YEMS Vehicle Checklist

Vehicle Checklist

• Unit #

• Conducted on

  Date

• Shift

  Night

  Day

  Swing

• Medic

  Medic 1

  Medic 2

  Medic 3

  Medic 4

Vehicle

• Unit #

  91-137

  91-159

  91-160

  91-161

  91-162

• Mileage of unit?

• Due for scheduled maintenance?

  No

  Yes

• Fuel Level

• Mirrors/Windshield Inspection

  Safe

  At Risk

  N/A

• Oil, transmission and wiper fluid?

  Safe

  At Risk

  N/A

• Noticeable damage to vehicle?

  No

  Yes

• Take a picture.

  Media

• Comms-Radio Check Front

• Comms-Radio Check Back

• Comms-Radio Check Portable

• Visual Tire Check and Air Pressure

• Exterior Lights and Emergency Flashers

• Backup Alarm

• Parking Brake engages high idle

• Unit Clean - inside and out

  Yes

  No

• Flares

• Fire Extinguisher

Cab

• iPad?

• Sufficient PCR's?

• PPE kit present in Driver and passenger door of unit?

• On car cellphone

• Charger

• GPS System

• 2 Fuel Cards?

• Key Ring?

• Map Book

• Helmets with visor

• Binoculars

Medical equipment

Outer Cabinet

• 2 Spineboards

• Scoop strecher

• Collar Kit

• KED

• Bag of clips

• Spider Straps

• Headblocks

Inside Cabinet

• Spider Straps

• Headblocks

Box

• Guidelines binder

• Inventory binder

• ZOLL check

• Day shift take picture of test strip

  Media

• Main Stretcher/Bracket

• Sharps full?

  No

  Yes

• New sharps container placed and full container disposed of properly?

  Yes

  No

• #9

• Stair Chair

• Tray stocked

• Adult BVM

• Paediatric BVM

• Neonatal BVM

• Cabinet/Overhead Lighting

• Manta Lift Sheet

• Extra Linen

• Onboard suction functioning?

  Yes

  No

• Portable suction functioning?

  Yes

  No

• PPE-Back shelf-min 5 small and regular masks and gowns

• BLS Jump Bag

• Jump Bag

• IV Kit

• Airway Kit

• Vital acquisition equipment

• BVM & Masks

• Sharps full?

  No

  Yes

• New sharps container placed and full container disposed of properly?

  Yes

  No

Under Bench

• Vacuum Splint Set, present and complete?

  Yes

  No

• Sager Splint

• Pedi-Pac

• Pedi-Mate

• Tool Kit, present and complete?

  Yes

  No

Medical Gas Levels

• M Tank

• Replace O2 Tank

• E Tank

• Replace O2 Tank

• D Tank

• Replace O2 Tank

• Entonox Tank

• Replace Entonox Tank

• Wednesday?

  No

  Yes

Full check

• Deep clean

• All medications within expiration dates?

  Yes

  No

• Glucometer test - Tray

• Glucometer test - Bag

Crew info

• Crew member #1

• Crew member #2

• Ground Supervisor

  Sign