EMS-TEI Level 2 Required Equipment Inventory EMS-TEI Name & Number
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1 EMS-TEI Level 2 Required Equipment Inventy EMS-TEI Name & Number Name of person completing fm Direct s Name Date Reason f Inspection Initial Renewal Upgrade 202 KAR 7:601. Training, education, and continuing education. Section 5. EMS-TEI Operating Requirements. (7) An EMS-TEI shall assure that all physical resources required by the curriculum, including classrooms, skill practice areas, notices of where to purchase access textbooks, instructional aides, equipment, and supplies shall be: (a) Available at each class session where skills are taught practiced; (b) Adequate in number to allow f practice by students enrolled; and (c) In good wking der and well-maintained. Note: Lease MOU option will only be available until December 31, 2018 Airway Equipment Present Not Present Lease Agreement Memandum of Understanding Automatic Transpt Ventilat Blind Insertion Airway Device-(KING, COMBITUBE,LMA, & I-Gel) Bulb Syringe Commercial ET Tube Holder Endotracheal Stylette (Adult and Pediatric) Endotracheal Tubes(Uncuffed & Cuffed ) ETCO 2 Detect-Colimetric Wavefm Intubation Detect Device Laryngoscope Blades-Assted (Straight and Curved) Laryngoscope Handle(Adult and Pediatric) Manually Triggered Flow Restricted Oxygen Powered Ventilation Device Nasal Cannula (Adult and Pediatric) Nasopharyngeal Airways (Infant, Child and Adult Sizes) 1 KBEMS-E-12-TEI Equipment List (Level-2) (6/2016)
2 Airway Equipment (Continued) Present Not Present Lease Agreement Memandum of Understanding Nebulizer (Mask and Hand Held device) Non-Rebreather Mask (Adult and Pediatric) Oropharyngeal Airways (Infant, Child and Adult Sizes) Oxygen Humidifier Bottle Oxygen Supply Tubing Partial-Rebreather Mask (Adult and Pediatric) Pocket Mask with Isolation Valves Ptable Oxygen tank w/regulat (0-15L) Self-Inflating Bag-Valve Mask Resuscitats with O2 Reservoir (Adult, Child, Infant & Neonate) Suction Catheters (Flexible and Rigid) (Various Sizes) Suction Tubing Suction Unit-Manual and Powered Venturi Mask Trauma Present Not Present Lease Agreement Memandum of Understanding Abdominal Pad (5x9) Adhesive Tape (Assted Sizes ½, 1, 2, 3...) Burn Sheet (Sterile) Clean Wrapped Sheets Commercial Tourniquet Gauze Pads (2x2, and 4x4) Multi-Trauma Dressing/Universal Dressing (10x30) Non-Adhering Dressing Occlusive Dressing Plastic Bags Plastic Wrap Roller Gauze (Various Sizes) Eye Pads Trauma Shears/Scisss Triangular Bandage 2 KBEMS-E-12-TEI Equipment List (Level-2) (6/2016)
3 Immobilization Present Not Present Lease Agreement Memandum of Understanding Air Splints Blankets (Disposable and Non-Disposable) Commercial Cervical Immobilization Device Commercial Pelvic Immobilization Device (Wrap/Binding) Extrication Device (KED Equivalent) Flexible Splints (Ladder, SAM Splint Equivalent) Head Blocks Towel Rolls Long Spine Boards (Straps Spider Straps Padded Board Splints- Arm and Full Leg (Various Sizes) Pediatric Immobilization Device Pillows Rigid Cervical Collars- (Adult & Pediatric Various Sizes) Scoop Stretcher Sheets Strap (Adjustable-various sizes and types) Towels Traction Splints (Adult and Pediatric) Vacuum Splints Diagnostic Present Not Present Lease Agreement Memandum of Understanding 12-Lead Cardiac Monit (capable of defibrillation, cardioversion, pacing, 12- Lead Acquisition, and with electrodes (Adult & Pediatric) and gel paste) Equivalent Simulat AED Trainer (with pads) Blood Pressure Cuffs (Adult-Small, Extra-Large, & Thigh, Child, and Infant) Sp02-Pulse Oximeter Glucose Moniting Device w/strips & Lancets Penlight Stethoscope Thermometer-Hypothermia and Hypothermia 3 KBEMS-E-12-TEI Equipment List (Level-2) (6/2016)
4 IV Supplies Present Not Present Lease Agreement Memandum of Understanding Alcohol Wipes IV Administration Sets (Macro and Micro) IV Catheters-Assted Sizes and Types (24g-14g) IV Securing Device (Tegaderm, Opsite, other transparent film) IV Fluids (NSS & LR - 250cc, 500cc, & 1000cc) May be Imitation and Expired Saline Locks Pharmacological Present Not Present Lease Agreement Memandum of Understanding Aerosol Bronchodilats simulat Auto-injection Trainer Medications Required by Curriculum and KY Protocols (May be Imitation and expired) Must include: (Ampules, Single and Multi-Dose Vials, Prefilled Syringes, and Mix-O- Vials) Mucosal Atomizer Device Body Substance Isolation Not Present Lease Agreement Memandum of Understanding Bio-Hazard Bags Exam Gloves- Nitrile Latex Free (Small, Medium, Large, & Extra Large) Face-Eye Shield Combo Masks and Eye Shields & Masks Gowns- Assted sizes Hand Sanitizer HEPA and N95 Masks Sharps Containers-Various Sizes Traditional Hand Washing Facilities (Sink with Running Water) Disaster Training Present Not Present Lease Agreement Memandum of Understanding Triage Tags (Start Triage) 4 KBEMS-E-12-TEI Equipment List (Level-2) (6/2016)
5 Manikins / Simulats Present Not Present Lease Agreement Memandum of Understanding Airway Management Manikin- (Adult, Child & Infant) CPR Manikins Adult, Child & Infant) IM/SQ Injection Simulat IV Simulation Hand Arm Trainer OB/Child Birth Manikin Miscellaneous Present Not Present Lease Agreement Memandum of Understanding Access to Ambulance f Training Purposes Bite Stick-Unbreakable Construction Bicycle Helmet Cleaning and Disinfectant Materials (Cleaner, Trash Bags, Disposable Towels, Tissues.) Cups (No Styrofoam) Cold and Hot Packs Commercial Child Restraint Device Designed f use in Ambulance Convertible Child Seat Cotton Tip Applicats Commercial Restraints- 1 set ( Ankle and Wrist) Disposable Bed Pan and Urinal Emesis Bag Container Flash Light Football Helmet with Pads Irrigation Fluid (500cc & 1000cc Bottles) Medic Alert Insignia Bracelet/Necklace Motcycle Helmet Multi-Level Stretcher w/ straps to include shoulder harness Obstetrical Kit Patient Care Rept Radio Communication Equipment (Communications) Spare Replaceable/Disposable Items f Equipment Stair Chair Water Soluble Lubricant 5 KBEMS-E-12-TEI Equipment List (Level-2) (6/2016)
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