Salt Lake City Fire Department ALS Daily Checklist - Online 324 Completed Checklists

Rig*
Paramedic Name*
Captain's E-mail*
Wednesday? (Expiration Checks)*

YesNo
*Please verify all highlighted items below*
Zoll Monitor Quantities*

OKUnacceptable
Zoll Batteries (2+)*

OKUnacceptable
Defib Test*

OKUnacceptable
Click Here for instructions on how to conduct a Defib test (use steps 1 thru 11)
Click Here for instructions on using an ALS monitor as an AED
Med Box (Orange) Quantities*

OKUnacceptable
3 Naloxone Kits*

OKUnacceptable
The daily narcotic report check has been completed:

YesNo
The weekly narcotic report check has been completed

YesNo
Click Here to open the Narcotic Tracking System
*If on Squad 6, Narcotics will remain in the safe and do not need to be checked.*
Airway Box (Yellow) Quantities*

OKUnacceptable
Pediatric Airway Quantities*

OKUnacceptable
Stethoscope*

OKUnacceptable
O2 Bag Quantities*

OKUnacceptable
O2 Bottle psi*
Suction Unit*

OKUnacceptable
Trauma Box Quantities*

OKUnacceptable
C-collar Bag Quantities*

OKUnacceptable
Vacuum Splint Bag Quantities*

OKUnacceptable
Other Durable Equipment Quantities*

OKUnacceptable
*Squads do not carry: backboard, pediatric board, backraft, backraft pump, or spider straps.*
Triage Bag Quantities*

OKUnacceptable
PPE Quantities*

OKUnacceptable
Expiration Checks (Wednesday Only)

NOTE: Medications expire on the *last* day of the month. For example a drug with an expiration date of 10/2017 expires on October 31, 2017.

Note: Use medications that are going to expire first and exchange medications that are 30 days from expiration.
Acetaminophen or Ibuprofen

MonthDayYear
Date
Adenosine

MonthDayYear
Date
Albuterol Bullet

MonthDayYear
Date
Albuterol Multi-Dose Vial

MonthDayYear
Date
Amiodarone

MonthDayYear
Date
Atropine Sulfate

MonthDayYear
Date
Aspirin Bottle

MonthDayYear
Date
Defibrillation Patch (Adult)

MonthDayYear
Date
Defibrillation Patch (Pediatric)

MonthDayYear
Date
Dextrose 10%

MonthDayYear
Date
Diphenhydramine

MonthDayYear
Date
DuoNeb

MonthDayYear
Date
Endotracheal Tubes (all sizes)

MonthDayYear
Date
Epinephrine 1:10,000

MonthDayYear
Date
Epinephrine 1:1,000

MonthDayYear
Date
Glucagon

MonthDayYear
Date
Lidocaine 2%

MonthDayYear
Date
Naloxone

MonthDayYear
Date
Naloxone Kits

MonthDayYear
Date
Nitroglycerin Tablets

MonthDayYear
Date
Normal Saline 1000cc

MonthDayYear
Date
Normal Saline 100cc

MonthDayYear
Date
Sodium Bicarb 8.4%

MonthDayYear
Date
Sodium Bicarb 4.2% (Qty. 1)

MonthDayYear
Date
Oral Glucose

MonthDayYear
Date
TXA (Tranexamic Acid)

MonthDayYear
Date
Zofran Tablets

MonthDayYear
Date
Zofran Vial

MonthDayYear
Date
Supplies needed? Click here for the MEDICAL SUPPLIES ORDER FORM.
Should be Empty:

*Please verify all highlighted items below*

Please verify all highlighted items below