Vehicle & Safety N/A DEF PASS Vehicle is clean & dust/debris/opim free Vehicle is free of hazards 40 Ch. UHF medical radio Vehicle Doors open & close securely Cabinet Doors open & close securely Emergency warning lights and siren functions properly Environmental conditioning (AC/Heat) Headlights, brake lights, etc. function Tire condition (tread depth & side walls) DC to AC inverter (ALS only) Fire extinguisher properly tagged and secured (3) DOT approved road triangles (2) "No Smoking" signs (front & rear) Stretcher N/A DEF PASS Ambulance stretcher with secure mounting bracket 4-point over-the-shoulder stretcher harness with 2 additional cross straps (1) ea. IV pole litter mounted (ALS only) Weight Appropriate Child Restraint Device w 2 tethering points (required for pediatric transports) General N/A DEF PASS (1) 2008 Maryland Protocols (1) Drug reference book (no older than 2 yrs) (ALS only) (2) Hand lights ("C" cell or larger) (1) Box tissue or (1) Roll toilet paper (1) Bed pan (1) Urinal (2) Emesis containers (1) O.B. kit (6) Sanitary napkins Linens N/A DEF PASS (2) Pillows; (2) Pillow cases; (2) Blankets; and (4) Sheets (cloth or disposable) Personal Protective Equipment N/A DEF PASS (4) Biohazard bags (3) Boxes of gloves Sm, Med, Lrg or uni-size (2) Non-absorbent gowns per crew member (1) Pair safety goggles per crew member (2) Particulate respirators per crew member (1) Sharps container, properly secured (2) Surgical face mask per crew member (1) Tuberculocidal disinfectant (1) Waterless hand cleaner or Towlettes Medications (BLS Only) Activated Charcoal (w/o Sorbitol) - 100 gm (1) ea. ADULT & PED. Epi-autoinjector (2) Glucose paste
Trauma Equipment N/A DEF PASS (2) Burn sheets (ADULT size) (4) Cold packs (12) Cravats (1) Pair bandage scissors (10) Bandage strips (1) Penlight (3) Rolls 1" hypoallergenic tape and (3) Rolls 2" hypoallergenic tape (12) Rolls 4" gauze bandage (24) Sterile gauze pads (2x2 or >) (1) Sterile occlusive dressing (18X25 or >) (5) Sterile trauma dressings (5x9 or >) (2) Tongue depressors Immobilization Devices N/A DEF PASS (1) Stair chair (1) Full spinal immobilization board (1) Half spinal immobilization board (1) Pediatric immobilization device (optional) (1) Orthopedic stretcher (1) CPR board or equivalent (1) Adult Hare Traction Splint (optional) (1) Pediatric Hare Traction Splint (optional) (3) 9ft straps (1) Set head blocks (2) Plasticized board splints - 54 36 15 (2) Adjustable rigid c-collars OR (1) ea. Extra Sm, Sm, Med rigid c-collars A.E.D. (BLS only) N/A DEF PASS (1) Automated External Defibrillator (2) Sets compatible Adult AED pads and (1) Set compatible Pediatric AED pads Medical Supplies in Portable Kit N/A DEF PASS (12) Sterile gauze pads (2x2 or >) (4) Sterile trauma dressings (5x9 or >) (6) Rolls 4" gauze bandage (2) Rolls 2" hypoallergenic tape (8) Cravats (1) Set of oropharyngeal airways (6 or more; newborn to large adult) (1) Adult Stethoscope (1) Pediatric Stethoscope (optional) (1) Adult and (1) Pediatric BP cuff (assembled) (1) Infant BP cuff (assembled) (required for infant transports) (1) Pair all purpose utility scissors (1) Penlight (6) Pair exam gloves (app. sizes) (6) Md. triage tags and ribbons (R, Y, G, B) and (1) Permanent Marker
Oxygen Delivery Devices and Suction Equipment N/A DEF PASS (4) ADULT non-rebreather masks and (6) ADULT nasal cannulas (2) ADULT venturi masks and (2) PEDIATRIC non-rebreather masks and (2) PEDIATRIC nasal cannulas (2) Oxygen connecting tubing (1) Adult BVM with (1) ADULT face mask and (1) small ADULT face mask (1) Pediatric BVM with (1) Infant ; (1) Child; and (1) Neonatal face mask (1) Infant BVM (optional) (1) Pocket mask with one way valve (1) Set oropharyngeal airways (6 or more; newborn to large adult) ALS only (2) Nebulizers (1) Set of Nasopharyngeal airways (18f 36f, set of 6 sizes ) (1) Meconium aspirator (1) Heimlich Valve w/ connecting tubing (1) Adult CPAP device (may be disposable) Onboard Suction N/A DEF PASS * Assembled & ready for use * Reliable power source * Adjustable suction force (1) Wide bore tubing and (1) Rigid (yankauer) pharyngeal tip (1) Suction catheter 6, 8, 10 and (1) Suction Catheter 14, 16, or 18 F 300mm Hg within 4 seconds: Free air flow >= 20 LPM: Portable Suction N/A DEF PASS Battery Powered Suction *Assembled & ready for use (1) Wide bore tubing and (1) Rigid (yankauer) pharyngeal tip (1) Suction catheter 6, 8, 10 and (1) Suction Catheter 14, 16, or 18 F (1) 250cc Sterile water or saline 300 mmhg within 4 seconds: Free air flow equal to >= 20 LPM: Res-Q-Vac TM (BLS only) (1) Pump (1) Pediatric; (1) Adult soft-tip and (1) ADULT rigid-tip canister Oxygen Systems N/A DEF PASS Onboard: A minimum of (2) High flow wall outlets and (1) Flowmeter Main Tank pressure PSI Main O 2 Line pressure PSI Portable: (1) E or Jumbo D cylinder or (2) D cylinders Cylinders IN Pt. compartment secured in bracket that meets Ambulance Manufacturers Division Oxygen Tank Retention Standard 003 (www.ntea.com) Cylinders NOT in Pt. compartment are secured in: 1) bracket appropriate for O2 cylinders; 2) cabinet doors have a positive locking latch; 3) both latch and hinges are bolted to the door frame structure.
Cardiac Monitoring Equipment N/A DEF PASS Capable of: 12-Lead, printing, Sync. Cardioversion, and Transcutaneous Pacing (2) Sets of monitoring leads/cables and (9) individual electrode pads (2) Sets ADULT pacing pads and (1) Set PEDIATRIC pacing pads (1) Spare monitor battery and (1) Spare EKG paper roll (1) Pulse Oximeter with (2) compatible PEDIATRIC probes and (1) NEONATE probe Required when NIBP is needed. (1) each set of compatible Adult, Infant, and Pediatric cuffs for NIBP Medications N/A DEF PASS Double lock controlled access (5) Adenosine - 6 mg each (2) Albuterol (Proventil) - 2.5 mg each *vehicle doors may not be included in equation (2) Activated Charcoal (w/o Sorbitol) - 50 gm [or (4) 25 gm] (1) Aspirin - 325 mg (3) Atropine Sulfate - 1 mg each (1) Atrovent (Ipratropium) - 500 ug (1) 20% Benzocaine Topical Anesthetic Spray (1) Calcium Chloride 2 g (1) Captopril 25 mg (1) Dextrose 50% - 25 g (1) Diazepam (Valium) - 10 mg (1) Diltiazem (Cardizem) - 50 mg (2) Diphenhydramine (Benadryl) -25 mg (1) Dopamine - 400 mg (4) Epinephrine 1:10,000-1 mg each (3) Epinephrine 1:1,000-1 mg (2) Furosemide (Lasix) - 40 mg (1) Glucagon - 1 mg (2) Haloperidol 5 mg (3) Lidocaine 2% - 100 mg each (1) Lidocaine Jelly 2% - 4 oz or greater (1) Morphine Sulfate - 10 mg OR (5) 2 mg (2) Naloxone (Narcan) - 2 mg (1) Nitroglycerin paste 1 gm or greater (tube or packet) (1) Nitroglycerin Spray OR (11) Nitroglycerin Tablets.4 mg (2) Saline Bullets (for Inhalation Use ) 3 ml each (1) Sodium Bicarbonate 50 meq (1) Terbutaline - 1 mg
Intravenous & Parenteral Equipment N/A DEF PASS Adequate Site Preparation Supplies (2) Macro Administration Sets and (1) Micro (60 gtts/ml) Administration Set (2) 16, 18, 20, 22, 24 gauge IV catheters (1) Intraosseous needle and stopcock with extension set (4) 18, 19 or 20 gauge straight needles (4) 1cc syringes (4) 25 gauge 1.5 needles (for IM injection) (4) 10cc syringes (1) Intranasal atomizer (2) Ringers Lactate 1000 ml or (4 x 500 ml) (1) Glucometer (with required supplies) (2) ea. Red tubes & Purple tubes w/ anticoag. and (2) Vacutainer barrels Intubation & Airway Equipment N/A DEF PASS **Equipment & supplies are clean, undamaged, and not expired. (1) Kit of adequate size to hold intubation equip. (1) each Adult and Pediatric laryngoscope handles Spare Batteries for Adult and Pediatric handles (5) Miller Blades Sizes 0,1, 2, 3, & 4 (4) McIntosh Blades Sizes 1, 2, 3, & 4 (2) Spare bulbs to fit both Miller & Mac blades (1) each ET tubes Uncuffed (sizes 2.5, 3, 3.5, 4, 4.5, 5, 5.5) (1) each ET tubes Cuffed (sizes 6, 7, 8, 9) (1) each Adult and Pediatric Magill Forceps (1) each Adult and Pediatric Stylet (4) Surgical lubricant - 3gm or (1) 4oz tube (1) 10cc syringe (2) 50 cc Bevel-tip Syringe (1) ea. Nasogastric tubes (8f, 10f, 12f, & 14f) (1) each Adult and Pediatric ETCO detector OR ET Capnography Optional Equipment (ALS only) N/A DEF PASS Combitube Lrg & Sm Capnography equipment IV Infusion pump Transport ventilator & necessary supplies (1) Mark 1 kit per crewmember ADDITIONAL INSPECTION COMMENTS