Kit
-
Miller Laryngoscope Blades ( 3 ): Put Blade on handle to make sure light works
-
Comments:
-
Mac Laryngoscope Blades ( 3 ): Put Blades on handle to make sure light works
-
Comments:
-
Lubricant Packets ( 2 )
-
Comments:
-
ET Tubes
-
5.5 ( 1 )
-
Comments:
-
6.0 ( 1 )
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Comments:
-
6.5 ( 1 )
-
Comments:
-
7.0 ( 1 )
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Comments:
-
7.5 ( 2 )
-
Comments:
-
8.0 ( 2 )
-
Comments:
-
8.5 ( 1 )
-
Comments:
-
9.0 ( 1 )
-
Comments:
-
10ml Syringe ( 1 )
-
Comments:
-
Benzocaine ( 1 )
-
Exp. Dates:
-
Comments:
-
Forceps ( 1 )
-
Comments:
-
Stylets ( 2 )
-
Comments:
-
Nasopharyngeal ( )
-
Comments:
-
Oropharyngeal ( )
-
Comments:
-
Tape ( 1 )
-
Comments:
-
Surgical Masks ( 2 )
-
Comments:
-
Spare Batteries ( 2 )
-
Comments:
Side Pocket
-
NRB Mask ( 1 )
-
Comments:
-
Nasal Cannula ( 1 )
-
Comments:
-
Neb TX w/ 1 Albuterol & 1 Atrovent ( 1 kit )
-
Albuterol Exp. Date:
-
Atrovent Exp. Date:
-
Comments:
Vitals Side Pocket
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Blood Pressure Cuff ( 1 adult )
-
Comments:
-
SPO2 Monitor
-
Comments:
-
Stethoscope ( 1 )
-
Comments:
-
Pen light ( 1 )
-
Comments:
-
Glucometer Case
-
Glucometer ( Make sure it is working )
-
Comments:
-
Test Strips ( 5 )
-
Comments:
-
Lancets ( 5 )
-
Comments:
-
Alcohol Preps ( 5 )
-
Comments:
-
Bandaids ( 5 )
-
Comments:
IV Pocket
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Tape
-
Comments:
-
Thermometer ( w/ covers )
-
Comments:
-
Carpoject
-
Comments:
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Oral Glucose
-
Comments:
-
Exp. Date:
-
Large Gloves
-
Comments:
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XL Gloves
-
Comments:
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IV Start Kit
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Comments:
-
IV Tubing
-
Comments:
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NS IV Bags
-
Comments:
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Ring Cutter
-
Comments:
-
Syringe/Needle Kit
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3mL syringe ( 2 )
-
Comments:
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3mL w/ Monoject SmarTip ( 2 )
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Comments:
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3mL w/ 22g 1 1/2 Needle ( 2 )
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Comments:
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5mL Syringe ( 2 )
-
Comments:
-
10mL Syringe ( 3 )
-
Comments:
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21g x 1" Safety Needle ( 1 )
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Comments:
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22g x 1 1/2" Safety Needle ( 1 )
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Comments:
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22g x 1 1/2" Hypodermic Needle ( 1 )
-
Comments:
-
Filter Straw ( 2 )
-
Comments:
-
MAD Nasal ( 1 )
-
Comments:
-
1mL 29g x 1/2" Insulin Syringe ( 1 )
-
Comments:
-
Filter Needle
-
Comments:
-
IV Catheters
-
14g IV
-
Comments:
-
16g IV
-
Comments:
-
16g Delnor IV
-
Comments:
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18g IV
-
Comments:
-
18g Delnor IV
-
Comments:
-
20g IV
-
Comments:
-
20g Delnor IV
-
Comments:
-
22g IV
-
Comments:
-
22g Delnor IV
-
Comments:
-
24g IV
-
Comments:
-
60mL Syringe
-
Comments:
-
20mL Syringe
-
Comments:
-
10mL NS Syringe
-
Comments:
-
Sharps Container ( 1 )
-
Comments:
CENTER OF JUMP BAG
-
MAD ( 1 )
-
Comments:
-
Nail Polish Remover
-
Comments:
-
Alcohol Preps ( 5 )
-
Comments:
-
1mL Syringe
-
Comments:
-
3mL Syringe
-
Comments:
-
SmarTip Needle ( 1 )
-
Comments:
-
Hypodermic Needle ( 1 )
-
Comments:
-
500mL Sterile Water ( 1 )
-
Comments:
-
Tape ( 1 )
-
Comments:
-
Filter Strew ( 1 )
-
Comments:
-
4 x 4 Gauze ( 2 )
-
Comments:
-
ACE Roll ( 1 )
-
Comments:
-
Trauma Shears ( 1 )
-
Comments:
-
4" Kling ( 1 )
-
Comments:
-
SAM Splint ( 1 )
-
Comments:
-
Cold Pack ( 2 )
-
Comments:
-
Hot Pack ( 2 )
-
Comments:
-
ALS Drugs
-
Aspirin
-
Exp. Dates:
-
Comments:
-
Atropine ( 2 )
-
Exp. Dates:
-
Comments:
-
Amiodarone ( 2 )
-
Exp. Dates:
-
Comments:
-
Adenosine ( 2 )
-
Exp. Dates:
-
Comments:
-
Benadryl ( 1 )
-
Exp. Dates:
-
Comments:
-
Dextrose 50% ( 1 )
-
Exp. Dates:
-
Comments:
-
Epi 1:1000 ( 3 )
-
Exp. Dates:
-
Comments:
-
Epi 1:10,000 ( 4 )
-
Exp. Dates:
-
Comments:
-
Glucagon ( 1 )
-
Exp. Dates:
-
Comments:
-
Lidocaine ( 1 )
-
Exp. Dates:
-
Comments:
-
Magnesium Sulfate ( 2 )
-
Exp. Dates:
-
Comments:
-
Nitroglycerin
-
Exp. Dates:
-
Comments:
-
Narcan
-
Exp. Dates:
-
Comments:
-
Sodium Bicarbonate ( 1 )
-
Exp. Dates:
-
Comments:
-
Vasopressin ( 2 )
-
Exp. Dates:
-
Comments:
-
Verapamil ( 2 )
-
Exp. Dates:
-
Comments:
-
Zofran Tablet ( 2 )
-
Exp. Dates:
-
Comments:
-
Zofran Vial ( 1 )
-
Exp. Dates:
-
Comments:
-
Narcotic Box
-
Old Drug Tag #:
-
New Drug Tag #:
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Etomidate
-
Exp. Dates:
-
Comments:
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Fentanyl 300mcg
-
Exp. Dates:
-
Comments:
-
Versed 5mg/5mL ( 2 )
-
Exp. Dates:
-
Comments:
-
Versed 5mg/1mL ( 2 )
-
Exp. Dates:
-
Comments:
TOP POCKET
-
EZ IO Needle ( 2 Adult )
-
Comments:
-
Exp. Dates:
-
EZ IO Needle ( 1 PEDS )
-
Comments:
-
Exp. Dates:
-
EZ IO Gun ( Make sure it's working )
-
Comments:
-
10mL NS Flush
-
Comments:
-
14g IV
-
Comments:
-
12g IV
-
Comments:
-
10g IV
-
Comments:
-
Alcohol Preps
-
Comments:
-
Scalpel
-
Comments:
-
3.0 ET Un-cuffed Tube
-
Comments:
-
IV Pressure Infusion Bag
-
Comments:
-
Additional Comments:
PEDS BAG
TOP POCKET PEDS BAG
-
Pediatric NRB Mask ( 1 )
-
Comments:
-
Pediatric Nasal Cannula
-
Comments:
-
Infant Nasal Cannula
-
Comments:
-
Pediatric Simple Mask
-
Comments:
LEFT SIDE POCKET PEDS BAG
-
Bone Marrow Needle
-
Comments:
-
1000ml NS IV Bag
-
Comments:
-
IV 10 Drip Tubing
-
Comments:
-
IV Start Kit
-
Comments:
FRONT SIDE POCKET PEDS BAG
-
BP Cuff and Stethoscope
-
Comments:
-
Pen Light
-
Comments:
-
SPO2 Monitor
-
Comments:
-
EKG Electrodes
-
Comments:
RIGHT SIDE POCKET PEDS BAG
-
CO2 Monitor
-
Comments:
-
10ml Syringe
-
Comments:
-
Trauma Shears
-
Comments:
-
Thermometer
-
Comments:
-
Lubricant ( 2 )
-
Comments:
-
Forceps
-
Comments:
-
Laryngoscope Handle
-
Comments:
-
SAM Splint
-
Comments:
-
Stylet
-
Comments:
CENTER PEDS BAG
-
Pediatric BVM
-
Comments
-
Infant BVM
-
Comments:
-
Broselow Tape
-
Comments:
-
4X4 Gauze ( 2 )
-
Comments:
-
Cling Wrap
-
Comments:
-
Gauze Rolls ( 4 )
-
Comments:
-
Tape
-
Comments
-
Meconium Aspirator
-
Comments:
-
Alcohol Preps
-
Comments
-
Bandaids
-
Comments:
-
Misc. OPA & NPA
-
Comments:
-
ET Tube Holder
-
Comments:
-
Emisis Bag
-
Comments:
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RED
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22-24g IV
-
Comments:
-
3.5 UC Tube
-
Comments:
-
14 French NPA
-
Comments:
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0-1 Straight Blade
-
Comments:
-
40-50mm OPA
-
Comments:
-
PURPLE
-
20-24g IV
-
Comments:
-
4 UC Tube
-
Comments:
-
18 French NPA
-
Comments:
-
1 Straight Blade
-
Comments:
-
50-60mm OPA
-
Comments:
-
YELLOW
-
18-22g IV
-
Comments:
-
4.5 UC Tube
-
Comments:
-
20 French NPA
-
Comments:
-
1-2 Straight Blade
-
Comments:
-
50-60mm OPA
-
Comments:
-
WHITE
-
18-22g IV
-
Comments:
-
5 UC Tube
-
Comments:
-
22 French NPA
-
Comments:
-
1-2 Straight Blade
-
Comments:
-
50-60mm OPA
-
Comments:
-
BLUE
-
18-20g IV
-
Comments:
-
5.5 UC Tube
-
Comments:
-
24 French NPA
-
Comments:
-
2 Curved or Straight Blade
-
Comments:
-
60-70mm OPA
-
Comments:
-
ORANGE
-
18-20g IV
-
Comments:
-
6 C Tube
-
Comments:
-
26 French NPA
-
Comments:
-
2 Curved or Straight Blade
-
Comments:
-
70-80mm OPA
-
Comments:
-
GREEN
-
16-20g IV
-
Comments:
-
6.5 C Tube
-
Comments:
-
30 French NPA
-
Comments:
-
3 Curved or Straight Blade
-
Comments:
-
80mm OPA
-
Comments:
-
Additional Comments:
IV CABINET
IV Cabinet
-
Bandaids ( 1 )
-
Comments:
-
IV Start Kit ( 4 )
-
Comments:
-
10ml NS Flushes ( 2 )
-
Comments:
-
18g x 1 1/2" Needle ( 2 )
-
Comments:
-
21g x 1" Needle ( 2 )
-
Comments:
-
22g x 1 1/2" Needle ( 2 )
-
Comments:
-
23g x 1" Needle ( 2 )
-
Comments:
-
25g x 1 1/2" Needle ( 2 )
-
Comments:
-
Filter Straws ( 2 )
-
Comments:
-
Filter Needle ( 5 )
-
Comments:
-
1ml Syringe ( 1 )
-
Comments:
-
2ml Syringe ( 1 )
-
Comments:
-
3ml Syringe ( 1 )
-
Comments:
-
3ml Syringe with Smartip ( 1 )
-
Comments:
-
12ml Syringe ( 1 )
-
Comments:
-
Butterfly Needles ( 21g & 23g ): Total of 2
-
Comments:
-
Lancets ( 5 )
-
Comments:
-
MAD Device ( 2 )
-
Comments:
-
Alcohol Preps ( 5 )
-
Comments:
-
Tape ( 2 )
-
Comments:
-
Arm Boards
-
Comments:
-
IV Catheters
-
14g IV ( 2 )
-
Comments:
-
16g IV ( 2 )
-
Comments:
-
18g IV ( 2 )
-
Comments:
-
Delnor Type 18g IV ( 1 )
-
Comments:
-
20g IV ( 2 )
-
Comments:
-
Delnor Type 20g IV ( 1 )
-
Comments:
-
22g IV ( 2 )
-
Comments:
-
24g IV ( 2 )
-
Comments:
-
Delnor Type 22g IV ( 1 )
-
Comments:
-
Additional Comments:
ALS DRUG EQUIPMENT
ALS Drug Equipment
-
Alcohol Preps ( 1 box )
-
Comments:
-
0.9% NaCL Solution 10ml Flush
-
Comments:
-
0.9% NaCL Solution 3ml ( 5 )
-
Comments:
-
Exp. Dates:
-
MAD Device ( 1 )
-
Comments:
-
3ml Syringe w/ Needle ( 1 )
-
Comments:
-
1ml Syringe w/ Needle ( 1 )
-
Comments:
-
Spare Test Strips ( 1 box )
-
Comments:
-
Spare Lancets ( 5 )
-
Comments:
-
Filter Straws ( 2 )
-
Comments:
-
Filter Needle ( 2 )
-
Comments:
-
1ml Syringe ( 1 )
-
Comments:
-
3ml Syringe ( 4 )
-
Comments:
-
5mL Syringe ( 4 )
-
Comments:
-
10mL Syringe ( 2 )
-
Comments:
-
20mL Syringe
-
Comments:
-
60mL Syringe
-
Comments:
-
Carpoject ( 1 )
-
Comments:
-
Needles
-
18g x 1 1/2"
-
Comments:
-
20g x 1"
-
Comments:
-
21g x 1"
-
Comments:
-
22g x 1 1/2"
-
Comments:
-
23g x 1"
-
Comments:
-
25g x 1 1/2"
-
Comments:
-
ALS Drugs: PLEASE MAKE SURE TO GET DRUGS EXCHANGED 30 DAYS BEFORE EXPIRATION DATE.
-
Amiodarone ( 2 )
-
Expiration Dates:
-
Comments:
-
Aspirin
-
Expiration Dates:
-
Comments:
-
Albuterol ( 2 )
-
Expiration Dates:
-
Comments:
-
Atrovent ( 3 )
-
Expiration Dates:
-
Comments:
-
Atropine ( 5 )
-
Expiration Dates:
-
Comments:
-
Adenosine ( 1 )
-
Expiration Dates:
-
Comments:
-
Benadryl ( 1 )
-
Expiration Dates:
-
Comments:
-
Dopamine ( 1 ) with 60 Drip Tubing
-
Expiration Dates:
-
Comments:
-
Dextrose 50% ( 1 )
-
Expiration Dates:
-
Comments:
-
Epi 1:1000 ( 3 )
-
Expiration Dates:
-
Comments:
-
Epi 1:10,000 ( 7 )
-
Expiration Dates:
-
Comments:
-
Glucagon ( 2 )
-
Expiration Dates:
-
Comments:
-
Lidocaine ( 4 )
-
Expiration Dates:
-
Comments:
-
Magnesium Sulfate ( 2 )
-
Expiration Dates:
-
Comments:
-
Narcan 2ml ( 2 )
-
Expiration Dates:
-
Comments:
-
Narcan 1ml ( 3 )
-
Expiration Dates:
-
Comments:
-
Nitroglycerine ( 1 )
-
Expiration Dates:
-
Comments:
-
Sodium Bicarbonate w/ 60mL Syringe and Needle ( 1 )
-
Expiration Dates:
-
Comments:
-
Tetracaine ( 1 )
-
Expiration Dates:
-
Comments:
-
Vasopressin ( 1 )
-
Expiration Dates:
-
Comments:
-
Zofran ( 1 Vial )
-
Expiration Dates:
-
Comments:
-
Zofran ( 1 Tablet )
-
Expiration Dates:
-
Comments:
-
Additional Comments:
INTERIOR CABINETS
Interior Cabinet #1
-
BVM
-
Adult ( 1 )
-
Comments:
-
Adult CO2 Detector ( 1 )
-
Comments:
-
Exp. Date:
-
Child ( 1 )
-
Comments:
-
PEDS CO2 Detector ( 1 )
-
Comments:
-
Exp. Date:
-
Infant ( 1 )
-
Comments:
-
Infant CO2 Detector ( 1 )
-
Comments:
-
Exp. Date:
-
500ml Sterile Water ( 2 )
-
Comments:
-
Exp. Dates:
-
1000ml Sodium Chloride ( 3 )
-
Comments:
-
Exp. Dates:
-
500ml Sodium Chloride ( 2 )
-
Comments:
-
Exp. Dates:
Interior Cabinet #2
-
1 Nebulizer tx w/ 1 Albuterol & 1 Atrovent
-
Albuterol Dates:
-
Atrovent Dates:
-
Comments:
-
1 Inline Nebulizer Kit w/ 1 Albuterol & 1 Atrovent
-
Albuterol Dates:
-
Atrovent Dates:
-
Comments:
-
Oxygen Tubing
-
Comments:
-
Adult Nasal Cannula ( 5 )
-
Comments:
-
Adult NRB ( 3 )
-
Comments:
-
0.9% NaCl Solution 3ml
-
Comments:
-
Exp. Dates:
-
Peds NRB ( 3 )
-
Comments:
-
Peds Nasal Cannula ( 3 )
-
Comments:
-
Infant NRB ( 3 )
-
Comments:
-
Infant Nasal Cannula ( 3 )
-
Comments:
Interior Cabinet #3
-
Triage Tags ( 1 set )
-
Comments:
-
Drug Tags ( 1 bag )
-
Comments:
-
Rubberbands ( 1 bag )
-
Comments:
-
Safety Vest ( 1 )
-
Comments:
Interior Cabinet #4
-
Stethoscope w/ Accessories ( 1 )
-
Comments:
-
Multi Cuff BP Bag
-
1 Adult
-
Comments:
-
1 Large Adult
-
Comments:
-
1 Child
-
Comments:
-
1 Infant
-
Comments:
-
1 Thigh
-
Comments:
-
Gauge ( 1 )
-
Comments:
-
Spare Child BP Cuffs ( 2 )
-
Amount:
-
1 Stethoscope
-
Amount:
-
1 Bag of Extra Pieces For Stethoscope
-
Amount:
Interior Cabinet #5
-
Cavi Wipes ( 1 )
-
Comments:
-
Garbage Bags & Soil Linen Bags
-
Comments:
Interior Cabinet #6
-
N95 Masks ( 5 )
-
Comments:
-
Safety Glasses ( 3 )
-
Comments:
Interior Cabinet #7
-
Adult EtCO2 Cannulas ( 2 )
-
Comments:
-
Adult EtCO2 Tube Connectors ( 2 )
-
Comments:
-
Peds Electrodes 1pk.
-
Comments:
-
Adult Electrodes 1pk.
-
Comments:
-
EKG Paper ( 2 )
-
Comments:
-
Adult Defib Pads ( 1 )
-
Expiration Date:
-
Comments:
Interior Cabinet #8
-
Baby Bottle ( 1 )
-
Comments:
-
OB Kit ( 1 )
-
Comments:
-
Baby Bunting Foil ( 2 )
-
Comments:
Interior Cabinet #9
-
IV Pressure Infusion Bag ( 1 )
-
Comments:
-
10 or 15 Drip IV Tubing ( 5 )
-
Comments:
-
1000ml Sodium Chloride IV Bags ( 3 )
-
Expiration Dates:
-
Comments:
-
60 Drip IV tubing ( 2 )
-
Comments:
-
Blood Tubing ( 2 sets )
-
Comments:
Interior Cabinet #10
-
Survival Wrap ( 2 )
-
Comments:
-
Soft Restraints ( 2 sets )
-
Comments:
-
Towels ( 3 )
-
Comments:
-
Hand Sanitizer
-
Comments:
-
Red Biohazard Bag ( 5 )
-
Comments:
-
Pocket Mask ( 1 )
-
Comments:
Interior Cabinet #11
-
Adult Arm Slings
-
1 Large
-
Comments:
-
1 Medium
-
Comments:
-
1 Small
-
Comments:
-
Peds Slings ( 2 )
-
Comments:
-
SAM Splints ( 3 )
-
Comments:
-
Face Shields ( 5 )
-
Comments:
-
ACE Wraps ( 4 )
-
Comments:
-
4" Kling ( 2 )
-
Comments:
-
4 1/2" Kerlix ( 1 )
-
Comments:
-
Eye Pads ( 4 )
-
Comments:
-
Tape ( 4 )
-
Comments:
-
Petrolatum/Vaseline
-
( 2 ) 3x9
-
Comments:
-
( 2 ) 3x18
-
Comments:
-
Arm Board ( 1 )
-
Comments:
-
Trauma Shears ( 1 )
-
Comments:
-
Triangle Bandages ( 3 )
-
Comments:
-
ACS Chest Seal Pads ( 1 )
-
Comments:
-
4x4 Gauze ( 15 )
-
Comments:
Interior Cabinet #12
-
Trauma Dressing ( 4 )
-
Comments:
-
Burn Sheet ( 2 )
-
Comments:
-
Aluminum Foil ( 1 )
-
Comments:
-
Isolation Kits ( 3 )
-
Comments:
-
Cold Packs ( 5 )
-
Comments:
-
Hot Packs ( 5 )
-
Comments:
Interior Cabinet 13
-
CPAP ( O2 Bottle, Tubing, Mask w/ Filter, and Regulator )
-
Comments:
-
O2 Pressure:
-
Portable Suction ( Test Unit To 300
-
Comments:
Bench
-
Mustang Suit w/ Ice Boots
-
Comments:
-
150' Water Rescue Rope w/ Carabiners ( 1 )
-
Comments:
-
Emergency Blanket
-
Comments:
-
Wool Blanket ( 4 )
-
Comments:
-
Burn Sheet ( 1 )
-
Comments:
-
Pillows ( 2 )
-
Comments:
-
Umbrella ( 1 )
-
Comments:
Spare Items
-
Oxygen Bottle ( 2 )
-
Comments:
-
Emesis Basin ( 2 )
-
Comments:
-
Sheets ( 3 )
-
Comments:
-
Blankets ( 3 )
-
Comments:
-
Urinals ( 1 )
-
Comments:
MISC.
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Drug Sheet Signed
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Comments:
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Stretcher Clean & Made
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Comments:
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Patient Area Clean And Sanitized
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Comments:
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Additional Comments:
EXTERIOR CABINETS
Exterior Cabinet #1
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Pressurized Water Can
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Comments:
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6' Pike Pole
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Comments:
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O2 Bottle
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Comments:
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Peds Hare Traction
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Comments:
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Adult Hare Traction
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Comments:
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Air splints ( 1L, 1M, 1S, & Pump )
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Comments:
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KED
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Comments:
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Broom ( 1 )
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Comments:
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Hydrant Bag
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Exterior Cabinet #2
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Body Bag
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Comments:
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Wool Blankets
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Comments:
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ABC Extinguisher
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Comments:
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Transfer Tarp
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Comments:
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Safety Blanket
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Comments:
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Throw Bag
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Comments:
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Noodle
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Comments:
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Life Vest
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Comments:
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Bolt Cutters
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Comments:
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Spare Cot Straps
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Comments:
Exterior Cabinet #3
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SCBA ( 2 ) :<br>Everything in working order. Bottle full w/ no leaks
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SCBA ( A ) P.S.I. :
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SCBA ( B ) P.S.I. :
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Comments:
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Flashlights ( 2 ):<br>Both work
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Comments:
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Irons ( 1 halligan & 1 flat head axe )
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Comments:
Exterior Cabinet #4
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Scoop Stretcher:<br>Clean and in working order
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Comments:
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Backboards w/ Straps:<br>1 w/ spider straps, 1 w/ seat-belts, 1 blank. All clean
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Comments:
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Child Car Seat
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Comments:
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C-Collar Bag
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Adult Collars ( 2 )
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PEDS/Infant Collars ( 3 )
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Baby No Neck Collar
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Adult Head Immobilizers ( 2 )
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PEDS/Infant Head Immobilizer ( 1 )
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Adult Head Immobilizers ( 2 )
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Comments:
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Child Head Immobilizers ( 2 )
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Comments:
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Peds Backboard:<br>Clean w/ all straps
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Comments:
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Stair Chair:<br>Chair in working order and clean
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Comments:
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Extra Spider Straps
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Comments:
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Additional Comments:
CAB
CAB
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Portable Radios ( 2 )
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Comments:
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Flashlight ( 1 )
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Comments:
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iPad Charged ( >75% )
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Comments:
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Gloves ( 1XL, 1L, 1M )
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Comments:
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Knox Box Key
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Comments:
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Passport Tags ( White & Red )
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Comments:
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Helmet Shields ( 2 )
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Comments:
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Safety Vests ( 2 )
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Comments:
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Road Triangles
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Comments:
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ERG Book
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Comments:
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Maps ( FRC, County, South Elgin )
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Comments:
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Garage Openers ( Station 1, Delnor, & St. Joes )
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Comments:
CLIPBOARD
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IF SHEETS ARE LOW PLEASE PRINT THEM OUT AND THEN HIT YES!
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10 Run Sheets
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10 Hippa Forms
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10 AMA/Refusal Forms
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10 Multiple Release Forms
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5 EMS Rehab Forms
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1 School Bus Form
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1 Involuntary Form
MISC.
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Cab Vacuumed & Cleaned Out
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Comments:
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Additional Comments:
MAINTENANCE
LIGHTS
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IF ANYTHING IS NOT WORKING PLEASE WRITE IT UP IN EMERGENCY REPORTING
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Emergency Lights
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Comments:
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Headlights ( High & Low Beam )
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Comments:
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Turn signals
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Comments:
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Brake Lights
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Comments:
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Scene Lights
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Comments:
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Running Lights
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Comments:
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Reverse Lights
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Comments:
FLUID LEVEL
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IF FLUIDS ARE LOW PLEASE ADD, IF WE HAVE HERE, THEN PUT IT IN EMERGENCY REPORTING
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Fuel ( > 3/4 )
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Comments:
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Oil
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Comments:
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Coolant
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Comments:
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Transmission
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Comments:
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Power steering
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Comments:
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Washer Fluid
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Comments:
TIRE PRESSURE
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IF TIRES ARE LOW PLEASE ADD AIR AND THEN PUT IT IN EMERGENCY REPORTING
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Front Tires
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Front Left PSI:
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Front Right PSI:
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Comments:
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Rear Tires
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Left Inner PSI:
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Left Outer PSI:
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Right Inner PSI:
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Right Outer PSI:
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Comments:
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Additional Comments:
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Officers Signature:
