Level 3 (PDF)

Site Tour Checklist
Hospital:
Reviewer:
Emergency Department
Equipment
Airway control & ventilation equipment
Pulse oximetry
Suction devices
Electrocardiograph/oscilloscope/defibrillator
Standard IV fluids and administration sets
Mechanism for IV fluid volume control
Large bore IV catheters
IO sets
Supplies for surgical airway
Arterial tourniquet
Supplies for thoracostomy
Drugs necessary for emergency care
Nasal & oral gastric tubes
Spine immobilization boards and c-collars
Pediatric length-based resuscitation tape
Thermal control for patients & fluids/blood
Rapid infuser system (e.g., pressure bag)
End-tidal CO 2 detector
*Ultrasound
*StO 2
*Video laryngoscopy
*PPE
*Decontamination supplies & equipment
Communication with EMS
Yes
No
adult
child
infant
↓ Notes ↓
Operating Room
Equipment
Yes
No
adult
child
infant
No
adult
child
infant
Thermal control for patients & fluids/blood
X-ray capabilities including c-arm intensifier
Rapid infuser system (e.g., pressure bag)
Post Anesthesia Recovery
(ICU acceptable)
Equipment
Yes
Equipment for monitoring and resuscitation
Pulse oximetry
Thermal control for patients and fluids/blood
Intensive Care Unit
Equipment
Yes
Equipment for invasive monitoring and resuscitation
Ventilator
Radiology
Equipment
Computed tomography
*Airways
*Bag-valve-mask
*Suction
Laboratory Services
Equipment
Standard analysis of blood, urine
and other body fluids (including
micro- sampling when appropriate)
Blood typing and cross matching
Coagulation studies
Comprehensive blood bank or
access to community blood bank
Blood gas and pH determination
Microbiology
* Not required
Yes
No
Yes
No
adult
No child
infant