Woodmere Squad One Daily Check 2019

• Conducted on

  Date

• Prepared by

• Shift

  ALS 7a - 7p

  ALS 7p - 7a

  BLS 7a- 7p

  BLS 7p-7a

• On Duty

  Select CPT. McCary P22 CPT. Ali P41 LT. Buffington. B66 Medic Swanson. P114 Medic Bialek. P111 Medic Cammon. P99 Medic Kowalski. P118 Medic Strauss. P95 Medic Lombardo. P131 EMT Sanchez. B67 EMT Brynak. B73 EMT Lavender. B93 EMT Clark. B89 EMT Nafasi. B100 EMT Large. B102 EMT Perrin. B103 EMT Johnson. B109 EMT Zilman. B112 EMT West. B115 EMT Jackson. B117 EMT Doran. B122 LT. Walton. B123 EMT Arth B124 EMT Draft B127 EMT Hall B128 Medic Worley P130 EMT Starks B131 EMT Grace B132

  • CPT. McCary P22
  • CPT. Ali P41
  • LT. Buffington. B66
  • Medic Swanson. P114
  • Medic Bialek. P111
  • Medic Cammon. P99
  • Medic Kowalski. P118
  • Medic Strauss. P95
  • Medic Lombardo. P131
  • EMT Sanchez. B67
  • EMT Brynak. B73
  • EMT Lavender. B93
  • EMT Clark. B89
  • EMT Nafasi. B100
  • EMT Large. B102
  • EMT Perrin. B103
  • EMT Johnson. B109
  • EMT Zilman. B112
  • EMT West. B115
  • EMT Jackson. B117
  • EMT Doran. B122
  • LT. Walton. B123
  • EMT Arth B124
  • EMT Draft B127
  • EMT Hall B128
  • Medic Worley P130
  • EMT Starks B131
  • EMT Grace B132

Front Cab & Exterior

• Mileage

• Fuel

  Select Full 3/4 1/2 1/4 7/8 5/8 3/8

  • Full
  • 3/4
  • 1/2
  • 1/4
  • 7/8
  • 5/8
  • 3/8

• Red Lights

  Yes

  No

  N/A

• Scene Lights (Left, Rear, Right)

  Yes

  No

  N/A

• Headlights (Low beam & High beams)

  Yes

  No

  N/A

• Turn Signals

  Yes

  No

  N/A

• Back up Camera

  Yes

  No

  N/A

• Siren

  Yes

  No

  N/A

• Air Horn

  Yes

  No

  N/A

• I pad fully charged

  Yes

  No

  N/A

• Binoculars

  Yes

  No

  N/A

• Garage door opener

  Yes

  No

  N/A

Driver side front

• Main O2 tank

• O2 wrench

  Yes

  No

  N/A

• Peds Board

  Yes

  No

  N/A

• Board Splints

  Yes

  No

  N/A

Driver side Rear

• Lucas w fully charged battery

  Yes

  No

  N/A

• SCBA w mask

• Harness #

• PSI

• SCBA w mask

• Harness #

• PSI

• SCBA tank w/mask

• Harness #

• PSI

Passenger side Rear

• Backboards w straps

  0

  1

  2

  >2

• Adult C collars

  O

  1

  2

  3

  >3

• Pediatric Ccollars

  O

  1

  2

  3

  >3

• Head bds

  O

  1

  2

  3

  >3

• Reeves stretcher

  Yes

  No

  N/A

• Stair Chair

  Yes

  No

  N/A

• Sager splint

  Yes

  No

  N/A

• KED board

  Yes

  No

  N/A

Interior

Drug Box cabinet

• Drug Box #

• Seal #

• Tag color

  Green

  Yellow

  Red

  None

• Mark one kit

  Yes

  No

  N/A

• Seal #

• IV solution 500ml

  O

  1

  2

  3

  >3

• IV solution 1000 ml

  O

  1

  2

  3

  >3

Airway cabinet (upper)

• King Vision blades

  Yes

  No

  N/A

• ET Tube holders

  Yes

  No

  N/A

• Manual Suction Canister

  Yes

  No

  N/A

• M95 masks

  Yes

  No

  N/A

• CPAP mask - Large x1

  Yes

  No

  N/A

• CPAP mask - small x1

  Yes

  No

  N/A

• Infant /Neonate BVM

  Yes

  No

  N/A

• 14 fr stylet

  Yes

  No

  N/A

• 10 fr stylet

  Yes

  No

  N/A

• 6 fr stylet

  Yes

  No

  N/A

• Suction tubing x2

  Yes

  No

  N/A

• Sterile water

  Yes

  No

  N/A

• Suction kit w chimney valve x2

  Yes

  No

  N/A

• Fluid shields

  Yes

  No

  N/A

• RES Q GARD x2

  Yes

  No

  N/A

• Adult D Fib pads x2

  Yes

  No

  N/A

• Pediatric D Fib pads x2

  Yes

  No

  N/A

• Pediatric pulse ox x2

  Yes

  No

  N/A

• EKG Electrodes x2 packs

  Yes

  No

  N/A

• Adult BVM

  Yes

  No

  N/A

• Pediatric BVM

  Yes

  No

  N/A

• Canister wipes

  Yes

  No

  N/A

• EZ IO needles & 3 way stoop cocks

  Yes

  No

  N/A

• Portable Razors x3

  Yes

  No

  N/A

• Quick Trac x2

  Yes

  No

  N/A

Cabinet below airway cabinet & Action area

• Monitor batteries x2 fully charged

  Yes

  No

  N/A

• LUCAS battery & Charger

  Yes

  No

  N/A

• Electric razor & charger

  Yes

  No

  N/A

• Cell phone & charger

  Yes

  No

  N/A

• Thermometer

  Yes

  No

  N/A

• Protocol book

  Yes

  No

  N/A

• EKG Rolls

  O

  1

  2

  3

  >3

• Stethoscope

  Yes

  No

  N/A

Cabinet above small bench seat

• Biohazard bags

  Yes

  No

  N/A

• Disposable vomit bags

  Yes

  No

  N/A

• Soft Restraints

  Yes

  No

  N/A

• Extra Blood Pressure Cuffs

  Yes

  No

  N/A

Cot & Monitor

• User check complete

  Pass

  Fail

  N/A

• Transmission check complete

  Pass

  Fail

  N/A

• Batteries x2 fully charged

  Yes

  No

  N/A

• EKG paper

  O

  1

  2

  3

  >3

• Adult DFib pads x2

  Yes

  No

  N/A

• Pediatric D fib pads x1

  Yes

  No

  N/A

• EKG electrodes x2 packs

  Yes

  No

  N/A

• Pulse ox

  Yes

  No

  N/A

• 3 lead cables

  Yes

  No

  N/A

• 12 lead cables V1, V2, V3, V4, V5, V6

  Yes

  No

  N/A

• BP Cuffs Large & XL

  Yes

  No

  N/A

Blue jump bag

Left compartment

• Adult BP Cuff Peds BP Cuff & Stethoscope

  Yes

  No

  N/A

Right compartment

• Disposable Vomit Bags

  Yes

  No

  N/A

• Trauma Shears

  Yes

  No

  N/A

Front compartment

• Glucometer, Lancets & Test Strips

  Yes

  No

  N/A

Top compartment

• Intubation kit

  Yes

  No

  N/A

• King Airways size 3,4,5

  Yes

  No

  N/A

• King Vision Scope

  Yes

  No

  N/A

• King Vision Blade

  Yes

  No

  N/A

• Yes

  No

  N/A

Inside Compartment

• EZ-IO Drill

  Yes

  No

  N/A

• Manual Suction

  Yes

  No

  N/A

• IV Kit with Supplies

  Yes

  No

  N/A

• Adult BVM

  Yes

  No

  N/A

• Saline Pressure Cuff

  Yes

  No

  N/A

• Sharps Container

  Yes

  No

  N/A

• Yellow and Orange pouches with miscellaneous supplies

  Yes

  No

  N/A

• Needle Decompression Kit

  Yes

  No

  N/A

Trauma cabinets

• NS flushes x4

  Yes

  No

  N/A

• IV Start kits x4

  Yes

  No

  N/A

• 10 gtts drip sets x4

  Yes

  No

  N/A

• 60 gtts drip sets x4

  Yes

  No

  N/A

• Extension sets x4

  Yes

  No

  N/A

• Tegaderms

  Yes

  No

  N/A

• Cold pack x4

  Yes

  No

  N/A

• Hot pack x4

  Yes

  No

  N/A

• Goggles x3

  Yes

  No

  N/A

• Sterile foil x2

  Yes

  No

  N/A

• 4:5 x 4:1 kling x3

  Yes

  No

  N/A

• 4x4

  Yes

  No

  N/A

• 2x2

  Yes

  No

  N/A

• Abdominal pads x3

  Yes

  No

  N/A

• SAM Splint x1

  Yes

  No

  N/A

• MAT Tourniquet x2

  Yes

  No

  N/A

• Quick clot bandages x5

  Yes

  No

  N/A

• Vaseline petroleum gauze x4

  Yes

  No

  N/A

• Black twist tourniquets x2

  Yes

  No

  N/A

• Triangle bandage x1

  Yes

  No

  N/A

• Trauma dressing x4

  Yes

  No

  N/A

• Box of bandaids

  Yes

  No

  N/A

IV boat

• Trauma Shears

  Yes

  No

  N/A

• IV start kits x2

  Yes

  No

  N/A

• Saline locks<br>

  Yes

  No

  N/A

• IV tourniquets

  Yes

  No

  N/A

• Tegaderms

  Yes

  No

  N/A

• NS flushes

  O

  1

  2

  3

  >3

• 16g (gray)

  O

  1

  2

  3

  >3

• 18g (green)

  O

  1

  2

  3

  >3

• 20g (pink)

  O

  1

  2

  3

  >3

• 22g (blue)

  O

  1

  2

  3

  >3

• 24g (yellow)

  O

  1

  2

  3

  >3

• Tape x2

  Yes

  No

  N/A

• Prep wipes

  Yes

  No

  N/A

Bottom of IV Tray

• Check for Supplies

• Yes

  No

  N/A

Long bench seat (underneath)

• Blankets x4

  Yes

  No

  N/A

• Emesis basin

  Yes

  No

  N/A

• OB/GYN kits x2

  Yes

  No

  N/A

• Infection control kit x1

  Yes

  No

  N/A

Cabinets under drug box cabinet

• Trauma Bag

  Yes

  No

  N/A

• Peds Bag

  Yes

  No

  N/A

• Burn kit

  Yes

  No

  N/A

• CPAP kit

  Yes

  No

  N/A

• Vacuum splints w pump

  Yes

  No

  N/A

• O2 tanks secured x3

  Yes

  No

  N/A

• Portable suction unit (batteries charged)

  Yes

  No

  N/A

• Portable Suction (Present and battery levels)

  Select O 1 2 3 >3

  • O
  • 1
  • 2
  • 3
  • >3

Small bench seat (underneath)

• Gloves (multiple sizes)

  Yes

  No

  N/A

Cabinets above long bench seat

• Towels & Linen

  Yes

  No

  N/A

• N/C

  O

  1

  2

  3

  >3

• NRB

  O

  1

  2

  3

  >3

• Nebulizers

  O

  1

  2

  3

  >3

• Capnography (nasal)

  O

  1

  2

  3

  >3

• Capnography (oral)

  O

  1

  2

  3

  >3

• RES Q POD

  O

  1

  2

  3

  >3

• Trash emptied

  Yes

  No

  N/A

• Sharps container safe

  Yes

  No

  N/A

Signatures

• Deficiencies found & noted

• The undersigned does hereby certify that the squad was duly checked and deficiencies were noted

  Sign

• The undersigned does hereby certify that the squad was duly checked and deficiencies were noted

  Sign

• The undersigned does hereby certify that the squad was duly checked and deficiencies were noted

  Sign

• 4th Man only

  Sign