Davidson County Emergency Services

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Anthony Kevin Horn
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1 Davidson County Emergency Services Date: / / Unit Number Personnel Numbers / Shift: FRONT OUTSIDE POCKET CLEAR DRUG BOX IO BAG 1-BP CUFF x / 6- EPI- 1:10,000 1mg 1- EZ-IO DRILL 1-STETHOSCOPE x / 1- D ea IO NEEDLES 1- GLUCOMETER x / 1- NARCAN x / ADULT/CHILD (blue) x / 1- GLUCOSE TEST STRIPS x / 1- LIDOCAINE x / LG ADULT (yellow) x / 6- LANCETS x / 1- SODIUM BICARB x / 2- IO STABILIZERS x / BAND-AIDS x / 1- CALCIUM x / 1-PRESSURE INFUSOR x / ALCOHOL PREPS BLACK MEDICATION PACK x / 1- LIDOCAINE 1- PULSE OXIMETER x / 1- ASPIRIN bottle x / 4- ALCOHOL PREPS x / 1- AMMONIA INHALANTS x / AMIODARONE (300mg) x / 2- SALINE FLUSHES 1- SHARPS SHUTTLE x / 1-ATOMIZER 1- ROLL 1" TAPE 1- PENLIGHT x / 1- NASAL SPRAY AIRWAY KIT LEFT OUTSIDE BLACK POCKET x / 1- NITRO TABLETS 1- ADULT BVM (INSIDE MAIN BAG) 2-SURGICAL MASKS x / 1-DIPHENHYDRAMINE INJ 1- CPAP LG MASK (INSIDE MAIN BAG) 2ea-N95 MASKS (KC/Moldex) x / 1-ONDANSETRON ODT 1- CPAP TUBING (INSIDE MAIN BAG) 1- RED BAG x / 1-ONDANSETRON IV LARYNGOSCOPE HANDLE 2sets GLOVES (M/L) x / 1-PHENERGAN x / 1- MILLER #3 1- BIOHOOP x / 1- IPRATROPIUM x / 1- MILLER #4 RIGHT OUTSIDE POCKET x / 1- ALBUTEROL x / 1-MACINTOSH #3 5-4x4 GAUZE x / 1- COMBIVENT x / 1-MACINTOSH #4 x / 1-VASELINE GAUZE x / 1- EPI-1:1000 mg x / 1-10-cc SYRINGE (luer-lock) 2- CAT TOURNIQUET x / 1-ORAL GLUCOSE x / KING AIRWAY 2- TRIANGULAR BANDAGES x / 1- GLUCAGEN x / 1- ET HOLDER 2-4" ROLLS KLING x / 1-SALINE FLUSH 2- SPARE BATTERIES 1-ROLL 2" TAPE x / 3-IM NEEDLES MAGILL FORCEPS, adult LEFT REAR OUTSIDE POCKET 1-1cc SYRINGE (luer-lock) x / 1-ea ET TUBE 6.5 x / 1- NEBULIZER 2-3cc SYRINGES x / 1-ea ET TUBE 7.5 x / 1- ADULT NASAL CANNULA 1-10cc SYRINGE 1- OPA 90mm x / 1- ADULT NON-REBREATHER RED IV BAG 1- OPA 100mm x / 1- ADULT AEROSOL MASK x / BAND-AIDS 1- OPA 110mm INSIDE TOP ZIPPER POCKET x / ALCOHOL PREPS x / 1- PACK LUBRICATING GEL 1-PARAMEDIC SHEARS x / 1-ea IV CATH #14 x / 1-BOUGIE 2-8X10 PADS x / 1-ea IV CATH #16 x / 1- CAPNO FILTER LINE (adult) x / 1- BURN SHEET x / 2-ea IV CATH #18 x / 1-TRAUMA DRESSING x / 2-ea IV CATH # 20 2-FACESHIELDS x / 1-ea IV CATH # 22 x / 1-CHEST SEAL KIT 2- TOURNIQUETS x / 2- PNEUMO NEEDLES x / 2- SALINE LOCKS x / 1- HEMOSTATIC AGENT x / 2- SALINE FLUSHES 1- ROLL 1" TAPE x / 2- TEGADERM 1-1" TAPE x / 1- SET-UP, 10/15gtt x / 1-250cc N/S x / cc N/S (center section) Page 1 REV

2 COMPARTMENT TWO 2- SUCTION CANISTER, 1ea 800/1200 IV BOX 1- ea. SUCTION CATHS x / 1- MILLER #3 4- ea ANGIOCATHS x / # 8 x / 1- MILLER #4 x / #14 x / #14 x / 1-MACINTOSH #3 x / #16 1- ea NG TUBE x / 1-MACINTOSH #4 x / #18 x / #10 1- O2 CHRISTMAS TREE x / #20 x / #16 1- O2 WRENCH x / # cc SYRINGE (slip tip) x / 1-10cc SYRINGE (luer-lock) x / #24 x / 1- PACK LUBRICATING GEL 2-FACESHIELDS 4- IV TOURNIQUETS x / 2- SUCTION TUBING x / 1-CRICH KIT x / 1- NITRO TABS 1- SUCTION CONNECTOR 1- PROTECTIVE EYE WEAR x / 4- NITRO OINTMENT w/ruler x / 2- RIGID SUCTION TIP x / 1- BOTTLE ASPIRIN 1- DCEMS PROTOCOLS COMPARTMENT SIX (TOP) 1- ROLL TAPE 1 x / 1- BVM infant x / BANDAIDS x / 1- BVM child x / ALCOHOL PREPS COMPARTMENT FOUR x / 1- BVM adult x / 4- SALINE LOCKS 1- ea ET TUBE 1- ea MASKS x / 4-SALINE FLUSHES x / #2.5 x / neonate #0 x / 4- TEGADERM x / #3.5 x / infant #1 x / #4.0 x / pediatric #2 x / #4.5 x / small #3 x / #5.0 x / medium #4 x / #5.5 x / large #5 x / 2-1cc SYRINGE (luer-lock) x / #6.0 COMPARTMENT SIX (BOTTOM) x / 4-3cc SYRINGE x / #6.5 x / 4- ADULT NASAL CANNULA x / 1-10cc (luer-lock) SYRINGE x / #7.5 x / 4- ADULT NON-REBREATHER x / 2-30cc SYRINGE x / #8.0 x / 2- PED NASAL CANNULA x / 5- IM NEEDLES x / 2- PED MASKS x / 2-STROKE KITS 1- ea. KING AIRWAY x / 4- NEBULIZERS x / #2 x / 2- ADULT AEROSOL MASKS x / #2.5 x / 2- PED AEROSOL MASKS 1- ea ARM BOARD- adult/ped x / #3 x / 1- BOX ALCOHOL PREPS x / #4 INHALATION THERAPY KIT x / 1- BOX BAND-AIDS x / #5 x / 3- IPRATROPIUM x / 1- BOX LANCETS x / 1- ET TUBE HOLDER x / 3- ALBUTEROL x / 4- IV SET-UPS, 10gtt x / 1- PACK LUBRICATING GEL x / 3- COMBIVENT x / 1- IV SET-UP, 60gtt 1- ea OPA CPR SEAT x / 1- DIAL-A-FLOW # 50, 60, 80, 90, 100, RED HAZ-MAT BAGS x / 1-BOX TEGADERM 1- ea NPA 1- URINAL x / #26, 28, 30, BED PAN COMPARTMENT TEN 1- BODY BAG x / cc LACTATED RINGERS 1- EMERGENCY BLANKET BURN RESOURCES CHART 1- ADULT FOIL BLANKET x / 1- OXYGEN HUMIDIFIER COMPARTMENT EIGHT (TOP) x / cc N/S x / cc N/S x / 1-PRESSURE INFUSOR Page 2 REV

3 ACTION AREA SHELF x / 1- EPI- 1:1000 1mg UNIT SUCTION OPERATIONAL x / 6- EPI- 1:10,000 1mg 1- CARRYING CASE x / 1- RIGID SUCTION TIP x / 1- GEODON 6- ADULT COLLARS SURGICAL CLIPPERS x / w/sterile water 4- PED COLLARS x / 1- CLIPPER BLADE x / 1- GLUCAGEN 4- ADULT IMMOBILIZERS 1- BOX KLEENEX x / 6- IBUPROFEN 4- PED IMMOBILIZERS 1- BP CUFF x / 1-AMIODARONE 2- INFANT IMMOBILIZERS 1- STETHOSCOPE x / 2-100cc D5W COMPARTMENT TWELVE x / 1-250cc D5W 8-ea SHOE COVERS x / 3- LIDOCAINE LARYNGYOSCOPE HANDLE 2- ea N95 MASKS, S/M x / 1- LIDOCAINE DRIP 4:1 x / 1- MILLER #0 4- ea ISOLATION GOWNS x / 2- MAG SULFATE 5g x / 1- MILLER #1 4- ea SURGICAL MASKS x / 1- MOTRIN (liquid w/syringe) x / 1- MILLER #2 COMPARTMENT FOURTEEN (TOP) x / 3- NARCAN x / 1- MAC #2 1- BOX ZIPLOC BAGS x / 3-ONDANSETRON ODT PED. MEASURING TAPE 1- THIGH BP CUFF x / 3-ONDANSETRON IV 1- STETHOSCOPE 1- OB KIT x / 2-PHENERGAN 1- PED B/P CUFF x / 1- PED SILVER THERMAL BLANKET x / 2- SALINE FLUSHES x / 1- BVM infant x / 4- HOT PACKS x / 3- SODIUM BICARBONATE x / 1- BVM child x / 6- COLD PACKS x / 3- SOLU-MEDROL 1- BULB SUCTION 2- PAIR PATIENT RESTRAINTS x / 2- ATOMIZERS x / 1- MICRO SET-UP, 60gtt COMPARTMENT SIXTEEN (TOP) 1- MEDICATION ADDED LABELS x / 1- SALINE FLUSH 1- BAG KLING 4 1- BOTTLED WATER x / 1- NS 1000cc 1- BOX 4x4s x / 1-1:10,000 EPINEPHRINE x / 1- PACK VASELINE GAUZE AMIODARONE DRIP x / 1- ATROPINE 1- PARAMEDIC SHEARS x / AMIODARONE (450mg total) x / 1-AMIODARONE 1- HEMOSTATS x / 100cc D5W x / 1-D10W, 250cc x / 2- TRAUMA DRESSINGS x / 1-3cc SYRINGE 1- MECONIUM ASPIRATOR x / 2- BURN SHEETS x / 1-10gtt DRIP SET MAGILL FORCEPS (ped) 4- TRIANGULAR BANDAGES 2- MED ADDED LABELS x / 1- CAPNO FILTER LINE (ped) 4-8x10 DRESSING x / 250cc D5W x / ET TUBE 1-RING CUTTER x / 1-10cc SYRINGE x / ET TUBE 1-1" TAPE x / 1-60gtt DRIP SET x / ET TUBE 1-2" TAPE x / 1- IM NEEDLE x / ET TUBE 4- ELASTIC WRAPS EPINEPHRINE DRIP x / ET TUBE COMPARTMENT SIXTEEN (BOTTOM) x / 1-1:1000 EPINEPHRINE x / ET TUBE x / 1-1cc SYRINGE x / ET TUBE x / 6- ACETAMINOPHEN x / 1- IM NEEDLE x / ET TUBE x / 5-ADENOSINE x / 250cc NS x / 1- PED ET TUBE HOLDER x / 2- ATROPINE x / 1-60gtt DRIP SET x / 3- DIPHENHYDRAMINE INJ 1- MED ADDED LABEL x / 2- DIPHENHYDRAMINE, 12.5mg oral PHENYLEPHRINE KIT x / 2- CALCIUM CHLORIDE x / 1- PHENYLEPHRINE x / 1- NASAL SPRAY 3- LABELED PHENYL SYRINGES x / 1- TRANEXAMIC ACID 1-3cc SYRINGE x / 1- CEFAZOLIN w/sterile water 3- IM NEEDLE C-SPINE PEDIATRIC BAG x / 3- D50% 1- MED ADDED LABEL Page 3 REV

4 PEDIATRIC BAG NARCOTIC BOX COMPARTMENT THREE x / 1- #8 SUCTION CATH x / MORPHINE SULFATE x / 4-PACKS ELECTRODES, adult x / 1- #14 SUCTION CATH x / LORAZEPAM (refrigerator) x / 5-PACKS ELECTRODES, ped x / 1- IV CATH 16 ga x / MIDAZOLAM 1-SPARE BATTERY x / 1- IV CATH, 18ga x / FENTANYL 2- EKG PAPER x / 1- IV CATH 20ga x / KETAMINE x / 1- ADULT/CHILD DEFIB PADS x / 1- IV CATH 22ga x / 1- LUBRICATING GEL x / 1- INFANT DEFIB PADS x / 1- IV CATH 24ga x / 1- ATOMIZER 1- MONITOR CHARGING CABLE 1-50mm ORAL AIRWAY 1- CARPUJECT PULSE OX CABLE (ped) 1-60mm ORAL AIRWAY 1-1cc LUER LOCK SYRINGE PULSE OX CABLE (infant) 1-80mm ORAL AIRWAY 1-3cc SYRINGE x / 2- CAPNO FILTER LINES (adult) x / 1- PED NASAL CANNULA 1-10cc LUER LOCK SYRINGE x / 2- adult CAPNO CANNULA x / 1- PED NON-REBREATHER x / 1- IM NEEDLE x / 1- ped CAPNO CANNULA 1- ea NPA NCEMS AIRWAY EVAL FORM 50 OHM TEST LOAD x / #14 RSI KIT 10- THERMOMETER COVERS x / #22 MED CALCULATION CHART x / 2 - BOUGIE x / #26 x / 2- ETOMIDATE 5- CLIPPER BLADES 1-30cc SYRINGE w/needles MONITOR PAIRING INSTRUCTIONS 1-10cc SYRINGE w/needles REFRIGERATOR DISPOSABLE CUFFS x / 2- SUCCINYLCHOLINE ADULT BP CUFF x / 2- ROCURONIUM ADULT X-LONG BP CUFF x / 2- DILTIAZEM (50mg minimum) CHILD BP CUFF LORAZEPAM (see narcotic above) INFANT BP CUFF SIDE COMPARTMENT x / cc NORMAL SALINE 1- PORTABLE SUCTION UNIT WALL COMPARTMENT MONITOR (LEFT POCKET) OPERATIONAL 1- BOX ea SIZE GLOVES S,M,L,XL PULSE OX CABLE (adult) 1- CHARGER THERMOMETER w/covers 1- ADULT NIBP CUFF x / 1- RIGID SUCTION TIP BENCH SEAT x / 1- PACK NAIL POLISH REMOVER 1- ea SUCTION CATH 2- RIGID SPLINTS, ped arm #1 x / #8 2- RIGID SPLINTS, adult arm #2 MONITOR (BACK POCKET) x / #14 2- RIGID SPLINTS, ped leg #3 3- LEAD CABLE 1- SUCTION CONNECTOR 2- RIGID SPLINTS, adult leg #4 12- LEAD CABLE 1- RINSING BOTTLE 2- LADDER SPLINT 1- EKG PAPER 2- BARIATRIC TARPS (REG/DISP) 2- SPARE O2 CYLINDERS x / 1- PACK ADULT ELECTRODES CHILD SEAT/RESTRAINT x / 2- PACKS PED ELECTRODES STRETCHER O2 TANK LEVEL: MONITOR (RIGHT POCKET) COMPARTMENT FIVE x / ADULT/CHILD DEFIB PADS CPAP BAG x / 3- BIO-HOOPS x / INFANT DEFIB PADS x / 2-CPAP TUBING w/neb 2- STUFFED ANIMALS NIBP CUFFS, LG ADULT & PED x / 2- LARGE ADULT MASK 1- DISINFECTANT SPRAY ON-SCENE PROTOCOL x / 2-MEDIUM MASKS 1- DISINFECTANT HAND WIPES x / 1-SMALL MASK 5- TOWELS x / 1- BOTTLE HAND SANITIZER 20- Q TIPS Page 4 REV

5 DRIVER BAG OUTSIDE POCKET BAG OF S,M,L,XL GLOVES ZIPPER POCKET PARAMEDIC SHEARS 1-4 KLING SECOND POCKET 1" TAPE GLUCOMETER 4-4x4s BP CUFF 1-8X10 STETHOSCOPE PULSE OX ZIPPER POCKET PENLIGHT x / 1-250cc NORMAL SALINE SHARPS SHUTTLE x / 1-10 gtt SETUP x / 2-SALINE FLUSH THIRD POCKET x / 2-SALINE LOCKS BAG VALVE MASK x / 2ea- ANGIOCATHS 14ga x / #4 KING AIRWAY x / 2ea- ANGIOCATHS 16ga x / NARCAN x / 2ea- ANGIOCATHS 18ga x / DEXTROSE 50% x / 2ea- ANGIOCATHS 20ga ATOMIZER x / ORAL GLUCOSE TEGADERMS 1ea- 90, 110mm OPA ALCOHOL PREPS 1ea - #26, 30 NPA TOURNIQUET 1" TAPE **** ON THE 1st, 2nd, 3rd OF EACH MONTH: **** RUN MONITOR DIAGNOSTIC CHECK w/50ohm LOAD AND ATTACH PRINTOUT TO THIS SHEET. RECORD EXPIRATION DATES FOR ALL EXPIRABLES, INCLUDING PEDS BAG. **** ON THE 1st ONLY**** ROTATE MEDS IN CABINET AND BAGS SO THAT EARLIEST EXPIRING MEDS ARE USED FIRST CLEAN THERMOMETER LENS w/alcohol PREP & Q-TIP ROTATE MONITOR BATTERY WITH THE ONE IN CABINET. CHECK IO DRILL-- short handle drill: pull trigger, confirm green LED; long handle drill: pull trigger only **IF ANY ITEM REQUIRES REPAIR/REPLACEMENT, AFFIX REPAIR TAG w/description AND SEND TO LOGISTICS** COMMENTS OR MISSING ITEMS WHICH YOU WERE UNABLE TO REPLACE: DRIVER SIGNATURE: ATTENDANT SIGNATURE: Page 5 REV

Davidson County Emergency Services

Davidson County Emergency Services Date: / / Unit Number Personnel Numbers / Shift: FRONT OUTSIDE POCKET CLEAR DRUG BOX IO BAG 1-BP CUFF x / 13- EPI-1:10,000 mg 1- EZ-IO DRILL 1-STETHOSCOPE x / 1- D-50