Data Flow Diagrams using Visio, Sample Screen, Power Point

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Bellbrook Fire Department

K.Downing

**********

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1

2/9/2016 6:32:14 PM

EMS Run Report

Fire Run Report

Equipment Checkoffs

Choose which report needed.

2

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2012-384

1116

11/15/2012

100 North Pole Drive

North Pole

Cold Place

10008

Elf County

Snowy Residence

Broken leg

Jingle

x

x

x

x

x

x

x

x

x

x

x

x

Jenny

J

116

x

12/24/1896

x

White

Non-Hispanic

Impact from fall

x

x

x

Pain in left leg, with protruding femur

6B

x

x

x

x

x

x

x

x

12 20

12 20

12 21

12 29

12 29

12 36

12 47

12 50

12 50

x

EMT 1116

Traction Splint

Control Bleeding

EMT 1128

A blank EMS report example.

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A blank EMS report example, showing it to be sectioned out.

4

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The beginnings of a fire run report.

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Checkoffs for Medic 21. Whomever is logged in, the person’s initials and department number will show in a bubble as a cursor is hovering over inserted information.

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Checkoffs for Medic 21 cont’d.

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Medic 21 Month July Year 2012
DAYS Total Calls EMS FIRE EMS & FIRE CANX’D
1 2 X X
2 1 X
3 1 X
4 1 X
5 1 X
6 3 X X X
7 1 X
8 1 X
9 1 X
10 2 X X
11 1 X
12 2 X X
Total Days Total Calls EMS FIRE EMS & FIRE CANX’D
31 41 24 6 3 8

Top table shows a month snapshot for calls during the month. The bottom table gives the totals for the month of July 2012.

8

Page1of2

App #: Medic 21 Year:

Day of the Month12345678910111213141516

Time

Fluid Levels

Belts and Hoses

Fuel Level (Fill at 3/4)

ER and Head Lights

Siren and Air Horn

Street Directories

Clip Boards

Portable Radios Charged

Handlight and Spot light

Gloves in Cab (1 of each size)

Gloves in Box (1 of each size)

Main O2 Level (PSI)

pppppppppppppp

On Board Suction

First-In Bag

* First-In O2 (PSI)

PPPPPPPPPPPPPP

* Airway Kit

* Glucometer

* IV Bag (Exp. Date)

DDDDDDDDDDDDDD

Life Pack 15

* Discharge and user Test (LP 15)

Trauma Bag

DDDDDDDDDDDDDD

IV Warmer

DDDDDDDDDDDDDD

Red Bag

DDDDDDDDDDDDDD

Pedi Bag

DDDDDDDDDDDDDD

Portable Suction

Drug Bag Sealed (Exp. Date)

DDDDDDDDDDDDDD

IV Bags

DDDDDDDDDDDDDD

PPE Equipment

Decon Supplies

CID Bags

Backboards

KED

Reeves Stretcher

Pedi Boards

Stair Chair

Traction Splint

Vac Splints (Pump and all sizes)

Cones x5

(2) Spare O2 Cylinders

Air Packs

.

.

.

BELLBROOK FIRE DEPARTMENT

MEDIC DAILY/POST RUN CHECKSHEET

Month:August2012

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Page2of2

App #: Medic 21 Year:

Day of the Month171819202122232425262728293031

Time

Fluid Levels

Belts and Hoses

Fuel Level (Fill at 3/4)

ER and Head Lights

Siren and Air Horn

Street Directories

Clip Boards

Portable Radios Charged

Handlight and Spot light

Gloves in Cab (1 of each size)

Gloves in Box (1 of each size)

Main O2 Level (PSI)

ppppppppppppp

On Board Suction

First-In Bag

* First-In O2 (PSI)

PPPPPPPPPPPPP

* Airway Kit

* Glucometer

* IV Bag (Exp. Date)

DDDDDDDDDDDDD

Life Pack 15

* Discharge and user Test (LP 15)

Trauma Bag

DDDDDDDDDDDDD

IV Warmer

DDDDDDDDDDDDD

Red Bag

DDDDDDDDDDDDD

Pedi Bag

DDDDDDDDDDDDD

Portable Suction

Drug Bag Sealed (Exp. Date)

DDDDDDDDDDDDD

IV Bags

DDDDDDDDDDDDD

PPE Equipment

Decon Supplies

CID Bags

Backboards

KED

Reeves Stretcher

Pedi Boards

Stair Chair

Traction Splint

Vac Splints (Pump and all sizes)

Cones x5

(2) Spare O2 Cylinders

Air Packs

.

.

.

W

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MEDIC DAILY/POST RUN CHECKSHEET

Month:August2012

Instructions

BELLBROOK FIRE DEPARTMENT
Page 1 of 2
ENGINE DAILY/POST RUN CHECKSHEET
Fill in only January for year and any new equipment. All fields will change after you enter them. All other sheets are protected.

M21 January

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: January Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: January Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 February

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: February Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: February Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D
IV Warmer D D D D D D D D D D D
Red Bag D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D
IV Bags D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 March

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: March Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: March Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 April

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: April Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: April Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 May

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: May Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Weekly Check
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: May Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 June

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: June Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: June Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 July

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: July Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: July Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 August

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: August Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: August Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 September

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: September Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: September Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 October

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: October Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: October Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 November

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: November Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: November Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #

M21 December

BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 1 of 2
App #: Medic 21 Month: December Year: 2012
Day of the Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time
Fluid Levels Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #
BELLBROOK FIRE DEPARTMENT
MEDIC DAILY/POST RUN CHECKSHEET Page 2 of 2
App #: Medic 21 Month: December Year: 2012
Day of the Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Time
Fluid Levels Weekly Check Weekly Check Weekly Check
Belts and Hoses
Fuel Level (Fill at 3/4)
ER and Head Lights
Siren and Air Horn
Street Directories
Clip Boards
Portable Radios Charged
Handlight and Spot light
Gloves in Cab (1 of each size)
Gloves in Box (1 of each size)
Main O2 Level (PSI) p p p p p p p p p p p p
On Board Suction
First-In Bag
* First-In O2 (PSI) P P P P P P P P P P P P
* Airway Kit
* Glucometer
* IV Bag (Exp. Date) D D D D D D D D D D D D
Life Pack 15
* Discharge and user Test (LP 15)
Trauma Bag D D D D D D D D D D D D
IV Warmer D D D D D D D D D D D D
Red Bag D D D D D D D D D D D D
Pedi Bag D D D D D D D D D D D D
Portable Suction
Drug Bag Sealed (Exp. Date) D D D D D D D D D D D D
IV Bags D D D D D D D D D D D D
PPE Equipment
Decon Supplies
CID Bags
Backboards
KED
Reeves Stretcher
Pedi Boards
Stair Chair
Traction Splint
Vac Splints (Pump and all sizes)
Cones x5
(2) Spare O2 Cylinders
Air Packs
.
.
.
(D) Daily or (W) Weekly
Unit #