Salt Lake City Fire Department BLS Daily Checklist - Online 325 Completed Checklists

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

YesNo
BLS Box Quantity*

OKUnacceptable
Stethoscope*

OKUnacceptable
3 Naloxone Kits *

OKUnacceptable
Trauma Box Quantity*

OKUnacceptable
O2 Bag Quantity*

OKUnacceptable
Pediatric Bag Quantity*

OKUnacceptable
O2 Bottle psi*
Suction Unit*

OKUnacceptable
C-Collar Bag Quantity*

OKUnacceptable
Vacuum Splint Bag Quantity*

OKUnacceptable
Other Durable Equipment Quantities*

OKUnacceptable
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
Triage Bag Quantity*

OKUnacceptable
PPE Quantity*

OKUnacceptable
Expiration Checks (Wednesday Only)
Defib Patch Adult/Pediatric

MonthDayYear
Date
Albuterol Bullet

MonthDayYear
Date
Aspirin

MonthDayYear
Date
Epi Kit Epinephrine

MonthDayYear
Date
Cardiac Epi Kit Epinephrine

MonthDayYear
Date
Naloxone Kits (Qty. 3)

MonthDayYear
Date
Narcan

MonthDayYear
Date
Oral Gluctose

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