Title Page
Daily
Cardiac Monitor
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Adult Dfib Pads (Test)
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Comments:
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Pediatric Defibrillation Pads
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4 Lead & 12 Lead Cables
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Adult/Peds Electrodes (12ea)
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CO2 Cable w/ BVM Adaptor
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CO2 Nasal Canula Adapter
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Pediatric SpO2
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Razor
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Spare Monitor Paper
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Rotate The Spare Battery
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Oxygen Levels
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Onboard Main Oxygen >500psi
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Oxygen Level:
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Stretcher Oxygen Cylinder >300psi
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Oxygen Level:
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CPAP Oxygen Cylinder > 300psi
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Oxygen Level:
Jump Bag
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Glucometer
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Vitals Equipment
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Clipboard & Forms (10ea form)
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Drug Bag
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IV Roll Up Bag
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Pediatric Bag
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Other Items
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Onboard/Portable Suction
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Interior Cabinets Stocked
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All Lights Working
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All Fluids Full (Fuel >3/4)
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Cab/Cot/Patient Areas Cleaned
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Radios and Phone Working
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Driver's Side Outside Cabinet 1
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Pressurized Water Can
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Broom
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6' Pike Pole
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Peds & Adult Hare Traction
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K.E.D.
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Vacuum Splints (1Sm, 1M, 1Lg & 1 Pump)
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Driver's Side Outside Cabinet 2
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Body Bag
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Wool Blanket
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Transfer Tarp
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Safety Blanket
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Throw Bag 50' (2)
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Noodle
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Step Chocks (2)
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Caution Tape Roll
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Extension Cord
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P.F.D.
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Water Bottles (1 Case)
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Smoke Detctors (3)
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Bolt Cutters
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Ice Scrapper & Salt Can
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Fire Extinguisher
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Road Triangles
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Driver's Side Outside Cabinet 3
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SCBA Bottle (A) >4000psi
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Psi Level:
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SCBA Bottle (B) >4000psi
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Psi Level:
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Flashlights (2)
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Set of Irons
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Passport Tag Holders (2)
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Helmet Shields (3)
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Passenger's Side Outside Cabinet 4
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Scoop Stretcher
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Backboards with Straps (3)
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Peds Backboard
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Child Car Seat
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Stair Chair
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Adult/Peds/Infant Head Bed (2ea)
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Cervical Collar Bag
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Infant Collar (2)
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Peds Collar (2)
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Adult Collar (2)
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Infant Head Bed
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Peds Head Bed
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Adult Head Bed
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Peds Bag Check Weekly
Top Compartment
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Infant Nasal Canula
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Peds Nasal Canula
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Infant NRB
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Peds NRB
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Simple Mask
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Left Compartment
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Saline Bag
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Expiration Date:
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IO Jamshidi
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IV Tubing
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IV Start Kit
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Front Compartment
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Stethoscope
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Peds BP Cuff
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Pen Light
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Thermometer
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Neonatal Spo2 Sensor
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Right Compartment
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SAM Splint
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Saline Flush (2)
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10ml Syringe
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Trauma Shears
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Magill Forceps
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Surgical Lube (2)
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Spare "AA" Batteries (2)
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Peds Laryngoscope Handle
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Co2 Detector
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Expiration Date:
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Stylet
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Inside Compartment Top Flap
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4x4 (20)
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Kerlex/Kling (4)
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Tape Roll (3)
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Meconium Aspirator
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Bandaids (10)
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Alcohol Prep Pads (10)
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Oropharyngeal Size 80
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Tube Holder (2)
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Vomit Bag (2)
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Inside Compartment Middle
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Infant BVM
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Peds BVM
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Broselow Tape
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Red Bag
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22g & 24g IV Catheter
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3.0 & 3.5 UC Tube
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14Fr NPA
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0 or 1 Straight (Miller) Blade
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40mm or 50mm OPA
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Purple Bag
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20g, 22g & 24g IV Catheter
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4.0 UC Tube
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18Fr NPA
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1 Straight (Miller) Blade
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50mm or 60mm OPA
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Yellow Bag
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18g, 20g & 22g IV Catheter
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4.5 UC Tube
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20Fr NPA
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1 or 2 Straight (Miller) Blade
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50mm or 60mm OPA
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White Bag
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18g, 20g & 22g IV Catheter
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5.0 UC Tube
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22Fr NPA
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1 or 2 Straight (Miller) Blade
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50mm or 60mm OPA
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Blue Bag
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18g & 20g IV Catheter
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5.5 UC Tube
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24Fr NPA
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2 Straight(Miller) or Curved(Macintosh) Blade
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60mm or 70mm OPA
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Orange Bag
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18g & 20g IV Catheter
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6.0 UC Tube
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26Fr NPA
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2 Straight(Miller) or Curved(Macintosh) Blade
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70mm or 80mm OPA
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Green Bag
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16g, 18g & 20g IV Catheter
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6.5 UC Tube
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30Fr NPA
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2 Straight(Miller) or Curved(Macintosh) Blade
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80mm OPA
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Officer's Signature
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Add signature
