Ambulance Equipment and Medication Inspection List In accordance to the REMSA requirements for Sioux Falls, South Dakota Date: Crew: Unit #: AIRWAY MANAGEMENT 2 10-12 Gauge IV Catherters for Chest Decompression 1 12fr Suction Catherter 1 3.0mm adapter for needle Cric 2 7.0 Endotracheal Tubes - 7.0 1 Adult Combi-Tube 2 Adult Disposable ETC02 detector or Electronic ETC02 detector 2 Adult Endotracheal Stylettes 2 Adult Face Mask with Tubing 2 Adult Nasal Cannulas with Tubing 2 Adult Sized Bag-Valve-Mask unit with reservoir Assorted Suction Catherters 8,10, 14 and French 2 Bougie 1 Child Sized Bag-Valve-Mask unit with reservoir with Infant and Noenate Masks 1 CPAP Mask - Large 1 CPAP Mask - Medium 1 Disposable Bulb Syringe 2 Disposable Hard Suction Tips 2 Endotracheal Holder - Adult 2 Endotracheal Holder - Pediatric 2 Endotracheal Tubes - 3.0 2 Endotracheal Tubes - 3.5 2 Endotracheal Tubes - 4.0 2 Endotracheal Tubes - 4.5 2 Endotracheal Tubes - 5.0 2 Endotracheal Tubes - 5.5 2 Endotracheal Tubes - 6.0 2 Endotracheal Tubes - 6.5 2 Endotracheal Tubes - 7.5 2 Endotracheal Tubes - 8.0 2 Endotracheal Tubes - 8.5 2 Endotracheal Tubes - 9.0 1 ETT Nebulizer Kit 1 Hand Held Nebulizer Kit 1 Handheld Suction Unit 1 Infant Face Mask with Tubing 1 Installed Oxygen Supply 1 Laryngoscope Handle w/extra batteries 1 Macintosh Blade - size 3 1 Macintosh Blade - size 4 1 McGill Forceps - Adult 1 McGill Forceps - Pediatric 1 Meconium Aspirator 1 Miller Blade - size 0 1 Miller Blade - size 1 1 Miller Blade - size 2 1 Miller Blade - size 3 1 Nasal Speculum 2 Nasopharyngeal Airway - 6.0 2 Nasopharyngeal Airway - 7.0 2 Nasopharyngeal Airway - 8.0 1 Nebulizer - Bear
2 Nebulizer Kit - Mask 1 Oropharyngeal Airway - 40mm 1 Oropharyngeal Airway - 60mm 1 Oropharyngeal Airway - 80mm 1 Oropharyngeal Airway - 90mm 1 Oropharyngeal Airway - 100mm 1 Oropharyngeal Airway - 110mm 2 Oxygen Connecting Tubes 1 Oxygen Humidifier 1 Oxygen Saturation Monitor with Probe 1 Pediatric Disposable ETC02 detector or Electronic ETC02 detector 1 Pediatric Endotracheal Stylettes 2 Pediatric Face Masks with Tubing 2 Pediatric Nasal Cannulas with Tubing 1 Pediatric Sized Saturation Monitor Probe 1 Permanently installed suction device capable of a minimum vacuum pressure of 300mm Hg with collection capacble of one liter 2 Portable Oxygen Tanks, Minimum Size "D" 1 Portable Regulator 0-15 LPM 1 Portable Suction Device 1 Replacement Laryngoscope Blub 4 Saline Vials for Nebulizer Treatments 1 SALT Airway 3 Suction Canisters 2 Suction Connecting Tubes 1 Tube Lubricating Jelly 2 Wall Regulators 0-15 LPM BURN MANAGEMENT 4 Ice Packs 6 Liters Sterile Saline Irrigating Solution 4 Sterile Gloves - pair 4 Sheets - Sterile COMMUNICATIONS 1 Portable and Mobile UHF radio compatible with frequency assigned for Minnehaha County Ambulance channel 1 Two-Way voice communications with local hospitals via the South Dakota EMS system CORONARY MANAGEMENT 4 4 Pack - Electrodes 6 6 Pack - Electrodes 2 Defibrillation Patches - Adult 1 Defibrillation Patches - Pediatric 2 ECG Paper - Roll 1 Electrodes Pack - Pediatric 1 Monitor-Defibrillator with external pacing and 12 lead ECG capability or equivalent 1 Patient Cables - Set EMERGENCY CHILDBIRTH 1 Disposable Sterile OD Kit with mylar blanket or equivalent 1 APGAR Chart STRETCHERS / IMMOBILIZATION OF FRACTURES 5 Adjustable Adult Cervical Collars 3 Adjustable Pediatric Cervical Collars 1 Folding Stretcher (or equivalent) 2 Head Blocks - Set
MEDICATIONS 1 KED 1 Long Backboard 1 Pediatric Immobilization Device 1 Pneumatic Splints - Set (or equivalent) 1 Primary Stretcher (Ferno-Washington or equivalent) 2 SAM Splint 1 Scoop Stretcher 1 Traction Splint (Sager or equivalent) Note: Sharps must be needles to comply with OSHA requirements 1 Activated Charcoal 50g 1 Adenosine 30mg (Adenocard) 3 Amiodarone 150mg (Cordarone) 2 Ativan 4mg (Lorazepam) 4 Atropine 8mg - Multi-Dose Vial 1 Baby Aspirin - Bottle 1 Benadryl 50mg (Diphenhydramine) 2 Calcium Chloride 1g 1 Cardizem 25mg (Diltiazem) 2 Dextrose 50% 25g (D50W) 8 Epinephrine 1:10,000 1mg (Adrenalin) 2 Epinephrine 1:1000 1mg (Adrenalin) 1 Epinephrine 1:1000 30ml (Adrenalin) 1 Glucagon 1mg (GlucaGen) 1 Intropin 400mg (Dopamine) 2 Lasix 100mg (Furosemide) 1 Lidocaine 1% Vial 10mg 1 Lidocaine 100mg 1 Lidocaine Premix Drip 4:1 1 Magnesium Sulfate 5g 6 Mark 1 Auto-Injector Kits (with Atropine and 2-Pam) 2 Morphine Sulfate 10mg 1 Narcan 2mg (Naloxone) 1 Neosynephrine Spray (or equivelant) 1 Nitrostat SL 0.4mg (spray or tablets) 1 Normal Saline 30ml 1 Ondansetron 4mg 1 Opthalmic Anesthetic 1 Oral Anesthetic Spray 2 Procainamide 1g 2 Proventil 3ml 3 Sodium Bicarbonate 50mEq 1 Solu-Medrol 120mg (Methylpredisolone) 2 Succinylcholine 200mg 1 Thiamine 100mg 2 Valium 10mg (Diazepam) 0 Versed 10mg (Midazolam) 1 Xylocaine Jelly (Lidocaine) VENIPUCTURE / FLUID ADMINISTRATION 5 IM Needles 1 Alcohol Wipes - Box 2 Atomization Device 1 Betadine Wipes - Box 6 Blunt Cannula 1 Brolow Resuscitation Tape 2 D5W 250cc 1 Implanted Port Needle - 19 gauge 90 degree angle huber needle with attached 6 inch extention tubing
3 Infusion Tubing - Full Set 4 Infusion Tubing - Half Set 2 IO Needles - 15 gauge 2 IO Needles - 18 gauge 6 IV Catheters - 14 gauge 6 IV Catheters - 16 gauge 6 IV Catheters - 18 gauge 6 IV Catheters - 20 gauge 6 IV Catheters - 22 gauge 6 IV Catheters - 24 gauge 6 Lock Cannula 5 Medication Labels 3 Microdrip Administration Sets 8 Normal Saline 1000ml 6 Regular Administration Sets 8 Saline Lock Adapters 8 Saline Tubex Vials 2 ml 5 SQ Needles 12 Sterile 2X2 Gauze 3 Sterile Water - Liters 10 Syringes - 10cc 5 Syringes - 1cc 5 Syringes - 3cc 2 Syringes - Tubex or equivalent 5 Tegaderm 2 Tourniquets 5 Veniguard 6 Vial Access Cannula WOUND DRESSINGS 2 2 inch Cloth Tape - Rolls 4 3 inch Elastic Wrap Bandage - Rolls 12 4X4 Sterile Gauze 1 Band-Aids 1x3 - Box 2 Co-Ban Roll 2 Hot Packs 4 Petrolatum Gauze 10 Sterile Kerlex Dressing or equivalent 10 Sterile Surgpad Dressing or equivalent 2 Transpore Tape Roll 2 Trauma Pads 2 Triangular Bandage MISCELLANEOUS EQUIPMENT 2 Adult Cuffs with Aneroid BP Manometers 2 Adult Stethoscopes 2 Bed Pan 3 Blankets 1 Blood Glucose Monitor 2 Body Bags 1 Box Tissues 2 Canisters for Air-Purifying Respirators 1 Child Cuff with Aneroid BP Manometer 10 Chucks or equivalent 1 County Accountability Kit 1 Crow Bar 1 Disinfectant Kit to meet OSHA Standards 6 Disposable Masks, Molded or equivalent 2 Emesis Bags or equivalent 1 Fire Extinguisher 5lb
1 Flashlight 1 Heavy-Duty Disaster Body Bag 1 Infant Cuff with Aneroid BP Manometer 2 Leather Gloves Pair 1 Moisture-Proof Waste Container - Non -Metal 1 Moisture-Proof Waste Container - Non-Metal for contaminated waste 6 Mylar Blankets 4 N-9S Disposable Masks 1 Non-Sterile Gloves Large - Box 1 Non-Sterile Gloves Medium - Box 1 Non-Sterile Gloves Small - Box 1 Non-Sterile Gloves X-Large - Box 1 Non-Sterile Gloves X-Small - Box 1 Pediatric Stethoscope 1 Personal Protective Air-Purifying Respirators - Large 2 Personal Protective Air-Purifying Respirators - Medium 1 Personal Protective Equipment Kit to meet OSHA Standards 4 Pillow Cases 2 Pillows 4 Restraints 1 Ring Cutter 1 Scissors 1 Sharps Container 6 Sheets for Stretcher - Set 1 Street Guide 1 Stuffed Toy Animal 1 Thermometer - Digital 1 Thermometer - Glass - Rectal capable of reading down to 86 degress 2 Towels 2 Urinal 1 XL Adult Cuff with Aneroid BP Manometer