Lanoka Harbor EMS
Rig & Building Check
Date & Time
*
-
Month
-
Day
Year
Date Picker Icon
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Rig#
*
Duty Rig Mileage
*
Crew Chief
*
Duty Crew
*
Fuel Level
*
Please Select
FULL
3/4
1/2
1/4
LESS THAN 1/4
Main Oxygen PSI (Change at 500)
*
Green Bag Oxygen PSI (Change at 1000)
*
Registration & Insurance
*
Yes
No
Clipboard & Paperwork
*
Yes
No
Toughbook Operational
*
Yes
No
Street Index
*
Yes
No
Radios Operational
*
Yes
No
GPS Unit
*
Yes
No
Interior Clean
*
Yes
No
Exterior Clean
*
Yes
No
Reeves
*
Yes
No
Life Jackets
*
Yes
No
Fire Extinguisher
*
Yes
No
Wheel Chocks
*
Yes
No
Turn Out Gear ( 2 sets)
*
Yes
No
Tool Box
*
Yes
No
Biohazard / Cleaning Kit
*
Yes
No
Throw Rope
*
Yes
No
Jumper Cables
*
Yes
No
Bolt Cutters
*
Yes
No
Stair Chair
*
Yes
No
Frac-Pac
*
Yes
No
KED
*
Yes
No
Traction Splint
*
Yes
No
Spare Green Bag
*
Yes
No
Pulse Ox
*
Yes
No
Pediatric Bag
*
Yes
No
Trauma Bag
*
Yes
No
Cooler
*
Yes
No
Longboard with Straps
*
Yes
No
Headblocks (Minimum 3 sets)
*
Yes
No
Spider Straps
*
Yes
No
Collar Bag
*
Yes
No
Band Aids
*
Yes
No
4X4's
*
Yes
No
8x10's
*
Yes
No
Scoop Stretcher
*
Yes
No
5x9's
*
Yes
No
Roller Gauze
*
Yes
No
Ice Packs
*
Yes
No
Heat Packs
*
Yes
No
Glucose (Check "No" if expired)
*
Yes
No
Medical Tape
*
Yes
No
Large Trauma Dressings
*
Yes
No
Cravats
*
Yes
No
Adult EpiPen (Check "No" if expired)
*
Yes
No
Child EpiPen (Check "No" if expired)
*
Yes
No
AED (Check "No" if Pads are expired)
*
Yes
No
NRB Masks
*
Yes
No
Nasal Cannulas
*
Yes
No
OPA Airways
*
Yes
No
NPA Airways
*
Yes
No
NPA Airway Lubricant
*
Yes
No
Adult BVM
*
Yes
No
Child BVM
*
Yes
No
Pediatric BVM
*
Yes
No
Blood Pressure Cuff
*
Yes
No
Stethoscope
*
Yes
No
Suction Tubing
*
Yes
No
Hard Tip Suction Catheter
*
Yes
No
Soft Tip Suction Catheter
*
Yes
No
Basins
*
Yes
No
Sterile Water / Saline
*
Yes
No
Suction Unit
*
Yes
No
Yellow Tarps
*
Yes
No
Suction Canisters
*
Yes
No
Small Gloves
*
Yes
No
Medium Gloves
*
Yes
No
Large Gloves
*
Yes
No
Xtra-Large Gloves
*
Yes
No
Pediatric Seat
*
Yes
No
Reflective Vests
*
Yes
No
Burn Dressings
*
Yes
No
Personal Protective Equipment Kit
*
Yes
No
Obstetrical Kit
*
Yes
No
Triage Tags
*
Yes
No
N95 Masks
*
Yes
No
Board Splints
*
Yes
No
Spare Oxygen Bottles
*
Yes
No
Flashlight Charging
*
Yes
No
Stretcher Battery Charged
*
Yes
No
Couches
*
Clean
Dirty
Floor
*
Clean
Dirty
Folding Tables
*
Clean
Dirty
Counters
*
Clean
Dirty
Dishes
*
Clean
Dirty
Bathrooms
*
Clean
Dirty
Garbage
*
Full
Ok
Needs Garbage Bag
Paper Towels
*
Full
Ok
Needs Replenishing
Toilet Paper
*
Full
Ok
Needs Replenishing
Other Comments and / or Concerns
Submit
Should be Empty: