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DAILY CHECKLIST- STATION 96

DATE:_______ UNIT#:_______________

CREW:___________________/______________________/_____________________ VEHICLE CAB LIGHTS - SIREN FLUID LEVELS OIL/TRANS/ANTIFREEZE FUEL >1/2 TANK BINOCULARS, FLASHLIGHT GLOVES SM/MED/LG 1 BX EA. SAFETY VESTS 1 REG. / 2 XL PATIENT COMPARTMENTS MAIN O2- >500 PSI AIRWAY BAG O2- >500 PSI STRETCHER O2- >500 PSI SPARE O2 CYLINDERS- 2 MAIN IV BAG LIFE PACK12/CHECK BATTERIES/CHARGER/SPARE ET KIT CHECK HANDLE/BLADES LOCK NUMBERS PEDIATRIC TRAUMA DRUG BOX DRUG BOX JUMP BAG DRUG BOX MAP BOOKS (4) CLIPBOARD PT INFO/BILLING/REFUSALS INFECTION CONTROL PLAN EMER. RESPONSE GUIDE STATION DOOR OPENER, FUEL CARD KNOX BOX KEY

PORTABLE SUCTION- BATTERY CHECK STAIR CHAIR/ KED PED. IMMOBILIZER/ SPLINT KIT HARE TRACTION ADULT/PED

TURNOUT GEAR/JUMPER CABLE

COLLAR/HEAD BLOCK/STRAP 3 SETS 3-BACKBOARD-HEAD CRADLE/SCOOP LOCK# LOCK # LOCK # LOCK # EXP. DATE

EXP. DATE EXP. DATE

COMMENTS: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

TALBOT EMS DOCS/DAILY CHECKLIST 96: REVISED 01/17/2006

DAILY CHECKLIST- STATION 96

DAILY DUTIES DUTY COMPLETE DAILY CHECKLIST WASH AMBULANCE AS NEEDED CLEAN OFFICE AS NEEDED REVIEW PASS DOWN AND SIGN EMPTY ALL TRASH IN OFFICE - BAY CLEAN FEMALE BUNK/BATHROOM AS NEEDED CLEAN MALE BUNK AS NEEDED MONDAY INVENTORY INTERIOR COMPARTMENTS DISINFECT AMBULANCE INTERIOR TUESDAY INVENTORY PEDIATRIC BAG/RESEAL CHECK TIRE PSI 70 FRONT 80 REAR LF WEDNESDAY INVENTORY TRAUMA BAG/RESEAL CLEAN AMBULANCE BAY THURSDAY INVENTORY MAIN IV BAG CHECK PORTABLE SUCTION/ROTATE BATTERY FRIDAY INVENTORY LIFE PAK12 ROTATE BATTERIES SATURDAY INVENTORY O2 BAG CHECK TIRE PSI 70 FRONT COMMENTS

RF

LRO

LRI

RRO

RRI

80 REAR

LF

RF

LRO

LRI

RRO

RRI

SUNDAY GLUCOMETER CHECK READING CLEAN AMBULANCE BAY

TALBOT EMS DOCS/DAILY CHECKLIST 96: REVISED 01/17/2006

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