Medical Check-Off
First Name
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Last Name
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Roster Number
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Date
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Apparatus
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Select an option:
Squad 80
EMT POV
Engine 84
LMTV
Tanker
Chief POV
Medical Supplies
Set of Protocols (1)
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Oral Airways 40, 60, 80, 90, 100 mm
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Portable Suction with Yankauer Tips (1)
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BVM (Bag Ventilation Mask) Adult (1)
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BVM (Bag Ventilation Mask) Child (1)
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BVM (Bag Ventilation Mask) Infant (1)
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Adult Nasal Canulas (4)
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Adult Non-Rebreather Oxygen Mask (4)
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Pediatric Nasal Cannula (2)
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Pediatric Non-Rebreather Oxygen Mask (2)
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Nebulizers (4)
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Portable Oxygen Cylinders (2)
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Portable Oxygen Cylinder Regulator (1)
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Multi-trauma Dressings (4)
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4X4 Sterile Gauze Pads (40)
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Occlusive Flap Dressings or Vaseline Gauze (2)
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1-inch Adhesive Medical Tape (2)
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2-inch Adhesive Medical Tape (2)
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3-inch Adhesive Medical Tape (2)
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Triangular Bandages (6)
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Sealed Sterile Burn Sheets (3)
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Kerlix or Kling Roller Bandages (3)
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Adult Extrication Cervical Collar (4)
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Child Extrication Cervical Collar (4)
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Infant Extrication Cervical Collar (4)
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Backboards with straps (3)
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Extremity Splint Set (small, medium, large) (2)
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Stethoscopes (1)
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Adult BP Cuff (1)
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Child BP Cuff (1)
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Infant BP Cuff (1)
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Sealed Sterile OB Packs (1)
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AED with Defib Pads (Adult and Pediatric) (1)
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Penlight (1)
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Glucometer and 10 strips (1)
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Blood Lancets (10)
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Bite Stick (1)
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Ice Packs (2)
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Heat Packs (2)
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Blanket (1)
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Nasal Airways 22, 24, 26, 28, 30, 32, 34
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H.I.D (4)
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Adult/Child Combo Traction Splint (1)
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Bottles of Sterile Water for Irrigation (3)
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Bottles of Drinking Water (4)
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Broselow Pediatric Tape (1)
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Mounted Fire Extinguisher (1)
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No Smoking Signs (2)
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Pelvic Binder (1)
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Small Box Protective Gloves (2)
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Medium Box Protective Gloves (2)
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Large Box Protective Gloves (2)
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X-Large Box Protective Gloves (2)
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Protective Isolation Kits (2)
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Medical Respiratory Masks- N95 (2)
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Sharps Container (1)
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Bio-hazard bags (6)
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Emergency Response Guide (1)
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Battery Operated Flashlight (1)
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Goggles (2)
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Triage Tags (25)
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Baby Aspirin 81mg/tab (8)
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Tylenol Children's Oral Suspension 160mg/5ml (1 bottle)
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Oral Glucose (1)
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Pulse Oximeter (1)
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Extra Set of Batteries for Every Portable Electrical Device (1)
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Thermometer (1)
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Tourniquet (1)
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Alcohol Prep Pads (10)
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Emesis Bags (3)
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Current Insurance and Registration
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Current State License
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Trauma Shears
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Band-Aids (25)
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Chest Seal (2)
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Warning Cones or Triangles (3)
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Emergency Vests (3)
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