AID/MEDIC EQUIPMENT CHECK FORM
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AID/MEDIC UNIT EQUIPMENT CHECKLIST
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Date:
Shift:
Unit Number:
Odometer:
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<<<< BEGINNING OF SHIFT RIG CHECK-OFF >>>>
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Firefighters Name:
Firefighters Name:
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DAILY
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Fuel, Oil, Transmission & Coolent (full levels, Fuel at 3/4+)
Medical Kit (thermometer, glucometer kit, finger SAO2, standard pulseOx, b/p cuffs)
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Headlights, Emergency Lights & Siren
Count and Sign for ALS drugs in safe
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Fuel Card/ Emergency Room Card/ Hand sanitizer
Airway Kit (full, Epi case, Narcan case, portable suction)
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Tire Pressure & Tread wear (**Thump test only**)
Action area/desk (larger suction device, 2nd glucometer kit, forms)
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Portable radios (Charged and set for Fire 5, min. two(2))
Heart monitor (batteries, cables, ENT Nasal & Oral, electrodes, razor, paper)
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Unit clean (exterior) and deconned (interior and cab)
Lifepack 500, or spare heart monitor (visual battery check, child & adult pads, other accessories)
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Fire extinguishers (one in cab, one in outside compartment)
On board "system" O2 supply tank (PSI:_____________; replace if below 500 psi)
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Flares (10 - 12 flares in red flare case), tool box, stop sign
Two(2) Portable O2 with regulators (PSI:_________, PSI:_________ replace if below 500 psi)
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Tool box and Stop/Slow handheld sign
SPARE portable O2 bottles(min. 2 full bottles)
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Forcible entry tools(axe & haligan), and Shark cribbing
Vehicle supplies (all compartments, shelves, drawers stocked)
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Safety vest (min three(3) on board), forcible entry tools
Vacuum Splints (one(1) full-body, straps and pump), (one(1)small, one(1)medium, one(1)large, pump)
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Absorbent Pads (10 ea. Grey & 10 ea. White)
SPARE full-size vacuum splint in Station Medical closet/storage
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Hurst Tools and Batteries (check all battery charges)
Exam gloves in cab & box (sm, med, large, extra large)
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Flashlights (min. two(2), both working)
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ADDITIONALLY ON FRIDAYS
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Charge portable airway unit from airway kit
Tire Pressure & Tread wear (Check with guage) psi: ___, ___, ___, ___, ___ ,___
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Run air conditioning in box for min. of five(5) minutes
Inspect and Exercise ON SPOT chains (exercise=lowering and raising in PARK)
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Check odometer: (next oil change:________________)
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EQUIPMENT STOCK TOTALS
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2- KTD's
1 - Scoop board "clam" "combi"
3- Adjustable C-collars2 - Doty belts
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1- KED1 - Stair chair2
- Head roll sets ((1) adj. C collar,(2) rolls)
1 - Bench blood pressure cuff
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1- Backboard1 - Rescue seat6- Head beds1 - Bench stethoscope
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1- Spider straps6- Quick straps (yellow plastic straps)1 - Shears and penlight
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- Pelvic Splints (stnd, sm, large)
1- MegaMover1 - Hospital bariatric sling
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EQUIPMENT STATUS
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LS- Left at scene
MI - Missing (unknown location)
RU- Removed to another unitAU - Added to unit
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LH- Left at hospital
MP - Missing from previous shift
RR- Removed for repairOT - Other
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INCIDENT NUMBER:CODE:
LIST EQUIPMENT
EMPLOYEE NUMBER:
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last revised: 04/22/2017
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